Neighborhood Characteristics, Ambulation Ability, and Social Vulnerability of Individuals with Spina Bifida

OBJECTIVE: This study examined the characteristics of neighborhoods where people with Spina Bifida (SB) live, driving distances, and the relationship of those factors to ambulatory ability. DESIGN: Data from patients attending an adult and pediatric SB clinic in the National Spina Bifida Patient Registry were matched to the 2022 CDC/ATSDR Social Vulnerability Index using patient zip codes. A multinomial logistic regression was used to predict ambulation ability, and Spearman's Rho correlations were used to assess the relationship between driving distance to clinic, nearest physical therapist (PT), and neighborhood characteristics. RESULTS: Most patients reside in zip codes characterized by lower access to resources. The model correctly predicted ambulation ability, and functional level of lesion was the only significant predictor. All social vulnerability neighborhood characteristics were correlated with driving distance to the clinic and to the nearest PT. On average, patients drove about 60 miles to access SB care and lived about 6 miles from a PT. CONCLUSION: People with SB reside in areas with social vulnerability risk factors and travel long distances to receive care. Although mobility may depend on environmental context, functional level of lesion was the only predictor of ambulatory ability.