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Comparative Study
. 2017 Oct 15;34(20):2877-2882.
doi: 10.1089/neu.2016.4931. Epub 2017 May 18.

Rural and Urban Living in Persons With Spinal Cord Injury and Comparing Environmental Barriers, Their Health, and Quality-of-Life Outcomes

Free PMC article
Comparative Study

Rural and Urban Living in Persons With Spinal Cord Injury and Comparing Environmental Barriers, Their Health, and Quality-of-Life Outcomes

R Andrew Glennie et al. J Neurotrauma. .
Free PMC article


There is worldwide geographic variation in the epidemiology of traumatic spinal cord injury (tSCI). The aim of this study was to determine whether environmental barriers, health status, and quality-of-life outcomes differ between patients with tSCI living in rural or urban settings, and whether patients move from rural to urban settings after tSCI. A cohort review of the Rick Hansen SCI Registry (RHSCIR) was undertaken from 2004 to 2012 for one province in Canada. Rural/urban setting was determined using postal codes. Outcomes data at 1 year in the community included the Short Form-36 Version 2 (SF36v2™), Life Satisfaction Questionnaire, Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), Functional Independent Measure® Instrument, and SCI Health Questionnaire. Statistical methodologies used were t test, Mann-Whitney U test, and Fisher's exact or χ2 test. In the analysis, 338 RHSCIR participants were included; 65 lived in a rural setting and 273 in an urban setting. Of the original patients residing in a rural area at discharge,10 moved to an urban area by 1 year. Those who moved from a rural to urban area reported a lower SF-36v2™ Mental Component Score (MCS; p = 0.04) and a higher incidence of depression at 1 year (p = 0.04). Urban patients also reported a higher incidence of depression (p = 0.02) and a lower CHIEF-SF total score (p = 0.01) indicating fewer environmental barriers. No significant differences were found in other outcomes. Results suggest that although the patient outcomes are similar, some patients move from rural to urban settings after tSCI. Future efforts should target screening mental health problems early, especially in urban settings.

Keywords: community needs; follow-up studies; quality of life; rural urban migration; spinal cord injury.

Conflict of interest statement

This study was supported by financial contributions from the Rick Hansen Institute, the Ontario Neurotrauma Foundation, and the Government of Canada through Health Canada and Western Economic Diversification Canada.


<b>FIG. 1.</b>
FIG. 1.
Sample size flow chart for the study analysis. RHSCIR, Rick Hansen Spinal Cord Injury Registry.

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