Health-related lifestyles and obesity among adults with and without disability in Australia: Implication for mental health care

Background: Numerous studies have reported people with disabilities are more likely to be obese and engaged in unhealthy lifestyles. Few studies explored the mechanism of health-related lifestyles and obesity among people with disabilities. Objective: We aimed to investigate health-related lifestyles and obesity in relation to disability among Australian adults. We further aimed to explore the potential mediating effect of psychological distress for disability in relation to health related lifestyles and obesity. Methods: Using the National Health Survey conducted in 2015 in Australia, we considered non-institutionalised adult participants (aged 18 + years old) as our study population (n = 11,598). Study outcomes included currently smoking, smoking daily, alcohol consumption, physical exercises, and obesity. We considered high psychological distress (Kessler 10 scores ≥ 22) a potential mediator for the disability-lifestyles and disability-obesity associations. Sample weights were calculated allowing for complex survey design. Adjusted Odds Ratios and 95% Confidence Intervals were evaluated using weighted Logistic regression models. Results: Compared to their disability-free counterparts, people with disabilities were more likely to be current smokers (aOR: 1.26, 95%CI: 1.08–1.47) and have obesity problems (1.44, 1.27–1.64), and were less likely to do physical exercises (0.67, 0.58–0.77), after controlling for socio-environmental factors. In the presence of high psychological distress, the disability-smoking association was no longer significant, and associations of disability-exercise (0.72, 0.62–0.84) and disability-obesity (1.38, 1.22–1.57) were influenced but remained significant. Conclusion: High psychological distress demonstrated important mediating effects. Tailored mental health care for people with disabilities might have the utility to reduce unhealthy behaviors.