abstract: 'Background: Trends in the patterns and prevalence of chronic disability

  among U.S. residents carry important implications for public health and

  public policies across multiple societal sectors.

  Objectives: To examine trends in U.S. adult population rates of chronic

  disability from 1998 to 2011 using 7 different disability measures and

  examining the implications of trends in population age, race and

  ethnicity, and body mass index (BMI).

  Methods: We used National Health Interview Survey data on civilian,

  non-institutionalized U.S. residents ages >= 18 from selected years

  between 1998 and 2011. We used self-reported information on functional

  impairments, activity/participation limitations, and expected duration

  to create 7 chronic disability measures. We used direct standardization

  to account for changes in age, race/ethnicity, and BMI distributions

  over time. Multivariable logistic regression models identified

  associations of disability with sociodemographic characteristics.

  Results: Without adjustment, population rates of all 7 disabilities

  increased significantly (p < 0.0001) from 1998 to 2011. The absolute

  percentage change was greatest for movement difficulties: 19.3\% in 1998

  and 23.3\% in 2011. After separate adjustments for trends in age,

  race/ethnicity, and BMI distributions, 6 disability types continued to

  show increased rates over time (p < 0.01), except for sensory

  disabilities. Over time, poor education, poverty, and unemployment

  remained significantly associated with disability.

  Conclusions: If these trends continue, the numbers and proportions of

  U.S. residents with various disabilities will continue rising in coming

  years. In particular, the prevalence of movement difficulties and work

  limitations will increase. Furthermore, disability will remain strongly

  associated with low levels of education, employment, and income. (C)

  2014 Elsevier Inc. All rights reserved.'
affiliation: 'Iezzoni, LI (Corresponding Author), Massachusetts Gen Hosp, Mongan Inst
  Hlth Policy, 50 Staniford St,Room 901B, Boston, MA 02114 USA.

  Iezzoni, Lisa I., Massachusetts Gen Hosp, Mongan Inst Hlth Policy, Boston, MA 02114
  USA.

  Iezzoni, Lisa I., Harvard Univ, Sch Med, Dept Med, Boston, MA USA.

  Kurtz, Stephen G.; Rao, Sowmya R., Univ Massachusetts, Sch Med, Dept Quantitat Hlth
  Sci, Worcester, MA USA.

  Rao, Sowmya R., Bedford Veteran Affairs Med Ctr, CHOIR, Bedford, MA USA.'
author: Iezzoni, Lisa I. and Kurtz, Stephen G. and Rao, Sowmya R.
author-email: liezzoni@mgh.harvard.edu
author_list:
- family: Iezzoni
  given: Lisa I.
- family: Kurtz
  given: Stephen G.
- family: Rao
  given: Sowmya R.
da: '2023-09-28'
doi: 10.1016/j.dhjo.2014.05.007
eissn: 1876-7583
files: []
issn: 1936-6574
journal: DISABILITY AND HEALTH JOURNAL
keywords: 'Disability; Prevalence rates; Movement difficulties; National health

  interview survey'
keywords-plus: 'UNITED-STATES; OLDER AMERICANS; US POPULATION; HEALTH; OBESITY;

  DISPARITIES; LIMITATIONS; DECLINES; LIFE'
language: English
month: OCT
number: '4'
number-of-cited-references: '30'
pages: 402-412
papis_id: bcb7ee6b2991cf3919e140c2bbe97b7e
ref: Iezzoni2014trendsus
times-cited: '40'
title: Trends in U.S. adult chronic disability rates over time
type: article
unique-id: WOS:000342331500006
usage-count-last-180-days: '1'
usage-count-since-2013: '12'
volume: '7'
web-of-science-categories: 'Health Care Sciences \& Services; Health Policy \& Services;
  Public,

  Environmental \& Occupational Health; Rehabilitation'
year: '2014'