Disability statistics for the states: The American Community Survey and the Behavioral Risk Factor Surveillance System

Different measures of disability result in varying estimates of prevalence, and assessing the comparability of measures from different datasets is essential. Two datasets can be used to calculate the prevalence of disability at the State level. The Census Bureau's American Community Survey (ACS) annually samples more than 500,000 households and uses a series of questions to identify distinct domains of disability. The Behavioral Risk Factor Surveillance System (BRFSS) is conducted by the CDC and state health departments and includes roughly 350,000 adults. The BRFSS includes two questions on activity limitations and use of assistive devices. In 2007, the average prevalence of disability for adults was 17.0% in the ACS and 20.0% in the BRFSS. Among the 50 States and the District of Columbia, adult disability prevalence in the ACS ranged from 13.5% in New Jersey to 26.7% in West Virginia and in the BRFSS ranged from 15.6% in North Dakota to 25.8% in West Virginia. The simple correlation coefficient between the two series was 0.76. Although the ranking of states in prevalence of disability was not identical, most states with relatively low or high rankings on one indicator were also low or high on the other. It appears that both the ACS and BRFSS disability indicators reflect the same underlying construct. The BRFSS can be used to examine health disparities among people with disabilities and the ACS can be used to study demographic and socioeconomic characteristics of the population with disabilities, including at the local level.