Disability: An Important Population to Consider for Achieving Health Goals

BACKGROUND:  Disabilities affect approximately 1 in 5 adults in the United States -- cutting across the boundaries of age, race, sex, and socioeconomic status. While the concept of health should be the same for adults with and without disabilities, those with disabilities often report poorer health status than those without. Recent studies have highlighted disparities in current smoking, physical inactivity, and hypertension between adults with disabilities and those without disabilities. Healthy People (HP) 2020 objectives in these areas are to reduce cigarette smoking by adults, reduce the proportion of adults who engage in no leisure-time physical activity, and reduce the proportion of adults with hypertension. Our objective is to compare estimates of these selected health measures among adults with disabilities to HP 2020 targets in those areas.

METHODS:  We used state-level data from the 2013 Behavioral Risk Factor Surveillance System (n = 491,773) to calculate age-adjusted prevalence and 95% confidence intervals (CI) of current smoking, physical inactivity, and hypertension for adults 18 years of age or older overall and stratified by disability status. We compared these estimates to HP 2020 national targets.

RESULTS:  Overall, 18.5% (95% CI: 18.2, 18.7) of adults reported current smoking, 28.9% (28.6, 29.2) reported physical inactivity, and 30.6% (30.3, 30.8) reported hypertension.  This compares to HP 2020 goals of 12.0%, 32.6%, and 26.9%, respectively.  Stratified by disability status, prevalence estimates for adults with disabilities and adults without disabilities were 31.2% (30.5, 31.8) vs. 15.4% (15.1, 15.6) for current smoking, 43.0% (42.3, 43.8) vs. 24.3% (24.0, 24.6) for physical inactivity, and 42.9% (42.3, 43.5) vs. 26.8% (26.6, 27.1) for hypertension.

CONCLUSIONS: For adults overall, only the HP 2020 target for physical inactivity was achieved; those for current smoking and hypertension were nearing achievement.  However, when further stratified by disability status, adults with disabilities were far from reaching these goals. For adults with disabilities, none of these targets have been achieved; however, for adults without disabilities, the targets have been achieved for both physical inactivity and hypertension. These findings highlight for state public health professionals the importance of considering disability as a demographic group as they monitor their state’s progress toward achieving HP 2020 goals. Including adults with disabilities in efforts aimed at reducing cigarette smoking, physical inactivity, and hypertension may aid in reaching targets set by HP 2020 for adults overall.