Impact of disability and chronic conditions on health

Abstract

Background: Today one in five Americans have a disability and nearly half of Americans experiences a chronic condition. Whether disability results from or is a risk factor for chronic conditions, the combined effects of disability and chronic conditions warrants further investigation.

Objectives: Examine the added impact of chronic conditions among those with and without disability on self-reported health status and behaviors.

Methods: 2009 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed to examine the association of disability with unhealthy behaviors and poor health stratified by number of self-reported chronic conditions (0, 1, or 2+). Linear and logistic regression models accounting for the complex survey weights were used.

Results: Participants with disability were 6 times more likely to report fair/poor self-rated health, reported 9 more unhealthy days in a month and 6 more days in a month when poor health kept them from usual activities, were 4 times more likely to be dissatisfied with life, had greater odds of being a current smoker, and were less likely to be physically active. Presence of chronic conditions in addition to disability was associated, in a dose-response manner, with poor health status and unhealthy behaviors.

Conclusions: People living with both chronic diseases and disability are at substantially increased risks for poor health status and unhealthy behaviors, further affecting effective management of their chronic conditions. Multi-level interventions in primary care and in the community that address social and environmental barriers that hinder adults with disability from adopting more healthy lifestyles and improving health are needed.

Keywords: Disability; Health behaviors; Health status.