Prevalence and Causes of Paralysis-United States, 2013.

OBJECTIVES: To estimate the prevalence and causes of functional paralysis in the United States. METHODS: We used the 2013 US Paralysis Prevalence & Health Disparities Survey to estimate the prevalence of paralysis, its causes, associated sociodemographic characteristics, and health effects among this population. RESULTS: Nearly 5.4 million persons live with paralysis. Most persons with paralysis were younger than 65 years (72.1%), female (51.7%), White (71.4%), high school graduates (64.8%), married or living with a partner (47.4%), and unable to work (41.8%). Stroke is the leading cause of paralysis, affecting 33.7% of the population with paralysis, followed by spinal cord injury (27.3%), multiple sclerosis (18.6%), and cerebral palsy (8.3%). CONCLUSIONS: According to the functional definition, persons living with paralysis represent a large segment of the US population, and two thirds of them are between ages 18 and 64 years. Targeted health promotion that uses inclusion strategies to account for functional limitations related to paralysis can be undertaken in partnership with state and local health departments.

Woman to Woman: Coming Together for Positive Change--using empowerment and popular education to prevent HIV in women.

HIV risk is the product of social, cultural, economic, and interpersonal forces that create sex-role definitions and expectations that can lead to gender inequalities in health. Woman to Woman: Coming Together for Positive Change is an HIV/AIDS prevention intervention that takes into account that choices and actions may be constrained by poverty, gender roles, and cultural norms. This project educates and empowers, promotes women's perspectives, reaches women "where they are," and encourages women to speak of their experience. The following study presents the evaluation of the effectiveness of an empowerment based participatory HIV prevention program over a 3-year period, implemented in both rural and urban settings in New Mexico, targeting over 300 women at-risk of HIV/AIDS. In addition, the practicalities of conducting participatory process and outcome evaluation with a small nonprofit with minimal budget will be discussed.

Adults aging 'with' and 'into' paralysis: Epidemiological analyses of demography and health.

BACKGROUND: Survival for many individuals with paralysis is increasing, making this population a larger subset of the aging population (Molton, & Jensen, 2010). Yet little is known about the demographics and health of this population (Freedman, 2014). OBJECTIVE: This study is one of the first evaluations of the differences in etiology, sociodemographic and health characteristics (i.e., health status, chronic, and secondary and medical conditions) of adults aging with versus into disability. METHODS: A cross sectional epidemiological study was performed using secondary data from a nationally representative sample of adults with paralysis. The National Paralysis Survey is a random digit-dial survey of over 70,000 households. Weighted descriptive and regression analyses were conducted. RESULTS: Eighty percent of those aging with paralysis had disabilities for 40+ years. They showed significantly better self-reported health status, and a trend for more secondary and medical conditions. Those aging into paralysis had more chronic diseases. CONCLUSIONS: Differences are evident between those aging with vs. into paralysis. These findings suggest that differentiating subgroups of older adults with disabilities by onset of disability makes disability and health information more actionable for programs and policies. Additional studies to explore the intersection of aging and disability onset across adulthood could increase our understanding of the dynamics of aging in persons with early and later onset disabilities.