Health-related quality of life and leisure-time participation in Chilean youth with disabilities: A cross-sectional study from the 2022 National Disability and Dependency Survey

Background Children with disabilities face marked inequities in well-being globally, yet population-based evidence on health-related quality of life (HRQoL) and leisure-time participation among Chilean youth is scarce in the Latin American context. This study aimed to estimate the association between disability severity and (i) HRQoL and (ii) leisure-time participation among children and adolescents in Chile. Methods A cross-sectional analysis was conducted using the survey-defined analytic subsample of 10-17-year-olds from ENDIDE-2022, a nationally representative Chilean disability survey (n = 2424). Disability severity was classified using the Model Disability Survey, HRQoL was assessed with KIDSCREEN-27, and leisure-time participation was assessed through reported engagement in activities/groups. Unweighted model-based linear and logistic regression models were fitted with adjustment for prespecified covariates. Results Compared with peers without disability, both mild-to-moderate and severe disability were inversely associated with all HRQoL domains, with the largest adjusted mean differences in psychological well-being (mild-to-moderate: β = −6.8, 95% CI: −8.4 to −5.2; severe: β = −6.1, 95% CI: −7.4 to −4.8). Disability was also associated with lower leisure-time participation, notably in play and conversation with friends (mild-to-moderate: OR = 0.46, 95% CI: 0.31-0.72; severe: OR = 0.37, 95% CI: 0.26-0.52). Conclusion In Chilean youth, disability severity was associated with lower HRQoL, especially psychological well-being, and reduced leisure-time social participation. These findings add country-level evidence from Latin America and support participation-oriented rehabilitation and inclusive community policies.