Physical impairments among adults in Denmark: a register-based study

(2022) 22:2416 Nikolajsen et al. BMC Public Health https://doi.org/10.1186/s12889-022-14747-9 Open Access RESEARCH Physical impairments among adults in Denmark: a register‑based study Helene Nikolajsen1,2* , Camilla Marie Larsen1,3 , Anders Holsgaard‑Larsen4,5 , Birgit Juul‑Kristensen1    and Lise Hestbaek1    Abstract Background: Knowledge of the prevalence and socio-demographic characteristics of physical impairments is lim‑ ited. This study aimed to determine the prevalence of physical impairments among adults in Denmark, both in total and according to nine common diagnostic subgroups, describe the socio-demographic and socio-economic profile, and compare the data with those of the general adult population. Methods: This descriptive, cross-sectional, register-based study evaluated the general socio-demographic and socioeconomic variables, including sex, age, geographical region, origin, educational level, occupation, marital status, and disability level, of adults with physical impairments extracted by diagnosis from the Danish National Patient Register and Statistics Denmark by 31 December 2018. These data were compared with those of the general adult population in Denmark extracted from Statistics Denmark by January 2019. Results: In total, 606,857 adults with physical impairments were identified. Of the nine selected diagnoses, osteoar‑ thritis (69.4%) was the most prevalent, followed by acquired brain injury (29.0%), rheumatoid arthritis (6.7%), multiple sclerosis (2.6%), spinal cord injury (1.5%), cerebral palsy (1.2%), amputation (0.7%), muscular dystrophy (0.5%), and poliomyelitis (< 0.1%). There were large variations in the socio-demographic and socio-economic profile between the nine diagnostic subgroups. The adults with physical impairments were more often women, were older, were less often immigrants and employed adults, had a lower educational level, and were more commonly married than the general adult population. Only the geographical region did not differ. Conclusion: The nine subgroups with diagnoses related to the musculoskeletal system represent 13% of the adult Danish population. The socio-demographic and socio-economic profile varied largely between the nine diagnostic subgroups, and almost all variables differed significantly between adults with physical impairments and the general adult population in Denmark. These findings reveal patterns and trends on socio-demographic and socio-economic variables essential for future planning at a societal level, including the healthcare and social sectors. Keywords: Physical impairment, Prevalence, Demography, Socio-demographic factors, Socio-economic factors, Population characteristics, Registry *Correspondence: 2 Department of Physiotherapy, Institute of Health Studies, University College South Denmark, Esbjerg‑Haderslev, Denmark Full list of author information is available at the end of the article Background People with physical impairments are a vulnerable group. as they have daily individual restrictions due to their impairment depending on the disability level and they are twice as likely to be physically inactive than people without impairments [1, 2]. Accordingly, these patients have an increased risk for both lifestyle-related © The Author(s) 2022. 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The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Nikolajsen et al. BMC Public Health (2022) 22:2416 morbidities and mortalities, leading to an individual and a societal economic burden [1, 3, 4]. Further, they more frequently develop other chronic diseases and conditions earlier than people without physical impairments [5]. Compared with the general population, people with physical impairments in Denmark lag behind in 9 of 10 indicators of the Disability Index: (1) equality and non-discrimination, (2) violence, (3) accessibility and mobility, (4) freedom and personal integrity, (5) living independently and being included in the community, (6) education, (7) health, (8) employment, and (9) social protection (only participation in political life was not affected). This trend appears to continue based on recent data [6]. As people with physical impairments currently live longer than they did previously, they constitute a growing group, accounting for approximately 1 billion people worldwide or about 15% of the world’s population in 2010 [7]. The inclusion of people with physical impairments in physical and sports activities, which has been shown to improve health and prevent lifestyle-related diseases in both adults with and without impairments [8], requires an infrastructure matching the needs of both groups. The inclusion in social and cultural activities is also essential to allow people with physical impairments to enjoy these activities with healthy relatives and friends on equal terms. However, when people with physical impairments attempt to engage in such activities, they encounter several barriers, including inaccessible environments or intra- or interpersonal issues [2, 9, 10]. This may be attributed to the limited knowledge about people with impairments and their experiences with such activities. There is a need for more specific knowledge on the similarities and dissimilarities of the characteristics of people with and without impairments to facilitate opportunities for such activities. To date, there are limited valid data on the prevalence and characteristics of specific impairments, as the present knowledge is based on small groups not always representative of the broader population of adults with physical impairments [11–14] or on single diagnoses (e.g. multiple sclerosis [15] or cerebral palsy [16]) often without socio-demographic information [17]. The combination of data on the prevalence and socio-demographic characteristics can provide a more detailed overview of people with physical impairments, which can be useful within various fields (e.g. healthcare, social, and cultural sectors or socio-economic estimation or budgeting). Th (...truncated)