Social exclusion and people with intellectual disabilities: a rural-urban comparison.
Place shapes exclusion: rural adults with ID get more daytime chances but fewer close friends than city peers.
01Research in Context
What this study did
Matson et al. (2013) compared rural and urban adults with intellectual disability. They looked at how left out each group felt in everyday life.
The team used surveys and service records to score things like daytime activities, money problems, and friendship quality.
What they found
Country adults had better jobs and clubs and less money stress. City adults used more day centers and had closer friends.
The results were mixed: rural life gave more chances but weaker bonds.
How this fits with other research
McGeown et al. (2013) ran the same 2013 rural-urban split. They found no gap in mental illness, but autism was more common in the country. The two papers agree that place matters, just for different outcomes.
Chiviacowsky et al. (2013) extend the story: rural adults with ID also land in the hospital more for problems that good primary care could prevent. So the countryside offers opportunity yet hides health risk.
Cooper et al. (2011) came first and showed that living in a poor area cuts specialist visits. L et al. add the rural piece: even non-poor country areas can leave people lonely.
Why it matters
When you write a support plan, ask where the person lives. Rural folks may need help building close ties. City folks may need help finding work or clubs. Match the intervention to the gap the map creates.
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02At a glance
03Original abstract
BACKGROUND: Research suggests that social exclusion is a problem both for people with intellectual disabilities (ID) and for people living in rural areas. This may give rise to a double disadvantage for people with ID living in rural areas. Conversely, aspects of rural life such as community spirit and social support may protect against social exclusion in this population. This study was designed to compare a number of measures of social exclusion in adults with ID living in rural and urban areas, with the aim of identifying whether a double disadvantage exists. METHOD: Adults with ID were recruited from a rural and an urban area in Scotland. Participants participated in a face-to-face interview and their medical notes were accessed. Social exclusion was investigated using a number of measures comprising: daytime opportunities and physical access to community facilities (using part of the British Institute of Learning Disabilities questionnaire), recent contact with others and the quality of personal relationships (using a modified Interview Measure of Social Relationships questionnaire) and area deprivation by postcode (using the Scottish Index of Multiple Deprivation). The data were analysed using a series of binary logistic regression models that adjusted for variables including age, gender, level of ID, mental illhealth and common physical co-morbidities. RESULTS: A representative sample of adults with ID from rural (n = 39) and urban (n = 633) areas participated. Participants from rural areas were significantly more likely to have any regular daytime opportunity [odds ratio (OR) = 10.8, 95% CI = 2.3-51.5] including employment (OR = 22.1, 95% CI = 5.7-85.5) and attending resource centres (OR = 6.7, 95% CI = 2.6-17.2) than were participants from urban areas. They were also more likely to have been on holiday (OR = 17.8, 95% CI = 4.9-60.1); however, were less likely to use community facilities on a regular basis. Participants from urban and rural areas had a similar number of contacts with other people in a wide range of situations, but the quality of relationships may have been less close in rural areas. Finally, participants lived in significantly less deprived areas when in rural compared with urban areas (Mann-Whitney U = 7826, Z = -3.675, P ≤ 0.001). CONCLUSIONS: These results suggest that adults with ID living in rural areas have better opportunities and live in less deprived areas than adults with ID living in urban areas. However, they may not hold such positive or close relationships, and this may be important when considering the subjective experience of social exclusion.
Journal of intellectual disability research : JIDR, 2013 · doi:10.1111/j.1365-2788.2012.01540.x