Low Level Of Social Participation Research Articles

The effect of the interaction between intrinsic capacity and social support on the trajectories of activities of daily living in older adults

ObjectivesThis study explored the effect of the interaction between intrinsic capacity and social support on the activities of daily living in the older adults. MethodsA total of 3,124 older adults participated in the study. Data on the assessment of intrinsic capacity as well as activities of daily living (ADL) and social support were collected. The latent growth curve model (LGCM) was used to examine the effect of the interaction between social support and intrinsic capacity on the activities of daily living in the older adults. ResultsA total of 3,730 older adults were included at baseline, and 3,124 older adults completed the 4-year follow-up. The ADL score of the older adults showed a significant downward trend with time over 4 years (β=-0.115, P<0.05). In the elderly population with high intrinsic capacity, the ADL of individuals with low levels of social participation decreased significantly over time (β=-0.114, P=0.012). In the elderly group with low intrinsic capacity, the ADL of individuals with low levels of social participation (β=-0.245, P=0.005) and high levels of life care (β=-0.167, P=0.001) decreased significantly over time. ConclusionThis is the first longitudinal study to explore the effects of interactions among intrinsic capacity, social participation and family support on the trajectory of ADL in the older adults from the perspective of the life course. Social participation can effectively improve functional ability of older adults with low intrinsic capacity. Life care is beneficial for maintaining the functional ability of older adults with intact intrinsic capacity, but it accelerates the deterioration of the functional ability of older adults with low intrinsic capacity.

Dual trajectories of social participation and frailty in Chinese older adults: a longitudinal study based on CLHLS from 2008 to 2018.

This study aimed to identify the dual trajectories of social participation (SP) and frailty index (FI) among Chinese older adults, and investigate common influential factors of both trajectories. Utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2018 surveys, 1,645 individuals were analyzed. A group-based dual trajectory model and logistic regression were used to examine trajectories, their interrelations and shared influencing factors. This study identified three SP, two FI trajectories and six distinct sub-groups of individuals. The study confirmed a long-term, interrelated relationship between two outcomes and identified some common factors. Compared to participants in the lower SP trajectory, those who followed the middle SP trajectory and higher SP trajectory had increased probabilities of belonging to the slow-growth FI trajectory (90.28 and 99.71%, respectively). And the participants in the slow-growth FI exhibited higher probabilities of belonging to the middle SP and the higher SP trajectory (37.64 and 25.34% higher, respectively) compared with those in the rapid-growth FI trajectory. Age, marital status, and drinking status were mutual factors associated with the dual trajectories. The results showed significant associations between higher levels of frailty and lower levels of social participation. Related intervention policies should consider the dual trajectories and the common factors that underlie these trajectories of SP and FI.

Social participation of women with breast cancer compared to the general population 5 years after primary surgery—what role do medical data and cancer-related complaints play?

PurposeThis study analyzes levels of social participation in patients with breast cancer on average 5 years following primary surgery as compared to women in the general population. In addition, the role of breast cancer-related complaints and medical data as possible influencing factors on levels of patients’ social participation is investigated.MethodsA total of n = 454 patients after primary surgery (t0) were recruited for a third follow-up study, and n = 372 completed this survey (t3), corresponding to a response rate of 82.2%. For measuring breast cancer-related complaints, participants completed a written questionnaire. Social participation was measured by a questionnaire on different leisure activities that was taken from the Socio-Economic Panel Study. Medical information was extracted from medical reports at t0. A principal component analysis was carried out to identify different dimensions of social participation. Chi2-tests and logistic regression analyses were applied to analyze social participation as compared to the general population and the role of possible medical and diagnosis-related influencing factors thereby.ResultsCompared to the general population, patients show lower levels of social participation in the domains “socio-cultural participation” and “participation in institutions,” while no significant differences for “social participation in the private sphere” and “social participation via social media” were found. Psychological symptoms, pain, and a history of mastectomy were most strongly associated with restrictions in social participation.ConclusionsOur study suggests that social withdrawal may happen due to disease-related symptoms, preventing some breast cancer patients from participating fully in society. Cancer-related follow-ups should address this issue and support patients’ reintegration into society through appropriate therapeutic interventions.

Social factors associated with changes in nutrition risk scores measured using SCREEN-8: data from the Canadian Longitudinal Study on Aging.

