Examining inequalities in people with spinal cord injury through functioning.

BACKGROUND

Socioeconomic disparities are a persistent determinant of health outcomes, yet limited research has explored how income affects the overall functioning of individuals with spinal cord injury (SCI).

OBJECTIVE

To examine the relationship between income and health in individuals with spinal cord injury (SCI), using functioning as a broader health measure.

METHODS

This study analyzed income-related health disparities across income groups in individuals with traumatic SCI from ten countries, using cross-sectional data from the first Internal Spinal Cord Injury Survey (InSCI) and related studies (2017-2019). Functioning was assessed with the brief International Classification of Functioning, Disability and Health (ICF) core set for SCI. Income was categorized using general population income deciles for comparability.

RESULTS

Lower-income individuals with SCI had poorer functioning than higher-income groups. The disparity in functioning scores between the highest and lowest income groups ranged from 3 to 14 points, with China showing the largest gap (11 points) and France and Switzerland the smallest (2 and 4 points, respectively). In South Korea, functioning scores were below 40 across all income groups. Age at injury onset significantly influenced disparities, with the greatest gaps among working-age individuals and, in some countries, older adults.

CONCLUSION

Income-based income-related health disparities are evident in individuals with SCI, with lower income consistently linked to reduced functioning. The findings emphasize the need to address economic and age-related factors in SCI health interventions across diverse national contexts.