{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:45:15Z","timestamp":1787028315485,"version":"build-2736575974"},"reference-count":37,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T00:00:00Z","timestamp":1600905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Persons experiencing disabilities often face difficulties to establish and maintain intimate partnerships and the decision whether to live alone or with others is often not their own to make. This study investigates whether individual and country-level characteristics predict the partnership status and the living situation of persons with spinal cord injury (SCI) from 22 countries. We used data from 12,591 participants of the International SCI Community Survey (InSCI) and regressed partnership status and living situation on individual (sociodemographic and injury characteristics) and country-level characteristics (Human Development Index, HDI) using multilevel models. Females, younger persons, those with lower income, without paid work, more severe injuries, and longer time since injury were more often single. Males, older persons, those with higher income, paid work, less severe injuries, and those from countries with higher HDI more often lived alone. This study provides initial evidence for the claim that the partnership status and the living situation of people with SCI are influenced by sociodemographic and socioeconomic factors and are not merely a matter of choice, in particular for those with severe injuries.<\/jats:p>","DOI":"10.3390\/ijerph17197002","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T01:39:33Z","timestamp":1600997973000},"page":"7002","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Partnership Status and Living Situation in Persons Experiencing Physical Disability in 22 Countries: Are There Patterns According to Individual and Country-Level Characteristics?"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3753-3017","authenticated-orcid":false,"given":"Christine","family":"Fekete","sequence":"first","affiliation":[{"name":"Swiss Paraplegic Research, 6207 Nottwil, Switzerland"},{"name":"Department of Health Sciences &amp; Medicine, University of Lucerne, 6002 Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1024-3682","authenticated-orcid":false,"given":"Mohit","family":"Arora","sequence":"additional","affiliation":[{"name":"John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW 2065, Australia"},{"name":"Sydney Medical School-Northern, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan D.","family":"Reinhardt","sequence":"additional","affiliation":[{"name":"Swiss Paraplegic Research, 6207 Nottwil, Switzerland"},{"name":"Department of Health Sciences &amp; Medicine, University of Lucerne, 6002 Lucerne, Switzerland"},{"name":"Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu 610207, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2231-6538","authenticated-orcid":false,"given":"Mirja","family":"Gross-Hemmi","sequence":"additional","affiliation":[{"name":"Swiss Paraplegic Research, 6207 Nottwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Kyriakides","sequence":"additional","affiliation":[{"name":"Spinal Cord Injuries Unit, University of Patras, Rio, 26500 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-2004","authenticated-orcid":false,"given":"Marc","family":"Le Fort","sequence":"additional","affiliation":[{"name":"Neurological Physical and Rehabilitation Medicine Department, University Hospital Saint-Jacques, 44093 Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0599-4908","authenticated-orcid":false,"given":"Julia","family":"Patrick Engkasan","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6213-9150","authenticated-orcid":false,"given":"Hannah","family":"Tough","sequence":"additional","affiliation":[{"name":"Swiss Paraplegic Research, 6207 Nottwil, Switzerland"},{"name":"Department of Health Sciences &amp; Medicine, University of Lucerne, 6002 Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1080\/15017419.2015.1081616","article-title":"The marital status of disabled women in Canada: A population-based analysis","volume":"18","author":"Savage","year":"2016","journal-title":"Scand. J. Disabil. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1300\/J015v26n03_01","article-title":"Representations of disability and the interpersonal relationships of women with disabilities","volume":"26","author":"Crawford","year":"2003","journal-title":"Women Ther."},{"key":"ref_3","first-page":"81","article-title":"Sex, disability and motherhood: Access to sexuality for disables mothers","volume":"22","year":"2002","journal-title":"Disabil. Stud. Quart."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Seidman, S., Fischer, N., and Meeks, C. (2006). The body, disability, and sexuality. Handbook of the New Sexuality Studies, Routledge.","DOI":"10.4324\/9780203824146"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/A:1010716820677","article-title":"National study of women with physical disabilities: Final report","volume":"19","author":"Nosek","year":"2001","journal-title":"Sex Disabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.dhjo.2016.05.004","article-title":"Marriage trends among Americans with childhood-onset disabilities, 1997\u20132013","volume":"9","author":"Tumin","year":"2016","journal-title":"Disabil. Health J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s11113-012-9259-0","article-title":"Disability trends by marital status among older Americans: 1997\u20132010: An examination by gender and race","volume":"32","author":"Liu","year":"2013","journal-title":"Popul. Res. Policy Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1080\/09687599.2013.831745","article-title":"Disability, partnership and parenting","volume":"29","author":"Clarke","year":"2014","journal-title":"Disabil. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Sandstr\u00f6m, G., Namatovu, F., Ineland, J., Larsson, D., Ng, N., and Stattin, M. (2020). The persistence of high levels of living alone among adults with disabilities in Sweden, 1993\u20132011. Popul. Res. Policy. Rev.","DOI":"10.1007\/s11113-020-09570-2"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"87","DOI":"10.2753\/IJS0020-7659410105","article-title":"Alter-bound? The effect of disability on the hazard of entry into first marriage","volume":"41","author":"MacInnes","year":"2011","journal-title":"Int. J. Sociol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"972","DOI":"10.3368\/jhr.47.4.972","article-title":"Insult to injury: Disability, earnings, and divorce","volume":"47","author":"Singleton","year":"2012","journal-title":"J. Hum. