TY - JOUR

T1 - The association between household wealth and the prevalence of child disability and specific functional limitations

T2 - Analysis of nationally representative cross-sectional surveys in 40 low- and middle-income countries

AU - Emerson, Eric

AU - Llewellyn, Gwynnyth

N1 - This is the author’s version of a work that was accepted for publication in Disability and Health Journal. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Disability and Health Journal, Volume 15, Issue 4, October 2022, 101364, DOI: 10.1016/j.dhjo.2022.101364

PY - 2022/10/31

Y1 - 2022/10/31

N2 - BACKGROUND: It is commonly stated that people with disabilities are at significantly greater risk of living in poverty than their non-disabled peers. However, most evidence supporting this assertion is drawn from studies in high-income countries and studies of adults. There is relatively little robust evidence on the association between poverty/wealth and the prevalence of child disability in low- and middle-income countries (LMICs).OBJECTIVE/HYPOTHESIS: To estimate the strength of association between an indicator of wealth (household assets) and the prevalence of disability among children in a range of LMICs.METHODS: Secondary analysis of data collected in Round 6 of UNICEF's Multiple Indicator Cluster Surveys. Nationally representative data were available for 40 countries with a total sample size of 473,578 children aged 2-17. Disability was ascertained by responses to the Washington Group for Disability Statistics module on functional limitations.RESULTS: There were significant dose-dependent relationships between household wealth quintile and the prevalence of disability and 13 of the 15 specific functional difficulties associated with disability. Children living in the poorest 20% of households were 35% more likely to have a disability than children living in the most affluent 20% of households. The strength of the association between household wealth and the prevalence of child disability was markedly lower in low-income countries than in middle-income countries. r CONCLUSIONS: Our results provide robust evidence that in LMICs the prevalence of child disability is disproportionately concentrated in poorer households. Further research is required to better understand why this association appears to be weaker in low-income countries. c.

AB - BACKGROUND: It is commonly stated that people with disabilities are at significantly greater risk of living in poverty than their non-disabled peers. However, most evidence supporting this assertion is drawn from studies in high-income countries and studies of adults. There is relatively little robust evidence on the association between poverty/wealth and the prevalence of child disability in low- and middle-income countries (LMICs).OBJECTIVE/HYPOTHESIS: To estimate the strength of association between an indicator of wealth (household assets) and the prevalence of disability among children in a range of LMICs.METHODS: Secondary analysis of data collected in Round 6 of UNICEF's Multiple Indicator Cluster Surveys. Nationally representative data were available for 40 countries with a total sample size of 473,578 children aged 2-17. Disability was ascertained by responses to the Washington Group for Disability Statistics module on functional limitations.RESULTS: There were significant dose-dependent relationships between household wealth quintile and the prevalence of disability and 13 of the 15 specific functional difficulties associated with disability. Children living in the poorest 20% of households were 35% more likely to have a disability than children living in the most affluent 20% of households. The strength of the association between household wealth and the prevalence of child disability was markedly lower in low-income countries than in middle-income countries. r CONCLUSIONS: Our results provide robust evidence that in LMICs the prevalence of child disability is disproportionately concentrated in poorer households. Further research is required to better understand why this association appears to be weaker in low-income countries. c.

U2 - 10.1016/j.dhjo.2022.101364

DO - 10.1016/j.dhjo.2022.101364

M3 - Journal article

C2 - 35977866

VL - 15

JO - Disability and Health Journal

JF - Disability and Health Journal

SN - 1936-6574

IS - 4

M1 - 101364

ER -