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County-Level Geographic Disparities in Disabilities Among US Adults, 2018
ORIGINAL RESEARCH — Volume 20 — May 11, 2023
PEER REVIEWED
This figure shows 6 US county maps of disability prevalence, one for each type of functional disability: hearing, vision, cognition, mobility, self-care, and independent living. Percentages for each disability ranged as follows: for hearing, 3.5% to 15.3%; for vision, 2.4% to 17.2%; for cognition, 6.2% to 29.4%; for mobility, 5.9% to 34.9%; for self-care, 1.9% to 12.7%; and for independent living, 3.6% to 19.8%. Counties in Alaska, Montana, Oklahoma, Arkansas, Kentucky and West Virginia had a higher prevalence of hearing disability. For other disability types, counties with a higher prevalence are in the South, along the southern Mississippi river, the Applachian Mountains, the US-Mexico border, in parts of New Mexico, Alabama, Georgia, and Florida, and along the Carolina coasts.
Figure 1.
County-level model-based estimates among adults aged ≥18 years by disability type, United States, 2018. Maps were classified into 5 classes by using Jenks natural breaks. Data sources: Behavioral Risk Factor Surveillance System 2018 (10), US Census Bureau (15,16).
The figure shows 6 US county maps, one for each functional disability: hearing, vision, cognition, mobility, self-care, and independent living. For single functional disabilities, clusters were similar for vision, cognition, mobility, self-care, and independent living, but the maps show large high–high cluster counties in New Mexico for vision and self-care and large high–high cluster counties along the southern Appalachian Mountains for cognition, mobility, and independent living. The cluster pattern for hearing differed from the other types of disability. Large high–high cluster counties for hearing were in Montana and Idaho; along the South Dakota–Nebraska border; in parts of Oklahoma, Arkansas, and Kansas; Kentucky and West Virginia; and parts of Alaska, Florida, and New Mexico.
Figure 2.
Cluster-outlier for model-based estimates among adults aged ≥18 years by functional disability type and county, United States, 2018. Data sources: Behavioral Risk Factor Surveillance System 2018 (10), US Census Bureau (15,16).
This figure presents 2 US county maps. Figure A shows a matrix of 6 rural–urban categories (large central metro, large fringe metro, medium metro, small metro, micropolitan, and noncore) and the percentage of any disability in each rural–urban category (with estimated prevalence classified into 4 groups: 12.9% to 25.6%, 25.7% to 29.6%, 29.7% to 34.3%, and 34.4% to 55.2%). A higher prevalence of any disability is found among counties in the southern states, along the Appalachian Mountains, along the Texas–Mexico border, in New Mexico, and in Arizona. Figure B shows the 5 categories of clusters and outliners: high–high cluster, high–low outlier, low–high outlier, low–low cluster, and not significant. For any disability, the high–high clusters included most counties in Mississippi, West Virginia, and Kentucky; all counties along the southern Mississippi River; most counties along the Texas–Mexico border; in portions of Alabama, Alaska, Arkansas, Florida, rural Georgia, Louisiana, Missouri, Oklahoma, and Tennessee; and some counties in North Carolina, South Carolina, Ohio, and Virginia. The map shows a large low–low cluster comprising counties in Colorado, Idaho, Utah, and Wyoming; a second large low–low cluster in North Dakota, eastern South Dakota, and Nebraska, most of Iowa, Illinois, and Wisconsin, and the southern half of Minnesota; and a third large low–low cluster in the 6 New England states (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) and the mid-Atlantic states (New Jersey and parts of New York, Pennsylvania, Maryland, and Virginia).
Figure 3.
Model-based estimates of any disability among adults aged ≥18 years by county, United States, 2018. A, Prevalence by urban–rural status, classified by quartiles. B, Prevalence by cluster-outlier analysis. Data sources: Behavioral Risk Factor Surveillance System 2018 (10), US Census Bureau (15,16).
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