Are persons with physical disabilities who participate in society healthier and happier? Structural equation modelling of objective participation and subjective well-being

Abstract

In many countries, governments pursue a policy of offering persons with disabilities greater opportunities for participation in society, based on the assumption that this will also improve their subjective well-being. Currently, however, it is not known whether this assumption is valid. In this study we relate the objective participation and the subjective well-being aspects of both disabled and non-disabled persons to an array of social and health-related determinants. Linear structural equation modelling of data of a sample selection of the Dutch population is analysed. The sample size is 5,826, including 642 respondents with physical disabilities. In terms of objective participation, the persons with disabilities are at a greater disadvantage as regards labour participation than is the case for social and cultural participation. When it comes to subjective well-being, we find that the persons with disabilities are more likely to lag behind in perceived physical health than in mental health and happiness. In a multivariate model relating objective participation to subjective health and happiness, correlations are much weaker than expected. It is striking to find that participation, perceived health and happiness are much less closely related than is often assumed. Their determinants differ widely in nature and strength. The empirical model leads to rejection of the hypothesis that higher participation by the persons with disabilities is associated with higher subjective well-being.

Fig. 1

First model of quality of life. Note: The fit and the explained variance of the model are shown in Table 2

Fig. 2

Perceived physical and mental health and happiness in the Dutch non-institutionalized population of 12 years and older with regard to the level of physical limitation, 2001 (scale values). Source: Statistics Netherlands (POLS’01), SCP processing Note: The scales are standardised to the Dutch population with a mean of zero and a standard deviation of 10 points. The indicators (on the left) are based on the corrected Physical Component Summary and the regular Mental Component Summary scores of the Short Form 12 [6]

Fig. 3

Second model of quality of life. Notes: (1) The fit and the explained variance of the model are shown in Table 3. (2) The standardized path coefficients of the straight lines are shown in Tables 4 and 6, the standardized correlation coefficients of the curved lines in Tables 5 and 7. (3) Error terms are indicated with the circles with an ‘e’