Abstract and Introduction
Abstract
Introduction: A strong relationship exists between disability and poor health. This relationship could exist as a result of disabilities emerging from chronic conditions; conversely, people with disabilities may be at increased risk of developing chronic conditions. Studying health in relation to age of disability onset can illuminate the extent to which disability may be a risk factor for future poor health.
Methods: We used data from the 2006–2012 National Health Interview Survey and conducted weighted logistic regression analyses to compare chronic conditions in adults with lifelong disabilities (n = 2,619) and adults with no limitations (n = 122,395).
Results: After adjusting for sociodemographic differences, adults with lifelong disabilities had increased odds of having the following chronic conditions compared with adults with no limitations: coronary heart disease (adjusted odds ratio [AOR] = 2.92; 95% confidence interval [CI], 2.33–3.66) cancer (AOR = 1.61; 95% CI, 1.34–1.94), diabetes (AOR = 2.57; 95% CI, 2.10–3.15), obesity (AOR = 1.81; 95% CI, 1.63–2.01), and hypertension (AOR = 2.18; 95% CI, 1.94–2.45). Subpopulations of people with lifelong disabilities (ie, physical, mental, intellectual/developmental, and sensory) experienced similar increased odds for chronic conditions compared with people with no limitations.
Conclusion: Adults with lifelong disabilities were more likely to have chronic conditions than adults with no limitations, indicating that disability likely increases risk of developing poor health. This distinction is critical in understanding how to prevent health risks for people with disabilities. Health promotion efforts that target people living with a disability are needed.
Introduction
Healthy People 2020 calls for increasing inclusion of people with disabilities in US health promotion efforts. Data indicate that chronic conditions are prevalent among people with disabilities; however, research that elucidates temporal relationships between disability and health outcomes is limited. Considerable research has addressed disability as a consequence of chronic conditions. Only a few studies have examined health conditions developed after disability onset, and these have focused on people with mobility limitations, especially spinal cord injuries.
Whether disability is a result of or a risk factor for chronic conditions has implications for health promotion and disease prevention efforts. If disability is viewed primarily as resulting from chronic conditions, then health promotion logically concentrates on people without disabilities and emphasizes prevention and control of conditions that could lead to disability. If, however, people who have disabilities are at increased risk for developing chronic conditions, then these populations are indeed an important target for health promotion efforts, as indicated by Healthy People 2020.
National longitudinal data are lacking on chronic conditions that manifest after disability onset. However, some cross-sectional data allow investigation of temporal relationships between disability onset and health. For example, Jamoom and colleagues used data on age of disability onset in the Behavioral Risk Factor Surveillance System to compare the health status of people with developmentally acquired disabilities to that of those with disabilities acquired later in life. Similar approaches can be used with data from the National Health Interview Survey (NHIS), which includes questions about how long respondents have had various limitations. The purpose of this study was to use NHIS data to determine whether chronic conditions are more prevalent in people with lifelong disability compared with people without limitations.