Disability and Patterns of Leisure Participation Across the Life Course.

OBJECTIVES: Patterns of healthy leisure are dependent upon age, but people with disabilities are particularly susceptible to passive and disengaged types of activities. This study evaluates how individuals with disabilities spend their time in passive, active, social, and isolated forms of leisure over the life course, and how these patterns vary by age. METHOD: I analyze nationally representative data from 70,165 respondents ages 15 and older in the 2008, 2010, and 2012-2016 American Time Use Survey. Linear regression models estimate the association between disability and leisure time, net of self-rated health and sociodemographic controls. Interactions between age and disability are also evaluated, as well as the robustness of results by sensory, cognitive, physical, and multiple disability status. RESULTS: People with disabilities report significantly more, and poorer quality, leisure than people without disabilities. This includes more than 2 hr more time in passive leisure as well as a disproportionate amount of isolated leisure spent at home, alone. These differences are not fully explained by health and sociodemographic controls. The isolated leisure time of people with disabilities is most different from people without disabilities in later life-whereas differences in total and passive leisure time, by disability status, are greatest in midlife. DISCUSSION: People with disabilities spend less time in health-promoting forms of leisure at all ages, but these patterns are unique across midlife and older age.

Disability, self-rated health, and time seeking medical care.

BACKGROUND: Population-level estimates of patient-reported time seeking medical care in the United States by disability status are unknown. OBJECTIVE: To estimate the likelihood of seeking medical care on an average day and the number of minutes spent traveling to, waiting for, and receiving medical care among those receiving care, by disability status. METHODS: Data are analyzed from the nationally representative 2008, 2010, and 2012-2016 American Time Use Surveys. Weighted logistic and linear regression models evaluate the association between sensory, cognitive, physical, or multiple disabilities and time spent seeking medical care, net of age, sex, race/ethnicity, education, employment, nativity, marital status, parental status, income, metropolitan area, and self-rated health. RESULTS: The presence of a disability positively associates with the likelihood of seeking medical care on an average day. Patients with disabilities spend more total time in medical care than patients without disabilities as a result of longer clinical and travel time. These differences cannot be explained by sociodemographic disparities or by poorer self-rated health. CONCLUSIONS: Patient time burden is exacerbated by the presence of a disability. It is important to consider disability status along with other social disparities when evaluating the delivery of timely and equitable care.

Disability and social participation: The case of formal and informal volunteering.

People with disabilities in the United States experience lower levels of social integration than people without disabilities. However, less is known about the association between disability and volunteer participation-despite an extensive literature on other disparities in volunteerism. This study uses data from the 2009-2015 Volunteer Supplement of the Current Population Survey to evaluate how working-aged adults with sensory disabilities, cognitive disabilities, physical disabilities, or multiple disabilities access, participate in, and maintain volunteer roles. Net of sociodemographic characteristics, adults with disabilities are no less likely than those without disabilities to report informal volunteering, although the presence of physical and multiple disabilities negatively associates with formal volunteering. Adults with disabilities report no fewer annual hours or weeks than those without disabilities if they are formal volunteers, but the mechanism through which they initially become involved in volunteer organizations varies. People with different types of disability experience different patterns of volunteering, and the sociodemographic characteristics associated with having a disability exacerbate many of these differences. Results suggest that adults with disabilities can-and do-participate in voluntary work, but may face barriers to accessing formal volunteer roles.

Disability and the Context of Boys' First Sexual Intercourse.

PURPOSE: The context in which first sexual intercourse takes place has lasting implications for subsequent sexual behavior. This study examines how adolescent disability associates with boys' age of sexual debut, relationship at first sexual intercourse, degree of discussion about birth control before first sexual intercourse, and contraceptive use at first sexual intercourse. METHODS: Data were used from the National Longitudinal Survey of Youth 1997, a nationally representative survey collected annually in the United States. Multinomial logistic regression of a base sample of 2,737 boys examines the likelihood of (1) sexual debut at ages 12-14, 15-17, or ≥18 years; (2) first intercourse with a stranger, casual acquaintance, dating partner, in a committed relationship, or in an undefined relationship; (3) level of discussion about birth control; (4) contraception; and (5) condom use among those who contracept. RESULTS: Compared to boys without disability, those with learning or emotional conditions are more likely-and those with sensory conditions are less likely-to report very early sexual debut. Boys with chronic illness are both more likely to have sex in a committed relationship and in an undefined relationship and also more likely to contracept at first intercourse. Boys with learning or emotional conditions are more likely to discuss birth control but less likely to use condoms if they do contracept. CONCLUSIONS: Boys with and without disabilities-and boys with different types of disabilities-vary significantly in multiple aspects of their first sexual experiences. It is pertinent that sexual health interventions are tailored to address this diversity.

Planning for motherhood: fertility attitudes, desires and intentions among women with disabilities.

