Introduction
In the U.S., disability affects approximately 61.4 million (25.7%) adults, with mobility
disability being the most prevalent type, affecting about 1 in 7 U.S. adults. However,
little is known about the prevalence of disability and functional disability types
by urbanization level.
Methods
Data from the 2016 Behavioral Risk Factor Surveillance System were analyzed. The prevalences
of disability, overall and by functional disability type, were estimated among U.S.
adults across 6 levels of urban–rural county categories based on the 2013 National
Center for Health Statistics Urban–Rural Classification Scheme for Counties. Adjusted
prevalence ratios with 95% CIs were estimated by conducting log-linear regression
analyses with robust variance estimator while adjusting for study covariates. Data
analyses were conducted in 2018.
Results
The prevalences of having any disability, functional disability type, or multiple
disabilities were lowest in large metropolitan centers and fringe metropolitan counties
and highest in noncore (rural) counties. After controlling for age, sex, race/ethnicity,
education, and federal poverty level, adults living in noncore counties were 9% more
likely to report having any disability, 24% more likely to report having 3 or more
disabilities, and 7% (cognition) to 35% (hearing) more likely to report specific disability
types than the adults living in large metropolitan centers.
Conclusions
Results of this study suggest that significant disparities in the prevalence of disability
exist by level of urbanization, with rural U.S. residents having the highest prevalence
of disability. Public health interventions to reduce health disparities could include
people with disabilities, particularly in rural counties.
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