Purpose: To examine the social network factors associated with changes in nutrition risk scores, measured by SCREEN-8, over three years, in community-dwelling Canadians aged 45 years and older, using data from the Canadian Longitudinal Study on Aging (CLSA).Methods: Change in SCREEN-8 scores between the baseline and first follow-up waves of the CLSA was calculated by subtracting SCREEN-8 scores at follow-up from baseline scores. Multivariable linear regression was used to examine the factors associated with change in SCREEN-8 score.Results: The mean SCREEN-8 score at baseline was 38.7 (SD = 6.4), and the mean SCREEN-8 score at follow-up was 37.9 (SD = 6.6). The mean change in SCREEN-8 score was -0.90 (SD = 5.99). Higher levels of social participation (participation in community activities) were associated with increases in SCREEN-8 scores between baseline and follow-up, three years later.Conclusions: Dietitians should be aware that individuals with low levels of social participation may be at risk for having their nutritional status decrease over time and consideration should be given to screening them proactively for nutrition risk. Dietitians can develop and support programs aimed at combining food with social participation.

Social and psychological implications of actual and defacto childlessness among older persons in East and Southeast Asia

We examine how ageing without children is linked to older adults’ social participation and psychological distress in selected East and Southeast Asian countries (South Korea, China, Thailand, Vietnam, and Myanmar). Recognizing the nuances of such ageing experiences, we distinguish between actual childlessness (older persons without children) and defacto childlessness (older persons whose children all lived far away). We harmonize and analyze recent nationally representative survey data from the five abovementioned countries, utilizing both descriptive and multivariate approaches. First, we investigate the prevalence and dimensions of actual and defacto childlessness. Second, we examine the extent to which actual and defacto childlessness are associated with social participation and psychological distress in old age. The analyses focus on gender and wealth differences. We find that actual childlessness is associated with lower levels of social participation in Southeast Asian countries and greater levels of psychological distress in Korea, Thailand, and Myanmar. The effects of defacto childlessness are, however, mixed. We discuss the social and psychological implications of childlessness for older adults across varying societal contexts in the five Asian countries.

Adverse childhood experiences increase the risk for low perceived social participation and health-related quality of life in a large-scale population-based study in Germany

BackgroundAdverse childhood experiences (ACEs) are highly prevalent and increase the risk for long-term adverse health outcomes. Next to well-known ACE-associated risks for morbidity, recent research is increasingly invested in exploring pathways towards health, overall functioning, and partaking in society following early adversity. ObjectivesThus, this study aims to assess the association between latent classes of ACEs with perceived social participation and health-related Quality of Life (QoL) in a large population-based sample and to explore potential moderators of these associations. MethodA representative sample of the German population (N = 2531; Mage = 48.7; 51 % women) was cross-sectionally investigated for ACEs, social participation (KsT-5), and health-related QoL (EuroQol-5D-5L). Latent Class Analysis (LCA) was performed to derive groups with similar ACE patterns. Multiple regression analyses were used to investigate the association of latent classes of ACEs with social participation and health-related QoL and to explore potential moderators. ResultsFour distinct latent classes of ACEs were identified; “no/low ACEs” (N = 1968, 77.8 %); “household-dysfunction” (N = 259, 10.2 %), “child abuse and neglect” (N = 188, 7.4 %), and “polyadversity” (N = 116, 4.6 %). Compared to participants in the no/low ACE class, those in the ACE-exposed classes showed overall lower levels of perceived social participation and health-related QoL. The polyadversity class showed lower levels of social participation compared to the two other ACE-exposed classes. Chronic stress, living with a partner, education, current job/educational involvement, and gender were found to moderate these associations in exploratory analyses. ConclusionsThis study shows people exposed to ACEs to have a higher risk for lower perceived social participation and lower health-related QoL – an increased risk, however, is not a deterministic uninventable fortune. Reduction of chronic stress, fostering of social support, and educational and vocational paths as interventional targets are discussed to enable those with precarious starting conditions to partake in society.

