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© 1992 Oxford University Press

research-article

Disadvantage as a Measure of Handicap: A Paired Sibling Study of Disabled Adults in Lebanon

K H SHAAR and M MCCARTHY

Department of Community Medicine, University College and Middlesex School of Medicine, University of London London WC1E 6EA, UK

Shaar K H (Department of Community Medicine, University College and Middlesex School of Medicine, University of London, London WC1E 6EA, UK) and McCarthy M. Disadvantage as a measure of handicap: a paired sibling study of disabled adults in Lebanon. International Journal of Epidemiology 1992; 21: 101–107.

In 1980 WHO defined disability as a functional limitation due to impairment, and handicap as the psychosocial disadvantage consequent to disability. This study was designed to investigate the advent of handicap in a group of adults physically disabled by poliomyelitis in childhood by companng them to their age arid sex-matched siblings. An area survey was conducted in West Beirut and its Southern Suburb and 240 such disabled people and their siblings were identified and interviewed. Handicap was defined as disadvantage in six areas, namely, education, work, income, marital status, housing, and mental well-being. The differences between each disabled person and his/her sex-matched sibling were assessed. Significant differences were noted in employment (Odds ratio (OR) = 4.20, confidence interval (CI): 1.38–15.26), social class (OR=2.67, CI: 1.11–6.79), income (OR=2.88, CI: 5.57–113.3) and marital status for both the disabled people compared with their elder siblings (OR =20.00, CI: 5.57–113.30) and for those disabled compared with their younger siblings (OR = 4.60, CI: 1.53–16.55). Multivariate analyses of the explanatory factors for each of these six areas of disadvantage among the disabled group showed that educational discrepancies cut across social class differences (OR= 1.90, CI:1.00–3.61), income differences (OR= 1.44, CI:0.97–2.14), and symptoms of depression (OR =2.33, CI: 1.42–3.84). Mantel-status disadvantage was related to lower income groups and disabled women (OR = 1.66, CI: 1.10–2.49; OR = 1.60, CI: 1.07–2.39). Disadvantage in housing was related to disad vantage in social class, mantal status, and income (OR =3.75, CI: 1.28–10.98; OR =2.21, CI: 1.39–3.50). Results of this study indicate that disadvantage may occur due to physical disability and one disadvantage may lead to another.

Received 1 June 1991


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