Purpose: Determine the association between incremental increases in the number of social risk factors and the prevalence of any disability and disability type.
Design: The cross-sectional analysis was conducted using 2017 Behavioral Risk Factor Surveillance System data from states whose surveys included items about social risk factors.
Setting: Respondents from 17 US states.
Subjects: Respondents included 136 432 adults.
Measures: Dichotomized social risk factors included food, housing, and financial insecurity, unsafe neighborhood, and healthcare access hardship.
Analysis: Weighted χ2 and logistic regression analyses adjusted for demographic characteristics, measures of socioeconomic position, and comorbid health conditions were used to examine differences in the prevalence of disability by social risk factor and via a social risk index created by summing the social risk factors.
Results: Compared to those reporting 0 social risk factors, respondents reporting ≥4 had more than thrice the odds of reporting a cognition ((adjusted odds ratio [AOR]=3.37; 95%CI [2.75-4.13]), independent living (AOR=3.24 [2.52-4.15]), self-care (AOR=3.33 [2.55-4.34]), or any disability (AOR=3.90 [3.24-4.70]); more than twice the odds of reporting a vision (AOR=2.61 [1.93-3.52]) or mobility (AOR=2.72 [2.16-3.41]) disability; and more than 1.5 times the odds of reporting a hearing disability (AOR=1.59 [1.22-2.07]).
Conclusions: Incremental increases in the number of social risk factors were independently associated with higher odds of disability. Intervention efforts should address the social context of US adults with disabilities to improve health outcomes.
Keywords: PURPOSE; health equity; health status disparities; healthcare disparities; outcomes; social determinants of health; social risk factors.