RELATIONSHIP BETWEEN PROFILES OF FARMERS WITH THEIR KNOWLEDGE ABOUT MANAGEMENT PRACTICES OF WHITE GRUB

The present study was conducted in the Amreli district of the Saurashtra region. Out of the eleven talukas, five talukas were randomly chosen for the study. One village was then randomly selected from each of the chosen talukas, and a total sample size of 75 farmers was taken, with fifteen farmers from each village. The study utilized an ex-post-facto research design and data was collected through surveys during the period of 2018-19. The findings of the study indicated that the majority of the farmers belonged to the middle to old age group and had attained primary to secondary education. They lived in small families and had low levels of social participation. The farmers mostly had low annual income levels and owned medium to small land holding. Additionally, most of the farmers were solely engaged in farming, had moderate access to sources of information, and displayed a high level of innovativeness. The study also revealed significant correlations between various factors and the respondents’ knowledge about the management practices of white grub in groundnut. Education (0.4225) and innovativeness (0.3711) were highly and significantly correlated at a probability level of 0.01. The source of information (0.2566) was found to be significantly correlated at a probability level of 0.05. However, occupation (-0.2245) showed a negative but significant correlation at a probability level of 0.05 with the respondents’ knowledge about the management practices of white grub in groundnut.

Assessments of class climate by primary school children with externalizing behavior problems – An exploratory study

ABSTRACT Children with externalizing behavior problems are likely to show poor school achievements, problems in social interactions with teachers and peers and an elevated school-related stress. Though class climate is a meaningful variable to explain school achievements and aspects of emotional well-being, there are hardly any studies that consider class climate from the perspective of children with externalizing problems. The present study examines the question how children with externalizing problems assess class climate. Furthermore, the study analyzes the possible impact of internalizing comorbidities. The sample of fourth grade primary school children (N = 119) includes 27 students with hyperactive-inattentive and 47 children with dissocial symptoms. Data are analyzed using ANOVAS and hierarchical linear regressions. Externalizing problems coincide with negative assessments of class climate, which are even more negative among students with dissocial symptoms and internalizing comorbidities. While hyperactive-inattentive children primarily focus on a few aspects of class climate (especially unfair teacher decisions), children with dissocial symptoms show more global negative perceptions. The results point to low levels of social participation of children with externalizing problems. Future studies should consider the potential importance of class climate for school-based diagnostics and behavior modification.

Prevalence and sociocultural correlates of post-traumatic stress disorder and complex PTSD among Chinese community health service users in Hong Kong.

Complex post-traumatic stress disorder (CPTSD) is a newly recognized trauma disorder in ICD-11. Little is known about the prevalence and correlates of CPTSD in primary care settings. Its cultural aspects also remained minimally explored. This study investigated the prevalence and sociocultural correlates of PTSD and complex PTSD among Chinese community health service users in Hong Kong. This study investigated ICD-11 PTSD and CPTSD in a sample of adults (N = 376) who had recently received services from Registered Chinese Medicine Practitioners in Hong Kong. Traditional Chinese medicine service is part of primary care services in Chinese societies. Participants completed self-report measures of CPTSD, trauma exposure, perceived family support, perceived caregiver's Chinese traditionality/modernity, participation (social activities and occupational productivity), depression and pain. The past-month prevalence of ICD-11 PTSD and CPTSD was 5.6% and 18.4%, respectively, in our sample. Chi-square tests and one-way ANOVAs revealed that participants with CPTSD were younger and reported more trauma, lower family support, lower levels of social participation and productivity, more depressive symptoms and pain, and more social welfare and mental health service usages than those without PTSD. We found that perceived caregiver's Chinese modernity (e.g. egalitarianism) was negatively correlated with CPTSD symptoms. Apart from age, non-betrayal trauma had the strongest association with classical PTSD symptoms, while betrayal trauma and perceived family support had the strongest association with disturbances in self-organization symptoms. This study provides the first data regarding the prevalence and correlates of ICD-11 PTSD and CPTSD among community health service users in Hong Kong. PTSD and CPTSD are common but often unrecognized mental health problems which are associated with more impairments and more service needs.

The Golden Opportunity? Migration to Svalbard from Thailand and the Philippines

The contribution focuses on international migration to rural peripheries in the Arctic, specifically Thais and Filipinx in Longyearbyen, Svalbard. Longyearbyen is entangled both in global migration trends and Norway’s geopolitical interests in the Arctic. This article explores the worlds of Thai and Filipinx migrants, why they migrate here and how the national strategy for Longyearbyen impacts their lives in the context of recent developments. Svalbard’s unique territorial status and legislation (e.g. absence of visas or work permits) facilitate international migration, but the place’s specificities constrain migrants’ inclusion (e.g. work-related and political rights, and access to social benefits). Higher chances for a good life of offspring motivate parents to stay longer than anticipated. The politically motivated absence of local focus on the needs of international migrants (e.g. language courses and counselling services) seeks to dampen migration. The result is a grey zone of informal power structures, unequal living, working and housing conditions, language barrier and perceived low level of social participation.