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1038\/sj.sc.3100933","article-title":"Spinal cord injury and partner relationships","volume":"38","author":"Kreuter","year":"2000","journal-title":"Spinal Cord"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/S0003-9993(95)80022-0","article-title":"Outcomes of post-spinal cord injury marriages","volume":"76","author":"DeVivo","year":"1995","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1038\/sc.2010.63","article-title":"Predictors of marital longevity after new spinal cord injury","volume":"49","author":"Kalpakjian","year":"2011","journal-title":"Spinal Cord"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Olsen, R., and Clarke, H. (2003). Parenting and Disability: Disabled Parents Experiences of Raising Children, Policy Press.","DOI":"10.46692\/9781847425683"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.4054\/DemRes.2015.32.40","article-title":"Living alone: One-person households in Asia","volume":"32","author":"Yeung","year":"2015","journal-title":"Demogr. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.healthpol.2013.01.009","article-title":"Explaining governmental involvement in home care across Europe: An international comparative study","volume":"110","author":"Genet","year":"2013","journal-title":"Health Policy"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1080\/14616696.2012.726733","article-title":"Intergenerational help and public assistance in Europe\u2013A case of specialization?","volume":"15","author":"Brandt","year":"2013","journal-title":"Eur. Soc."},{"key":"ref_19","unstructured":"Bickenbach, J., Officer, A., Shakespeare, T., and von Groote, P. (2013). International Perspectives on Spinal Cord Injury, World Health Organization."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1097\/PHM.0000000000000678","article-title":"The international spinal cord injury survey and the learning health system for spinal cord injury","volume":"96","author":"Stucki","year":"2017","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1097\/PHM.0000000000000647","article-title":"Study protocol of the International Spinal Cord Injury (InSCI) community survey","volume":"96","author":"Post","year":"2017","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1097\/PHM.0000000000000622","article-title":"A Structured approach to capture the lived experience of spinal cord injury: Data model and questionnaire of the International Spinal Cord Injury community survey","volume":"96","author":"Fekete","year":"2017","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_23","unstructured":"Fekete, C., Brach, M., Ehrmann, C., Post, M.W., and Stucki, G. (2020). Cohort profile of the International Spinal Cord Injury (InSCI) community survey. Arch. Phys. Med. Rehabil."},{"key":"ref_24","unstructured":"United Nations Educational, Scientific and Cultural Organization (1997). International Standard Classification of Education (ISCED), UNESCO."},{"key":"ref_25","unstructured":"Hagenaars, A., De Vos, K., and Zaidi, M.A. (1994). Poverty Statistics in the Late 1980s: Research Based on Micro-Data, Publications Office of the European Union."},{"key":"ref_26","unstructured":"(2020, August 27). Human Development Index. Available online: http:\/\/hdr.undp.org\/en\/content\/human-development-index-hdi."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Hox, J., Moerbeek, M., and van de Schoot, R. (2018). Multilevel Analysis. Techniques and Applications, Routledge.","DOI":"10.4324\/9781315650982"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/sim.4067","article-title":"Multiple imputation using chained equations: Issues and guidance for practice","volume":"30","author":"White","year":"2011","journal-title":"Stat. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/BF02590076","article-title":"Dating and relationship issues","volume":"14","author":"Gill","year":"1996","journal-title":"Sex Disabil."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1016\/j.apmr.2019.03.018","article-title":"Participation in people living with spinal cord injury in Switzerland: Degree and associated factors","volume":"100","author":"Post","year":"2019","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1300\/J087v25n03_09","article-title":"The impact of unemployment on marriage and divorce","volume":"25","author":"Lester","year":"1996","journal-title":"J. Divorce Remarriage"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1080\/00036846.2017.1366642","article-title":"Unemployment, marriage and divorce","volume":"50","year":"2018","journal-title":"Appl. Econ."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1111\/padr.12311","article-title":"Living alone over the life course: Cross-national variations on an emerging issue","volume":"46","author":"Esteve","year":"2020","journal-title":"Popul. Dev. Rev."},{"key":"ref_34","unstructured":"Klinenberg, E. (2012). Going solo: The Extraordinary Rise and Surprising Appeal of Living Alone, Penguin Press."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1037\/a0031859","article-title":"Marital quality and health: A meta-analytic review","volume":"140","author":"Robles","year":"2014","journal-title":"Psychol. Bull."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/S0031-9384(03)00160-4","article-title":"The physiology of marriage: Pathways to health","volume":"79","author":"Robles","year":"2003","journal-title":"Physiol. Behav."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1037\/amp0000388","article-title":"Marriage, divorce, and the immune system","volume":"73","year":"2018","journal-title":"Am. Psychol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/19\/7002\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:13:24Z","timestamp":1760177604000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/19\/7002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,24]]},"references-count":37,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["ijerph17197002"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17197002","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,24]]}}}