CONTEXT: An estimated 10% of U.S. women of reproductive age report a current disability; however, the relationship between disability, motherhood attitudes and fertility intentions among these women is largely unknown. METHODS: Data from the 2006-2010 National Survey of Family Growth were used to examine attitudes toward motherhood and fertility intentions among 10,782 U.S. women aged 15-44. A series of regression models assessed, separately for mothers and childless women, associations between disability status and women's attitudes and intentions. RESULTS: Women with and without disabilities held similar attitudes toward motherhood. Among women without children, women with and without disabilities were equally likely to want a child and equally likely to intend to have one. However, childless women with disabilities who wanted and intended to have a child were more likely to report uncertainty about those intentions than were childless women without disabilities (odds ratio, 1.7). Mothers with disabilities were more likely to want another child (1.5), but less likely to intend to have a child (0.5), than were mothers without disabilities. CONCLUSIONS: Deepening understanding of the reproductive health desires, needs and challenges of women with disabilities is essential if the highest quality reproductive health services are to be provided for all.

Disability and sleep duration: evidence from the American Time Use Survey.

BACKGROUND: Regular short and long sleep durations are associated with increased mortality and morbidity. While previous research shows significant sleep disparities between people with and without disabilities, less is known about the association between different types of disability and high-risk sleep using nationally representative data. OBJECTIVE: We examine the association between short and long sleep durations and having a work disability or an impairment in sensory, cognitive, or physical functioning among a nationally representative sample of working-age adults in the United States. METHODS: We estimate multinomial logistic regression models using data from the 2003-2012 American Time Use Survey to identify how different types of disabling conditions--net of other sociodemographic factors--relate to the likelihood of reporting short (6 h or fewer) or long (9 h or more) sleep, versus mid-range (between 6 and 9 h) sleep. RESULTS: For respondents with work disabilities versus those without work disabilities, the relative risk of short and long sleep is 1.4 and 1.5 times (respectively) that of those with mid-range sleep. The risk of short and long sleep durations is also higher among respondents with cognitive, physical, or multiple impairments. CONCLUSIONS: Individuals with disabilities are less likely than those without disabilities to have optimal sleep durations. These results demonstrate the importance of health promotion services among this population, with specific attention to sleep hygiene interventions.

Child and adult disability in the 2000 Census: disability is a household affair.

BACKGROUND: Survey data indicate that individuals with disabilities in the United States often experience less advantageous economic and social resources than individuals without disabilities. Furthermore, they often reside with other individuals with disabilities in the same household. However, less is known about resource availability when multiple child and adult household members have a disability. OBJECTIVE: We use child-level data from the 2000 Census to examine the relationship between aggregation of disability in households with children and education, labor force participation, poverty level, and inadequate housing. METHODS: We utilize tabular analysis and Kruskal-Wallis tests to examine how resources in education, employment, income, and housing adequacy compare for children with disabilities who are the only member of their household with a disability, children with disabilities who live in a household with at least one other member with a disability, children without disabilities who live in a household where no other member has a disability, and children without disabilities who live in a household where at least one other member has a disability. RESULTS: Among children without a disability, 86% live in a household in which no other member has a disability. Among children with a disability, 53% live in a household in which no other adult or child has a disability. Poverty, inadequate housing, and low adult education were more than two times more likely - and adult unemployment over five times more likely - in households with multiple members with disability versus households without disability. CONCLUSION: There is a high prevalence of aggregation of adults and children with disability in households of children with disability. These households have substantially fewer resources than households who do not have children or adults with disabilities.

The first sexual experience among adolescent girls with and without disabilities.

First sexual intercourse is an important experience in the young adult life course. While previous research has examined racial, gender, and socioeconomic differences in the characteristics of first sexual intercourse, less is known about differences by disability status. Using a racially diverse (27% Black, 20% Hispanic, and 53% non-Hispanic white) sample of 2,729 adolescent girls aged 12-24 at first sexual intercourse from the National Longitudinal Survey of Youth 1997, this article examines the association between disability and type of first sexual relationship, degree of discussion about birth control, and pregnancy wantedness. Regression analyses indicate that girls with mild or learning or emotional disabilities experience first sexual intercourse in different types of relationships than girls without disabilities. Adolescents with learning or emotional conditions have greater levels of discussion about birth control with their first sexual partners than those without disabilities. In addition, among those who do not use birth control at first sexual intercourse, girls with multiple or seriously limiting conditions are more likely to want a pregnancy-versus not want a pregnancy-at first sexual intercourse. Findings indicate that disability status is important to consider when examining adolescent sexuality; however, not all youth with disabilities have equal experiences.

Delinquency Among Adolescents with Disabilities.

