Using Population-based Data to Examine Health Care Access and Health Status, by Disability Type

Background

Studies analyzing health disparities experienced by people with disabilities compared to those without disabilities have typically operationalized disability as a single population or examined one or two disability subpopulations.  Additionally, few studies have examined the effect of multiple disabilities on health disparities.

Methods

Using pooled MEPS data (2004–2010), we examined health care access (delayed/not received care, usual source of care, and having health insurance) and health status (self-reported health and mental health status, and multiple chronic conditions) among five disability types (physical, cognitive, visual, hearing, and multiple) and the non-disabled population.  We conducted logistic regression analyses for the entire population and separately for each disability type, adjusting for sociodemographic factors related to access to care and health status.

Results

Insurance status and multiple chronic conditions (MCC) were strongly associated with access to care across all disability types; MCC was associated with health status for all disability types.  In addition, having more than one disability of any type affected access and health status outcomes. 

Conclusion

This study expands earlier analyses by examining associations within and between categories of disabilities, and compared to the general population.  Notably, despite the majority of members of each group having a usual source of care and health insurance, all disability groups were significantly more likely than the no disability group to report having delayed or not receiving necessary health care.  People with multiple disabilities were four times more likely than those with no disability to have delayed or not received necessary care.