Objective

To investigate residential mobility among community-living adults with spinal cord injury (SCI) and the individual, health, and neighborhood factors associated with the propensity to relocate.

Design

Retrospective analysis of data from the National SCI Model Systems (SCIMS) Database collected between 2006 and 2018 and linked with the American Community Survey 5-year estimates.

Setting

Community.

Interventions

Not applicable.

Participants

People with traumatic SCI (N=4599) who participated in 2 waves of follow-up and had residential geographic identifiers at the census tract level.

Main Outcome Measures

Moving was a binary measure reflecting change in residential locations over a 5-year interval. Move distance distinguished nonmovers from local movers (different tracts within the same county) and long-distance movers (to different county or state). Move quality included 4 categories: stayed/low poverty tract, stayed/high poverty tract, moved/low poverty tract, and moved/high poverty tract.

Results

One in 4 people moved within a 5-year interval (n=1175). Of the movers, 55% relocated to a different census tract within the same county and 45% relocated to a different county or state. Thirty-five percent of all movers relocated to a high poverty census tract. Racial and ethnic minorities, people from low-income households, and younger adults were more likely to move, move locally, and relocate to a high poverty neighborhood. High poverty and racial/ethnic segregation in the origin neighborhood predicted an increased risk for remaining in or moving to a high poverty neighborhood.

Conclusions

Although people with SCI relocated at a lower rate than has been reported in the general population, moving was a frequent occurrence postinjury. People from vulnerable groups were more likely to remain in or relocate to socioeconomically disadvantaged neighborhoods, thus increasing the risk for health disparities and poorer long-term outcomes among minorities and people from low-income households. These findings inform policy makers’ considerations of housing, health care, and employment initiatives for individuals with SCI and other chronic disabilities.

中文翻译：

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谁在 SCI 之后行动？国家脊髓损伤模型系统数据库参与者的个人、健康和社区居民流动性预测因素

客观的

调查患有脊髓损伤 (SCI) 的社区成人的居住流动性以及与搬迁倾向相关的个人、健康和邻里因素。

设计

对 2006 年至 2018 年间收集的国家 SCI 模型系统 (SCIMS) 数据库中的数据进行回顾性分析，并与美国社区调查的 5 年估计值相关联。

环境

社区。

干预措施

不适用。

参与者

创伤性 SCI 患者 (N=4599)，他们参与了 2 波随访并在人口普查区具有居住地理标识符。

主要观察指标

搬迁是反映住宅位置在 5 年间隔内变化的二元测量。移动距离将非移动者与本地移动者（同一县内的不同区域）和长途移动者（到不同县或州）区分开来。搬家质量包括 4 类：留宿/低贫困地区、留守/高度贫困地区、搬家/低贫困地区和搬家/高度贫困地区。

结果

四分之一的人在 5 年内搬家（n=1175）。在搬家者中，55% 搬迁到同一县内的不同人口普查区，45% 搬迁到不同县或州。35% 的搬家者搬迁到高度贫困的人口普查区。种族和少数民族、来自低收入家庭的人和年轻人更有可能搬家、搬到当地，并搬迁到高度贫困的社区。原籍社区的高度贫困和种族/民族隔离预示着留在或搬到高度贫困社区的风险增加。

结论

尽管 SCI 患者的搬迁率低于一般人群的报道，但搬家是受伤后经常发生的事情。弱势群体的人更有可能留在或搬迁到社会经济处于不利地位的社区，从而增加了少数族裔和低收入家庭人群健康差异和长期预后较差的风险。这些发现为政策制定者对 SCI 和其他慢性残疾患者的住房、医疗保健和就业计划提供了参考。