Does Type of Disability Matter to Public Health Policy and Practice?

Abstract

Background: Surveillance has been insufficient to inform and evaluate public health practices for people with disabilities. No studies have investigated whether there is statistical justification for subdividing the large, heterogeneous group of people with disabilities into subpopulations, for surveillance. Methods: Pooled data from the Medical Expenditures Panel Survey (2004-2010, unweighted n=132,198) included the following disability types: physical, cognitive, visual, hearing loss, and multiple disabilities. We examined differences among the disability subgroups and the no disability group on receipt of flu shot, dental exam, and timely care; insurance status; usual source of care (USOC); mental and physical health; and multiple chronic conditions (MCC). Results: The disability subgroups were sociodemographically heterogeneous and differed from each other and the no disability group on health status (mental, physical, and MCC) and healthcare outcomes (flu shot, dental exam, timely receipt of care, USOC, insurance status). Conclusion: Findings demonstrate that disability subgroups differ in the magnitude of the disparities they experience compared to each other and to people without disabilities. Disability subgroups should be examined separately for public health measures to enable effective tailoring of public health policies and programs to better meet the needs for all people.