FACTORS AFFECTING PERCEIVED USEFULNESS OF THE SORGHUM GROWERS ABOUT CoFS 29 VARIETY

Sorghum is one of the most important fodder crops. In middle Gujarat, farmers of Kheda district mainly grow single cut variety sorghum, pearl millet and maize as a fodder crop as this district possesses good number of livestock population. After understanding the importance of multi cut variety of sorghum, KVK Kheda conducted FLDs on CoFS 29 variety from year 2017. To understand the factors responsible behind perceived usefulness of this variety and to understand the problems realized among its users as well as to get the suggestions from them to overcome the problems, this study was conducted on 200 CoFS 29 user sorghum growers whom KVK Kheda selected as FLD farmers. The profile characteristics were also studied of the selected CoFS 29 users. Ex-post-facto research design was used and interview schedule was prepared in light with the objective. Frequency, percentage, arbitrary method, mean score and coefficient of correlation were major statistical tools used for analysis of the study. From the study, it was observed that more number of CoFS 29 users were from middle age group with secondary level of education, 1 to 2 ha land, 4 to 6 animals and up to 1 lakh rupee annual income. Majority of them were getting yield from CoFS 29 variety was 120 to 130t, very low level of social participation, and medium level of extension contact. More number of farmers had high level of mass media exposure, medium level of scientific orientation and innovativeness and using bore well for irrigation. Profile characteristics like land holding, annual income, yield and scientific orientation were positive and significantly associated with perceived usefulness about CoFS 29 variety for their users. Major problems realized by the CoFS 29 variety user sorghum growers were high price of seeds; difficulty in availability of seeds and more irrigation are required. Major suggestions offered by the sorghum growers to overcome the problems realized by them while utilizing CoFS 29 variety were price of seeds of CoFS 29 variety should be less and seeds of CoFS 29 variety should be made available easily.

Concurrent and lagged associations of social participation and frailty among older adults.

Frailty is a pervasive symptom among the older population, and social participation is a beneficial factor of late-life well-being. However, studies on the bidirectional association between social participation and frailty are limited. This study examined the cross-sectional and lagged associations of social participation and frailty. The analytic sample contained 6865 community-dwelling older adults, with 21,141 observations, from the first four waves (2011-2018) China Health and Retirement Longitudinal Study (CHARLS). Frailty was measured by the Frailty Index (FI). Social participation was measured by the accumulation of the frequencies of six social activities. Random intercept two-level models were used to analyse the concurrent and lagged association between social participation and frailty. The results showed significantly cross-sectional associations between higher levels of frailty and lower levels of social participation in the same wave. Moreover, there was a lagged association of social participation in the prior wave with the current frailty (b=-0.001, SE=0.001, p=0.028), and frailty in the prior wave with the current social participation (b=-0.634, SE=0.088, p < 0.001) even after adjusting for sociodemographic characteristics, and frailty or social participation in the prior wave. The bidirectional associations between social participation and frailty imply the necessity of enhancing social participation to prevent or slow the frailty progression, and improving the physical and social environment to reduce social participation restrictions imposed by frailty status.

Are Psychosocial Factors Determinant in the Pain and Social Participation of Patients with Early Knee Osteoarthritis? A Cross-Sectional Study.

The main objective of this research is to determine the psychosocial differences between patients with knee pain or early osteoarthritis (EOA) and healthy subjects at risk of developing osteoarthritis. The secondary objective is to determine how psychosocial factors might influence pain and social participation in patients with EOA. A cross-sectional study was performed. Participants were divided according to the presence of pain or EOA. Pain intensity both at rest and walking, psychological variables such as anxiety and depression, and social participation were evaluated. A total of 105 participants were included (64 with knee pain and 41 without pain), with a mean age of 51.42 ± 5.92 (35 men and 70 women). Patients with knee pain had higher levels of anxiety (MD = −2.35; p < 0.01; d = 0.66) and depression (MD = −2.45; p < 0.01; d = 0.87), regardless of the presence of EOA. In addition, patients with higher depression levels had lower levels of social participation. The results revealed a relationship between the psychological variables, anxiety and depression, with knee pain and the onset of symptomatic OA, as well as an influence of depression levels on social participation. Improving these psychological characteristics may be useful in delaying the onset of symptomatic OA and enhancing social participation.

