Trends in U.S. adult chronic disability rates over time |
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| Institution: | 1. Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, USA;2. Department of Medicine, Harvard Medical School, Boston, USA;3. Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA;4. Center for Healthcare Organization and Implementation Research (CHOIR), Bedford Veteran Affairs Medical Center, Bedford, MA, USA;1. Oregon State University Corvallis, College of Public Health and Human Sciences, 255 Hallie Ford Center, Corvallis, OR 97330, USA;2. Disability and Health Policy Division, Center for Development & Disability, University of New Mexico, 2300 Menaul Boulevard NE, Albuquerque, NM 87107, USA;3. Administration for Community Living, US Department for Health and Human Services, One Massachusetts Avenue NW, Washington, DC 20001, USA;1. Institute for Social Research, University of Michigan, 426 Thompson Street, Room 3330 ISR, Ann Arbor, MI 48104, USA;2. Indiana University-Purdue University Indianapolis, USA;1. Oregon Health & Science University, Portland, OR, USA;2. Pacific University, Forest Grove, OR, USA;3. Oregon Evidence-based Practice Center, Scientific Resource Center, AHRQ Effective Health Care Program, USA;1. Institute on Development & Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239, USA;2. Center for Disabilities Studies, College of Education and Human Development, University of Delaware, 461 Wyoming Road, Newark, DE 19716, USA;3. Dr. Lee was formerly affiliated with the Rehabilitation Medicine Department, Clinical Research Center, National Institutes of Health, USA |
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| Abstract: | BackgroundTrends in the patterns and prevalence of chronic disability among U.S. residents carry important implications for public health and public policies across multiple societal sectors.ObjectivesTo examine trends in U.S. adult population rates of chronic disability from 1998 to 2011 using 7 different disability measures and examining the implications of trends in population age, race and ethnicity, and body mass index (BMI).MethodsWe used National Health Interview Survey data on civilian, non-institutionalized U.S. residents ages ≥18 from selected years between 1998 and 2011. We used self-reported information on functional impairments, activity/participation limitations, and expected duration to create 7 chronic disability measures. We used direct standardization to account for changes in age, race/ethnicity, and BMI distributions over time. Multivariable logistic regression models identified associations of disability with sociodemographic characteristics.ResultsWithout adjustment, population rates of all 7 disabilities increased significantly (p < 0.0001) from 1998 to 2011. The absolute percentage change was greatest for movement difficulties: 19.3% in 1998 and 23.3% in 2011. After separate adjustments for trends in age, race/ethnicity, and BMI distributions, 6 disability types continued to show increased rates over time (p < 0.01), except for sensory disabilities. Over time, poor education, poverty, and unemployment remained significantly associated with disability.ConclusionsIf these trends continue, the numbers and proportions of U.S. residents with various disabilities will continue rising in coming years. In particular, the prevalence of movement difficulties and work limitations will increase. Furthermore, disability will remain strongly associated with low levels of education, employment, and income. |
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| Keywords: | Disability Prevalence rates Movement difficulties National health interview survey |
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