Expert Commentary

Disability among working-age adults: A close look at the states

In some states, 20 to 30 percent of working-age adults have a physical, emotional or cognitive disability, according to a new study that looks at disability prevalence in each state.

Disabled in America

In some states, 20 to 30 percent of working-age adults have a physical, emotional or cognitive disability, according to a new study that looks at disability rates among age groups by state.

The issue: When an adult becomes disabled, it can be hard to hold down a job and pay the bills. Some individuals have been so impaired by a physical, mental or emotional condition they have never been able to support themselves financially. Across the United States, almost 23 million working-age adults have some type of disability, according to researchers at the U.S. Centers for Disease Control and Prevention.

Disability and poverty are often linked. Disabled adults are less likely to be employed and typically work jobs with lower pay than adults with no disability. Meanwhile, research suggests an association between poverty and intellectual disabilities in children. The poor generally are at a greater risk of becoming injured or disabled.

To provide financial support, federal and state governments offer programs serving disabled people of all ages. In 2015, the U.S. government spent $143 billion to help nearly 9 million disabled workers and about 2 million of their family members through the Social Security Disability Insurance (SSDI) program. A 2016 report from the U.S. Social Security Administration shows that another $54.8 billion was distributed in 2015 as cash payments through a second federal program, the Supplemental Security Income (SSI) program, which targets low-income people who are disabled or elderly. The majority of SSI payments, however, go to disabled adults.

An academic study worth reading: “Do U.S. States’ Socioeconomic and Policy Contexts Shape Adult Disability?,” published in Social Science & Medicine, 2017.

Study summary: Three scholars from Syracuse University and the University of Texas at Austin examined the prevalence of adult disability across the U.S. and the characteristics of disabled people in each state. They also looked at state policies and other factors, including the local economy, to gauge their impact on the number of disabled people living in each state. The authors analyzed a nationally-representative sample of more than 5.5 million adults who participated in the American Community Survey (ACS), an ongoing survey by the U.S. Census Bureau, between 2010 and 2014. The study focuses on adults aged 25 to 94.

For the purposes of this study, individuals were considered to be disabled if they responded affirmatively to at least one survey question about difficulties hearing, seeing, getting around, performing certain tasks, concentrating, remembering or making decisions.

To examine the prevalence of adult disability, the authors estimated the age-standardized disability prevalence (ASDP) for each state. The ASDP is calculated based on disability rates for different age groups in each state, the number of people nationwide in each age group and the total U.S. population aged 25 to 94. Using the ASDP allows for a more accurate comparison of disability rates across states.

Among the key findings:

  • There are large differences in disability prevalence among states. Prevalence among U.S-born residents ranges from about 13 percent in North Dakota, Minnesota and Hawaii to 22 percent or more in Kentucky, Mississippi and West Virginia. The national average is 16.6 percent.
  • The authors studied individuals who live in the same state where they were born and found substantial differences among age groups across the states. For example, in North Dakota, 4.1 percent of people aged 25  to 34 who were born in that state are disabled, while in West Virginia, 10.5 percent of people aged 25 to 34 who were born in that state are disabled. In Minnesota, 14.6 percent of people aged 55 to 64 who were born in that state are disabled. The proportion is more than twice that (31 percent) in West Virginia.
  • “Younger adults in the ‘unhealthiest’ states experience levels of disability similar to adults a decade or two older in the ‘healthiest’ states.”
  • The patterns are similar for men and women.
  • The states with the largest prevalence of residents with hearing disabilities are Alaska (10.2 percent), West Virginia (7.4 percent) and New Mexico (7.3 percent). New Jersey had the smallest prevalence with hearing disabilities (3.7 percent).
  • The states with the largest prevalence  of residents with vision-related disabilities are Alaska (6.3 percent), New Mexico (5.3 percent) and Mississippi (5.0 percent). Minnesota had the smallest prevalence of residents with vision-related disabilities (1.7 percent).
  • The states with the largest prevalence  of residents with cognitive disabilities are Mississippi (9.0 percent), West Virginia (8.9 percent) and Kentucky (8.7 percent). North Dakota had the smallest prevalence of residents with cognitive disabilities (4.1 percent).
  • Living in a state that has a long history of offering an Earned Income Tax Credit (EITC) seems to reduce the odds of disability later in life.
  • Higher tobacco taxes are linked to lower odds of disability for middle-age women.
  • “Living in a state with a strong economic output (measured by GSPPC [gross state product per capita]) and a population that shares more equally in those fortunes seems to be particularly salubrious.”

Other resources for journalists:

  • The U.S. Social Security Administration’s website provides a variety of information on disabled Americans and disability benefits. In February 2017, disabled workers received a monthly benefit averaging $1,171.
  • The Americans with Disabilities Act is a civil rights law enacted in 1990 that prohibits discrimination against disabled people.
  • A 2016 report from the U.S. Centers for Disease Control and Prevention suggests the most common disabilities among working-age adults are related to mobility (51 percent) and cognition (38 percent).
  • The U.S. Census Bureau provides detailed data on household income and employment status.

Related research:

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