Prevalence of Behavioral Health Problems Among Adults With and Without Communication Disabilities

J Am Board Fam Med. 2020 Nov-Dec;33(6):932-941. doi: 10.3122/jabfm.2020.06.200216.


Background: Adults with communication disabilities (CDs) experience poor health and health care outcomes. Few studies have examined behavioral health outcomes among this population. We compare the behavioral health of adults with CDs to their peers without such disabilities.

Methods: Retrospective cohort study examining the 2012 National Health Interview Survey Voice, Speech, and Language Supplement. We compared adults (> 17 years old) with voice only (n = 2169), speech/language (SL) only (n = 730), and speech/language and voice (SLV; n = 450) disabilities to adults without CDs (n = 29,873). Outcomes include behavioral health diagnoses (eg, depression), substance misuse (eg, excessive alcohol or tobacco use), experiences (eg, nonspecific psychological distress), and health care utilization. Unadjusted Pearson's χ2 and adjusted logistic regression analyses controlling for sociodemographic, health, and other disability measures were conducted.

Results: Adults with CDs more frequently reported diagnoses (7.1% to 35.9% vs 1.8% to 8.6%), substance misuse (SL only: 15.5% vs 5.5%), and nonspecific psychological distress (SL only: 14.7%; SLV: 22.3% vs 2.3%) compared with adults without CDs (all P < .001). These findings were consistent for all outcomes and in multivariate analyses. Odds ratios ranged from 1.4 (99.7% CI, 1.1-1.7) to 5.0 (99.7% CI, 3.6-6.8). Adults with CDs more frequently endorsed visiting mental health professionals compared with adults without CDs (voice only: 11.4%; SL only: 19.1%; SLV: 23.1%; vs 6.8%, all P < .001), but these differences became nonsignificant in multivariate analyses.

Conclusions: Adults with CDs experience poorer behavioral health and health care outcomes compared with persons without CDs. Barriers to identification and treatment related to CDs must be addressed for persons with CDs.

Keywords: Communication Disorders; Logistic Models; Mental Health; Multivariate Analysis; Outcomes Assessment; Psychological Distress; Retrospective Studies; Speech; Substance-Related Disorders; Surveys and Questionnaires.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Communication Disorders*
  • Disabled Persons*
  • Humans
  • Patient Acceptance of Health Care
  • Prevalence
  • Retrospective Studies