Health Behavior Profile for Adults with Mobility Limitations

1. Gwyn C. Jones, PhD National Rehabilitation Hospital Center for Health and Disability Research Washington, DC NRH Center for Health and Disability Research Health Behavior Profile for Adults with Mobility Limitations

2. NRH Center for Health and Disability Research Funding

3. NRH Center for Health and Disability Research Objectives • Develop a profile of health behaviors for working-age adults with mobility limitations • Compare health behavior profiles for working-age adults with and without mobility limitations to facilitate monitoring of HP2010 health behavior objectives

4. NRH Center for Health and Disability Research Methods • Data from the 1997 National Health Interview Survey Sample Adult (n = 29,142 cases) were analyzed with crosstabulation and logistic regression procedures (with controls for age, race and gender) to examine health behaviors for working-age adults with and without mobility limitations • Health behaviors included measures of (1) physical exercise and weight problems, (2) tobacco use, and (3) alcohol use

5. NRH Center for Health and Disability Research Definitions • Mobility limitation - Respondent reported that without any help or use of an assistive device, he or she had difficulty walking 1/4 mile, climbing 10 steps without resting, or standing for 2 hours. • Severe limitation - Respondent reported being unable to perform the activities listed above. • Mild/moderate limitation - Respondent reported having some or a lot of difficulty with these activities. • No limitation - Respondent reported having no difficulty with these activities.

6. NRH Center for Health and Disability Research 1997 NHIS Sample Sizes for Working-Age Adults • Mobility Limitation • Unweighted - 5,376 • Weighted 28,096,443 • Severe Mobility Limitation • Unweighted - 1,047 • Weighted 5, 207,570 • Mild/Moderate Mobility Limitation • Unweighted - 4,329 • Weighted - 22,888,873 • No Mobility Limitation • Unweighted - 23,766 • Weighted - 135,159,625

7. NRH Center for Health and Disability Research NRH Center for Health and Disability Research 1997 NHIS: Exercise Data Limitations • Survey interviewers were instructed to visually identify respondents with physical disabilities and to refrain from asking these identified respondents the questions on exercise participation. • A total of 66 respondents who reported having a severe mobility limitation were not visually identified by survey interviewers. They stated that they engaged in vigorous exercise on a weekly basis. • Although this cell size does not support a reliable population estimate, it is reported in these findings to highlight the need to collect such information on working-age adults with severe disabilities.

8. NRH Center for Health and Disability Research 1997 NHIS: Percent of Working-Age Adults Reporting Participation in Weekly Exercise

9. NRH Center for Health and Disability Research 1997 NHIS: Weight Distributions For Working-Age Adults

10. NRH Center for Health and Disability Research 1997 NHIS: Percent of Working-Age Adults Reporting Tobacco Use

11. NRH Center for Health and Disability Research 1997 NHIS: Percent of Working-Age Adults Reporting Alcohol Use

12. NRH Center for Health and Disability Research Health Behavior Profile of Working-age Adults with Mobility imitations • Compared with their non-limited counterparts, people with mobility limitations appear to be • less likely to participate in regular exercise • two for (moderate limitation) to three (for severe limitation) times more likely to meet the body mass index criteria for obesity (BMI >30)

13. NRH Center for Health and Disability Research 1997 NHIS Health Behavior Profile (Continued) • Working-age adults with mobility limitations appear to be • equally as likely to smoke cigarettes and equally likely to attempt to quit smoking • more than twice as likely to smoke 2 or more packs of cigarettes per day • less likely to drink alcohol and less likely to be heavy drinkers (5+ drinks per day)

14. NRH Center for Health and Disability Research Conclusions • Working-age adults with mobility limitations have a high likelihood of obesity and of smoking two or more packs of cigarettes per day. Both of these preventable health risks are strongly associated with adverse health conditions, such as heart disease and stroke. • People with mobility limitations appear less likely to engage in regular weekly exercise, although the data are not of sufficient quantity to support reliable estimates at this time. • Findings from this study indicate that people with mobility limitations are less likely to drink alcohol and less likely to be heavy drinkers. These findings contrast with earlier data from the National Institute on Alcoholism and Alcohol Abuse, and other research published in the early 1990’s on people with SCI and TBI.

15. NRH Center for Health and Disability Research Implications • Adults with mobility limitations may need on-going education about the risks of smoking cigarettes, smoking cessation programs, and the benefits of and strategies for maintaining a healthy weight to guard against the development of debilitating secondary conditions. • Findings in this study suggest that adults with mobility limitations may be less likely to drink alcohol and less likely to be heavy drinkers. Since earlier research documents heavy drinking among men with spinal cord injury and traumatic brain injury, more work needs to be done in this area to examine the differences in drinking patterns for current cohorts of persons with mobility limitations. • Exercise is an important health benefit for adults with mobility limitations. The paucity of data in this area needs to be addressed in further research.