Physical Multimorbidity and Social Participation in Adult Aged 65 Years and Older From Six Low- and Middle-Income Countries.

ObjectivesMultimorbidity is common among older adults from low- and middle-income countries (LMICs). Social participation has a role in protecting against negative health consequences, yet its association with multimorbidity is unclear, particularly in LMICs. Thus, this study investigated the relationship between physical multimorbidity and social participation among older adults across 6 LMICs.MethodCross-sectional, community-based data including adults aged 65 years and older from 6 LMICs were analyzed from the WHO Study on Global AGEing and adult health survey. The association between 11 individual chronic conditions or the number of chronic conditions (independent variable) and social participation (range 0–10 with higher scores indicating greater social participation; dependent variable) was assessed by multivariable linear regression analysis.Results14,585 individuals (mean age 72.6 [SD 11.5] years; 54.9% females) were included. Among individual conditions, hearing problems, visual impairment, and stroke were significantly associated with lower levels of social participation. Overall, an increasing number of chronic conditions was dose-dependently associated with lower levels of social participation (e.g., ≥4 vs 0 conditions: β = −0.26 [95% CI = −0.39, −0.13]). The association was more pronounced among males than females.DiscussionOlder people with multimorbidity had lower levels of social participation in LMICs. Future longitudinal studies are warranted to further investigate temporal associations, and whether addressing social participation can lead to better health outcomes among older people with multimorbidity in LMICs.

Depression and Elevated Inflammation Among Chinese Older Adults: Eight Years After the 2003 SARS Epidemic.

This study examined associations between exposure to the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic and Chinese older adults' depression and inflammation 8 years after the crisis. Further, this study investigated the buffering effects of perceived social support and social participation. Data were drawn from the 2011 China Health and Retirement Longitudinal Survey, including N = 4,341 Chinese adults aged 60 years and older. For the survey, local officials identified whether the 2003 SARS outbreak was one of the major disasters in the history of their communities. Depression was assessed by the Center for Epidemiological Studies-Depression scale and inflammation was measured by C-reactive protein (CRP) collected from participants via venous blood draws. Results from multilevel logistic regression models revealed that Chinese older adults living in communities exposed to SARS were more likely to have elevated CRP compared to those not living in such communities. Moreover, community SARS exposure was associated with greater risks of depression for Chinese older adults who had no perceived social support. Among Chinese older adults who had low levels of social participation, community SARS exposure was more strongly related to elevated CRP. Findings suggest community-level exposure to the SARS epidemic had enduring consequences for Chinese older adults' health. However, active social participation and supportive social ties provided important resources that may buffer against negative effects of exposure to the SARS epidemic.

A Mobile App to Optimize Social Participation for Individuals with Physical Disabilities: Content Validation and Usability Testing.

Background: Social participation is beneficial for individuals’ health. However, people with disabilities that may lead to mobility limitations tend to experience lower levels of social participation. Information and communication technologies such as the OnRoule mobile application (app) can help promote social participation. Objectives: To obtain potential users’ perceptions on the usability and content of the OnRoule app for providing information on accessibility, as well as its potential to optimize social participation. Materials and Methods: Cross-sectional user-centered design study. Individuals with physical disabilities (n = 18) were recruited through community organizations and interviewed using a semi-structured guide. Interviews were recorded, transcribed, and analyzed using thematic analysis. Results: Three main themes were identified: (1) “user-friendliness”; (2) “balance between the amount and relevance of information”; and (3) “potential use of the app”. Discussion and Conclusion: Findings from this study indicated that the app was easy to use, had pertinent information, and enabled a positive experience of finding information. However, several areas of improvement were identified, such as the clarity of specific elements, organization and amount of information, optimization of features, and inclusiveness. Apps such as OnRoule could optimize social participation by facilitating the process of finding resources in the community and building a sense of connectedness between users.

