Exploring disability as an antecedent to health status: National health interview survey 2008-2011

Background: Research has shown strong relationships between disability and poor health. Much of this association could be due to disabilities emerging from chronic conditions. Studying health in relation to disability onset can help illuminate the extent to which disability may be a risk factor for future poor health rather than the other way around. The purpose of this study is to utilize the National Health Interview Survey (NHIS) to examine chronic conditions among non-institutionalized US adults with and without lifelong disability (LLD). Methods: Although the NHIS is cross-sectional, it contains duration of limitation information. Using 2008-2011 NHIS data, weighted logistic regression analyses were conducted to describe chronic conditions (i.e., coronary heart disease, cancer, diabetes, and obesity) in adults with (LLD)(n=1,460) compared to persons with no limitations(ND)(n=69,155). Results: Adults with LLD were more likely to have coronary heart disease compared to adults with ND after adjusting for sociodemographics (adjusted odds ratio (AOR) 4.36, 95% CI 3.29, 5.78). Adults with LLD were also more likely to have cancer, diabetes, and obesity compared to adults with ND after adjusting for sociodemographics (cancer AOR 1.49, 95% CI 1.13, 1.95; diabetes AOR 3.51, 95% CI 2.86, 4.31; obesity AOR 2.82, 95% CI 2.46, 3.23). Conclusion: Adults with LLD were more likely to have chronic conditions compared to ND, indicating that disability likely increases risk of developing poor health rather than solely being a result of poor health. Further research should investigate the reciprocal relationship of disability and health utilizing longitudinal data.