abstract: 'Background Social relationships are powerful determinants of health and

  inequalities in social relationships across socioeconomic status (SES)

  groups may contribute to social inequalities in health. This study

  investigates inequalities in social relationships in an international

  sample of persons with spinal cord injury and explores whether social

  gradients in relationships are moderated by the countries'' socioeconomic

  development (SED). Methods Data from 12,330 participants of the

  International SCI Community Survey (InSCI) performed in 22 countries

  were used. We regressed social relationships (belongingness,

  relationship satisfaction, social interactions) on individual SES

  (education, income, employment, financial hardship, subjective status)

  and countries'' SED (Human Development Index) using multi-level models

  (main effects). To test potential moderation of the SED, interaction

  terms between individual SES and countries'' SED were entered into

  multi-level models. Results Paid work, absence of financial hardship and

  higher subjective status were related to higher belongingness (OR, 95\%

  CI: 1.50, 1.34-1.67; 1.76, 1.53-2.03; 1.16, 1.12-1.19, respectively),

  higher relationship satisfaction (OR, 95\% CI: 1.28, 1.15-1.42; 1.97,

  1.72-2.27; 1.20, 1.17-1.24, respectively) and fewer problems with social

  interactions (Coeff, 95\% CI: 0.96, 0.82-1.10; 1.93, 1.74-2.12; 0.26,

  0.22-0.29, respectively), whereas associations with education and income

  were less consistent. Main effects for countries'' SED showed that

  persons from lower SED countries reported somewhat higher relationship

  satisfaction (OR, 95\% CI: 0.97, 0.94-0.99) and less problems with

  social interactions (Coeff, 95\% CI: -0.04, -0.09- -0.003). Results from

  moderation analysis revealed that having paid work was more important

  for relationships in lower SED countries, while education and subjective

  status were more important for relationships in higher SED countries

  (interaction terms p<0.05). Conclusion Social relationships in persons

  with spinal cord injury are patterned according to individual SES and

  the countries'' SED and larger socioeconomic structures partly moderate

  associations between individual SES and social relationships.'
affiliation: 'Fekete, C (Corresponding Author), Swiss Parapleg Res, Nottwil, Switzerland.

  Fekete, C (Corresponding Author), Univ Lucerne, Dept Hlth Sci \& Med, Luzern, Switzerland.

  Fekete, Christine; Reinhardt, Jan D.; Gross-Hemmi, Mirja; Tough, Hannah, Swiss Parapleg
  Res, Nottwil, Switzerland.

  Fekete, Christine; Reinhardt, Jan D.; Tough, Hannah, Univ Lucerne, Dept Hlth Sci
  \& Med, Luzern, Switzerland.

  Reinhardt, Jan D., Sichuan Univ, Inst Disaster Management \& Reconstruct Sichuan
  Un, Chengdu, Peoples R China.

  Arora, Mohit, Royal North Shore Hosp, John Walsh Ctr Rehabil Res, Kolling Inst Med
  Res, St Leonards, NSW, Australia.

  Arora, Mohit, Univ Sydney, Fac Med \& Hlth, Sydney Med Sch Northern, Sydney, NSW,
  Australia.

  Engkasan, Julia Patrick, Univ Malaya, Dept Rehabil Med, Kuala Lumpur, Malaysia.

  Kyriakides, Athanasios, Univ Patras, Spinal Cord Injuries Unit, Patras, Greece.

  Le Fort, Marc, Univ Hosp, Neurol Phys \& Rehabil Med Dept, Nantes, France.'
article-number: e0255448
author: Fekete, Christine and Reinhardt, Jan D. and Arora, Mohit and Engkasan, Julia
  Patrick and Gross-Hemmi, Mirja and Kyriakides, Athanasios and Le Fort, Marc and
  Tough, Hannah
author-email: christine.fekete@paraplegie.ch
author_list:
- family: Fekete
  given: Christine
- family: Reinhardt
  given: Jan D.
- family: Arora
  given: Mohit
- family: Engkasan
  given: Julia Patrick
- family: Gross-Hemmi
  given: Mirja
- family: Kyriakides
  given: Athanasios
- family: Le Fort
  given: Marc
- family: Tough
  given: Hannah
da: '2023-09-28'
doi: 10.1371/journal.pone.0255448
files: []
issn: 1932-6203
journal: PLOS ONE
keywords-plus: 'ENVIRONMENTAL BARRIERS; PSYCHOLOGICAL DISTRESS; HEALTH INEQUALITIES;

  OLDER-PEOPLE; LONELINESS; SUPPORT; PARTICIPATION; INDIVIDUALS; TRENDS;

  RISK'
language: English
number: '8'
number-of-cited-references: '67'
orcid-numbers: 'Arora, Mohit/0000-0003-1024-3682

  Engkasan, Julia Patrick/0000-0003-0599-4908

  Kyriakides, Athanasios/0000-0002-4906-6874

  Le Fort, Marc/0000-0002-6360-2004'
papis_id: 2da59effb1ceeb873989f3bc1057e6d8
ref: Fekete2021socioeconomicstatus
researcherid-numbers: 'Arora, Mohit/D-3373-2015

  Engkasan, Julia Patrick/M-5547-2018

  '
times-cited: '4'
title: 'Socioeconomic status and social relationships in persons with spinal cord
  injury from 22 countries: Does the countries'' socioeconomic development moderate
  associations?'
type: Article
unique-id: WOS:000684737400038
usage-count-last-180-days: '2'
usage-count-since-2013: '4'
volume: '16'
web-of-science-categories: Multidisciplinary Sciences
year: '2021'