Young women living in Iran: gendered drivers influencing social participation and wellbeing

ABSTRACT This paper investigates the social participation and wellbeing outcomes of young Iranian women, using a concurrent mixed method. Findings demonstrated relatively low levels of structural and functional social support as well as low level of social participation at the community level, particularly local and national group participation compared with casual/informal group participation. The individuals who socialized more with friends, relatives, colleagues, neighbours, as well as those with higher civic participation, were more likely to report higher wellbeing, as measured through satisfaction with life, quality of life and healthier lifestyle behaviours. The most common themes regarding barriers to social participation included: lack of time, money, cultural and societal barriers such as low socialization/leisure opportunities/infrastructure in the neighbourhood, lack of community/civic groups, lack of the culture of volunteering/volunteer jobs and low level of trust in society. This study suggests that women are further united and focus on their internal power through challenging gender bias and creating a culture of transformational change; which, in turn, lends itself to positive well-being outcomes. Furthermore, studies are required among Iranian men, how they can advocate for women’s rights and reconstruction of the gendered systems for the interest of both genders.

MENTAL HEALTH AND WELL-BEING OF EMPTY-NESTERS: A CHINESE URBAN CASE STUDY

The research examined the mental health and well-being of a sample of empty-nesters in Jinan City, Shandong Province, China. An in-depth individual interview approach, with document analysis and participant observation, was performed on three types of interviewees (N = 33) recruited via purposive sampling. The empty-nesters faced many unique problems, especially a sense of being disjointed from the family, community and society. Influencing factors included Chinese traditional filial piety culture, lagging implementation of relevant policies and development of community aging services, as well as the loss of productive roles for the empty nesters. While this paper supports the argument that religious and related social activities play a role in facilitating the psychological adjustment of older people, it reveals a different finding from previous studies that highly educated empty nesters are likely to have lower levels of social participation and psychological fulfillment. Moreover, by employing the social-ecological systems theory for analysis, this study confirms the importance of the family interactions in the life of empty nesters, which contributed to the implication to relevant social policy and social work practice.

Barriers to leisure-time social participation and community integration among Syrian and Iraqi refugees

ABSTRACT One important, yet understudied aspect of refugees’ resettlement experience is social participation. How are new social relationships created and maintained during the transition to the United States? This exploratory study examines social participation among a sample of recently resettled refugees. Twenty face-to-face interviews were conducted with Iraqi and Syrian refugees in a Connecticut resettlement community. Primary social activities included attending small family gatherings and worship services. Several constraints emerged, including transition to American life, little leisure time (i.e., time scarcity), maintaining dual time schedules, and varying levels of social network connections as central barriers to more active social participation. Overall, findings indicate that having less unstructured, leisure time results in lower levels of social participation and fewer friendships. Within-group differences find that some participants report feeling more socially isolated, and generally less supported, compared to others (e.g., women and single men). This research suggests that a lack of leisure time and limited social networks may hinder or delay relationship formation and community building, and should be explored further.

Disability and social participation in Europe 2002-2016

Abstract Background Social participation is an important aspect of social inclusion and affects health, wellbeing, equality and citizenship. Informal participation is particularly important for the inclusion and wellbeing of disabled people who are a growing demographic across Europe and the world (GBD, 2017). Despite some disability rights progress such as the UNCPRD, increasing foodbank use may reflect rising prevalence of social exclusion and inequality for some disabled people. Methods Analysis of data from all countries that participated in the European Social Survey Rounds 1-8, using Stata16, assessed the extent of a relationship between informal social participation and disability (defined as being hampered by disability or ill-health in daily activities), and over time. Logistic regression was used including possible confounding variables e.g. country variation. Preliminary Findings In most years, the data showed a significant negative association between disability severity and social participation, after accounting for potential confounders. For example, in 2016 people who reported 'no' disability (OR 1.678, CI 1.102948 - 2.551828) were more likely to socialise and to have higher levels of participation than people disabled 'a lot' (OR 1.253, CI 1.097011 - 1.431516). The association fluctuated slightly over time but no clear trend was yet identifiable. Conclusions It is likely that the relationship observed reflects real inequality in social participation among disabled people, suggesting persisting significant barriers to inclusion for disabled people, which can negatively impact on people's wellbeing and broader health systems. Analysis accounted for some personal and socioeconomic barriers but not cultural or environmental barriers. Inclusion and accessibility issues become an even more acute concern (and opportunity) for policy and practice relating to equality and wellbeing when facing climate chaos: more barriers to inclusion and increased disability prevalence. Key messages Inequality indicated by lower levels of social participation of people with disabilities remains a significant concern considering personal and social costs of social isolation. Successful social inclusion improves lives of people and communities here and now and can assist in developing resilience to climate change.