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Neurological Rehabilitation

Accessibility for Spinal Cord Injury Model System Sites in the United States

Saturday, October 25, 2025
8:00 AM - 9:30 AM MT
Location: Kiosk 8

    Poster Presenter(s)

  • Maria Lee, Other

    Medical Student
    State University of New York (SUNY) Downstate Health Sciences University
    Brooklyn, New York

    • Co-Author(s)

  • EH

    Elver Ho, MD

    Resident Physician
    SUNY Downstate College of Medicine
    Brooklyn, New York

  • WM

    Walter S. Mathis, MD

    Associate Professor
    Yale School of Medicine
    New Haven, Connecticut

  • SA

    Sanjeev Agarwal, MD

    Program Director
    SUNY Downstate Health Sciences University
    Brooklyn, New York

Disclosure(s):
Maria Lee, Other: No financial relationships to disclose
Sanjeev Agarwal, MD: No financial relationships to disclose
Background and/or Objectives: Examining inequities to Spinal Cord Injury Model System (SCIMS) sites is essential for improving outcomes, ensuring diverse representation, and advancing evidence-based care. This study explores how demographic and socioeconomic factors are related to travel time and identifies barriers to equitable access and research participation.

Design: Cross-sectional study calculating minimum travel times from each census block center to the nearest SCIMS site. Population-weighted mean travel times were computed for each census tract.

Setting : The lower 48 states and the District of Columbia, excluding Alaska and Hawaii.

Participants : 2021 American Community Survey 5-Year Estimates.

Interventions: N/A

Main Outcome Measures: Proportions of population by demographic and socioeconomic factors across travel intervals.

Results: 100% of 18 SCIMS sites were in urban areas. American Indian and Alaska Native individuals have the highest proportion facing travel times over 120 minutes (86.08%), followed by White (61.72%), Black (47.59%), Hispanic (44.51%), and Asian (31.61%). English-only speakers face the longest travel times (59.65%) compared to those who speak English very well (39.89%) and less than very well (36.23%). Lower-income groups, particularly those earning $15k-$19,999 (61.91%) and $20k-$24,999 (61.86%), experience the longest travel times, while those making $200k+ are most likely to have the shortest travel times (40.20%). Those not in the labor force experience the longest travel times (57.63%), followed by employed (53.68%) and unemployed individuals (51.25%). Public insurance holders are more likely to experience the longest travel times (55.55%) than those with private insurance (53.37%) or no insurance (53.87%). Households with no vehicles have the shortest travel times (15.24%), while those with three or more vehicles face the longest (59.02%).

Conclusions: Targeted policy interventions are needed to address geographic inequities in spinal cord injury care, as the urban concentration of SCIMS sites may disproportionately disadvantage marginalized populations.