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Do U.S. states' socioeconomic and policy contexts shape adult disability?

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  • Montez, Jennifer Karas
  • Hayward, Mark D.
  • Wolf, Douglas A.

Abstract

Growing disparities in adult mortality across U.S. states point to the importance of assessing disparities in other domains of health. Here, we estimate state-level differences in disability, and draw on the WHO socio-ecological framework to assess the role of ecological factors in explaining these differences. Our study is based on data from 5.5 million adults aged 25–94 years in the 2010–2014 waves of the American Community Survey. Disability is defined as difficulty with mobility, independent living, self-care, vision, hearing, or cognition. We first provide estimates of age-standardized and age-specific disability prevalence by state. We then estimate multilevel models to assess how states' socioeconomic and policy contexts shape the probability of having a disability. Age-standardized disability prevalence differs markedly by state, from 12.9% in North Dakota and Minnesota to 23.5% in West Virginia. Disability was lower in states with stronger economic output, more income equality, longer histories of tax credits for low-income workers, and higher cigarette taxes (for middle-age women), net of individuals' socio-demographic characteristics. States' socioeconomic and policy contexts appear particularly important for older adults. Findings underscore the importance of socio-ecological influences on disability.

Suggested Citation

  • Montez, Jennifer Karas & Hayward, Mark D. & Wolf, Douglas A., 2017. "Do U.S. states' socioeconomic and policy contexts shape adult disability?," Social Science & Medicine, Elsevier, vol. 178(C), pages 115-126.
    • Handle: RePEc:eee:socmed:v:178:y:2017:i:c:p:115-126
    DOI: 10.1016/j.socscimed.2017.02.012
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    1. Montez, Jennifer Karas & Zhang, Wencheng & Zajacova, Anna & Hamilton, Tod G., 2018. "Does college major matter for women's and men's health in midlife? Examining the horizontal dimensions of educational attainment," Social Science & Medicine, Elsevier, vol. 198(C), pages 130-138.
    2. Jason Fletcher & Hans G. Schwarz & Michal Engelman & Norman Johnson & Jahn Hakes & Alberto Palloni, 2022. "Understanding Geographic Disparities in Mortality," NBER Working Papers 30572, National Bureau of Economic Research, Inc.
    3. Nathan T. Dollar & Iliya Gutin & Elizabeth M. Lawrence & David B. Braudt & Samuel Fishman & Richard G. Rogers & Robert A. Hummer, 2020. "The persistent southern disadvantage in US early life mortality, 1965‒2014," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 42(11), pages 343-382.

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