Participation and Achievement in the Summer Paralympic Games: The Influence of Income, Sex, and Assistive Technology

Abstract

Background: Global participation at the Paralympic Games has been steadily growing in the past 60 years. However, inequities in relation to geographic representation of Paralympians, sex representation, access to assistive technology and medal success remain. Understanding the relationship between these determinants is important to inform strategies to increase future participation from everywhere, and promote a level playing field. The objectives of this research are to describe and compare trends in Paralympians’ participation in the summer Paralympic Games by income level and sex, trends in participation in events requiring assistive products (wheelchairs, hand cycles/trikes, and prostheses) by income level, and medal achievement by income level in all sport events, and events requiring assistive technology. Methods: A retrospective secondary analysis of publicly available data was conducted. Participation, sex, and medal tally data were extracted from data available on the International Paralympic Committee website and archives. Data regarding income (income level, GDP) and population were collected from publicly available data available from the World Bank website. Findings: Participation in the Summer Paralympic Games differs significantly by income level (p=0.000) with high- income countries sending, on average, more Paralympians than low-and middle-income countries. There is a significant difference between male and female participation (p=0.00), with approximately 29% of all Paralympians being female. High income countries demonstrate significantly higher achievement than low-and middle-income countries (p=0.000), including in events requiring assistive products (p=0.007). Interpretation: Despite growth in overall participation, low- and middle-income countries remain severely underrepresented in both participation and achievement at the Paralympic Games, especially in the events that require high quality assistive products to succeed. Funding: None to declare. Declaration of Interest: None to declare.