This study expands upon previous research by utilizing nationally representative data and multivariate analyses to examine the relationship between an adolescent's disability status and their likelihood of engaging in a spectrum of delinquent behaviors through age 16. Logistic regression models of 7,232 adolescents from the National Longitudinal Survey of Youth 1997 are used to investigate the association between the presence of a learning disability or emotional condition, chronic health condition, sensory condition, physical disability, or multiple conditions and ten delinquent acts, including violence-related delinquency, property crimes, drug offenses, and arrest. Additional analyses explore differences in delinquency prevalence by more specific types of limiting conditions. Results indicate that adolescents with learning disabilities or emotional conditions are particularly at risk of committing delinquent acts. Findings suggest that disability status is important to consider when examining adolescent delinquency; however, not all youth with disabilities have equal experiences.

Life-Course Transitions Among Adolescents With and Without Disabilities: A Longitudinal Examination of Expectations and Outcomes.

Research on adolescents suggests that young people are able to form reasonable expectations about future life-course transitions-and that these expectations are predictive of future outcomes. However, less is known about how these expectations might vary for adolescents with disabilities, who might face additional challenges when transitioning to adulthood. The present study addresses this gap in the literature by using nationally representative data from the National Longitudinal Survey of Youth (NLSY97) to suggest that young people's expectations about pregnancy, parenthood, education, and employment do vary according to disability status. Furthermore, disability status conditions the relationship between these expectations and their future outcomes. In general, adolescents with disabilities are more proficient in the prediction of educational outcomes than employment or pregnancy outcomes. However, their expectations about education are significantly lower-and expectations about teenage parenthood much higher-than those of adolescents without disabilities.

The Educational Attainment Process Among Adolescents with Disabilities And Children of Parents with Disabilities.

This article uses data from the National Longitudinal Survey of Youth 1997 (NLSY97) to examine the relationship between disability, parental and youth university expectations in 1997, and youth high school completion and university enrolment by 2003. Results indicate that educational attainment is not equal for young adults with and without disabilities in the United States. Parents-but not adolescents-are likely to reduce their educational expectations when adolescents have a mild or serious disability, net of school performance. These parental-but not adolescent-expectations are significantly associated with high school completion. Finally, even after controlling for educational expectations and school performance, youth with serious disabilities are much less likely to graduate from high school than youth without disabilities. Despite the considerable strides made in the implementation of the Individuals with Disabilities Education Act, students with disabilities are not achieving educational parity in graded schooling.

PARENTING A CHILD WITH A DISABILITY: AN EXAMINATION OF RESIDENT AND NON-RESIDENT FATHERS.

Children with disabilities often require more extensive family involvement and greater paternal support than other children. Yet these children are the children least likely to live with their fathers. This paper uses data from the National Longitudinal Survey of Youth 1997 from the United States to examine the association between child disability and resident and non-resident biological fathers' supportiveness, relationship, and monitoring of their children. Regression analyses indicate significant challenges for all fathers of children with disabilities. Children of resident fathers report more positive interactions than children of non-resident fathers. However, earlier co-residence and more frequent contact significantly improve the quality of father-youth relationships among men who do not live with their children.

School-to-work program participation and the post-high school employment of young adults with disabilities.

Previous research on the education-to-employment transition for students with disabilities has suggested that participation in school-to-work programs is positively associated with post-high school success. This article utilizes data from the National Longitudinal Survey of Youth 1997 (NLSY97) to extend these findings in several ways. First, we assess the efficacy of specific types of school-based and work-based initiatives, including job shadowing, mentoring, cooperative education, school-sponsored enterprise, technical preparation, internships, and career major. Next, we extend the usual focus on the employment outcomes of work status and financial compensation to consider job-specific information on the receipt of fringe benefits. Overall, results from longitudinal multivariate analyses suggest that transition initiatives are effective in facilitating vocational success for this population; however, different aspects of school-to-work programs are beneficial for different aspects of employment. School-based programs are positively associated with stable employment and full-time work while work-based programs most consistently increase the likelihood that youth with disabilities will be employed in jobs that provide fringe benefits. Analyses also indicate that - once individuals with disabilities are stably employed - they can be employed in "good" jobs that provide employee benefits.

Family developmental risk factors among adolescents with disabilities and children of parents with disabilities.

This paper investigates how the learning environments and family dynamics differ if households have a child with a disability or a parent with a disability. Using data from the National Longitudinal Survey of Youth 1997, results indicate that children with disabilities experience similar learning environments as other children, but have somewhat weaker relationships with their parents. In two-parent families, maternal disability lowers parents' school involvement and is associated with a less enriching home environment. Paternal disability reduces maternal monitoring and positive family activities possibly because mothers divert care-giving resources from their children to their male partners. Children in mother-headed households experience learning environments and family dynamics that are similar regardless of their own disability status or that of their mothers, but these outcomes are markedly inferior to those of children growing up in two-parent households. Future research on adolescent development should consider the disability status of children and parents, with particular attention to patterns of gendered care-giving in American families.