A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).
Adults with disabilities may have difficulty participating in social activities. Challenges such as a lack of accessible transportation, health limitations, and discrimination can make it harder for adults with disabilities to connect and build relationships with others in their communities. This may lead to feelings of isolation, or a lack of perceived social support. Past studies have found that feeling isolated is linked with worse physical and mental health for people with and without disabilities. For working-age adults with disabilities, factors such as overall health, number of disabilities, employment status, and living arrangements may be related to feelings of social involvement or isolation. In addition, experiences of social involvement and isolation may be different for adults with disabilities who live in rural vs. urban areas.
In a recent NIDILRR-funded study, researchers asked working-age adults with disabilities about their experiences of social involvement and feelings of isolation. The researchers wanted to find out how factors such as the number of disabilities, living arrangements, and employment were related to social involvement and perceived isolation. They also wanted to find out if these relationships were different for people living in rural vs. urban parts of the country.
Researchers at the Collaborative on Health Reform and Independent Living and the Rehabilitation Research and Training Center for Place-Based Solutions for Rural Community Participation, Health, and Employment analyzed responses from 1,246 adults with disabilities living across the United States who completed the National Survey on Health Reform and Disability. The respondents were between the ages of 18 and 62. On the surveys, the respondents were asked about their satisfaction with social involvement by indicating, on a scale of 1 to 5, how satisfied they felt with their level of participation in leisure and social activities, the amount of time they spent in social involvement, and their ability to do all the activities they wanted in their communities. The respondents were also asked about their perceived isolation by indicating, on a scale of 1 to 5, how much they felt “isolated from other people in my community.” The respondents also answered additional questions about the types of disabilities they experienced, their overall health, whether or not they lived alone, and whether or not they were employed. Finally, the respondents provided the ZIP code for the county where they lived. The researchers classified each respondent’s county as “urban” if it was within or connected to a city of at least 50,000 people, and “rural” if it was in or connected to a town of less than 50,000 people.
When the researchers looked at which factors were related to social involvement and perceived isolation, they found that:
- The respondents who reported being healthier and those with a lower number of disabilities reported higher levels of satisfaction with social involvement and less perceived isolation than those with poorer health and more disabilities.
- The respondents who reported living alone reported higher levels of satisfaction with social involvement than the respondents who did not live alone. There was no connection between living arrangement and perceived isolation.
- The respondents who were employed reported higher levels of satisfaction with their social involvement and less perceived isolation than the respondents who were unemployed.
The researchers found that about 85% of the respondents lived in an urban area, while the other 15% lived in a rural area. When the researchers compared the responses of urban and rural residents, they found that:
- The respondents living in urban and rural areas reported similar levels of satisfaction with social involvement on average. However, the respondents living in urban areas reported feeling more isolated than the respondents living in rural areas.
- For the respondents living in rural areas, employment status was more strongly related to social involvement than for the respondents living in urban areas. For respondents in rural areas, being unemployed was associated with much lower levels of satisfaction with social involvement compared to those who were employed. For respondents in urban areas, being unemployed was associated with only slightly lower levels of satisfaction than those who were employed.
- For the respondents living in rural areas, those who reported having more disabilities were much more likely to report lower levels of satisfaction with their social participation than those with fewer disabilities. For the respondents in urban areas, those who reported having more disabilities were also more likely to report lower levels of satisfaction than those with fewer disabilities, but not to the same degree as their rural counterparts.
The authors noted that there were some unexpected findings in this study. Despite being surrounded by more people, the urban residents in this study felt more isolated than the rural residents. According to the authors, urban residents may have higher standards for feeling socially connected than rural residents, who may be more accustomed to spending less time around other people. Urban residents with disabilities may benefit from supports to help them build strong social support networks. Another finding from this study was that people who lived alone reported more social involvement than those who did not live alone. People with disabilities who live alone may have greater independence or motivation to engage in community activities outside the home.
The authors noted that, in general, urban and rural residents with disabilities may benefit from different supports to help them stay socially connected. Although the urban and rural residents in this study reported similar levels of satisfaction with social involvement, the rural residents who had more disabilities and those who were unemployed reported being the least satisfied with their level of social involvement. Rural residents with disabilities may benefit from supports aimed at helping them stay employed and overcome access barriers in their local communities. Urban residents, meanwhile, may benefit most from programs designed to help reduce their perceived isolation. Future research may be useful to test the impacts of community health programs on social participation for urban and rural residents with disabilities.
To Learn More
The Rehabilitation Research and Training Center on Community Living and Participation of Individuals with Psychiatric Disabilities offers several tools for people with disabilities and the professionals who support them to become more involved in the community. These include Using Social Media to Enhance Community Participation and Jumpstarting Community Inclusion: A Toolkit for Promoting Participation in Community Life, which contains sixty-six practical first steps that community mental health providers can take to more effectively support their service recipients’ participation in everyday community life.
Centers for Independent Living are organizations run by and for people with disabilities. They offer a range of services and supports that promote full participation of individuals with disabilities in their community.
Your Action Planning Guide for Promoting Full Community Participation Among People with Disabilities (PDF), developed by the Rehabilitation Research and Training Center for Community Living, guides Centers for Independent Living and other community-based organizations in identifying and removing barriers to participation and building consensus to create change in the community.
To Learn More About this Study
Repke M.A., Ipsen C. (2019) Differences in social connectedness and perceived isolation among rural and urban adults with disabilities. Disability and Health Journal, 2019. This article is available from the NARIC collection under Accession Number J81802.