Key Findings: Disability Status, Mortality, and Leading Causes of Death in the United States Community Population

Adults with Any Disability Have Different Leading Causes of Death than Adults without a Disability

CDC researchers have published an article in the journal Medical Care that examines the relationship between disability and death using data from a nationally representative survey of U.S. adults, ages 18 and older, living in communities. They studied the relationship between having any type of disability and death, as well as by disability type (sensory, mental or substance use disorders, cognitive, movement, and employment disability) during an 11-12 year follow-up period. Researchers looked at all causes of death, as well as specific causes (heart disease; cancer; chronic lower respiratory diseases, such as bronchitis; cerebrovascular diseases, such as stroke; unintentional accidents; and suicides/assaults). They found that adults with disabilities were more likely to die during the follow-up period than adults without disabilities, and that adults with any disability were more likely to die of heart disease, cancer, cerebrovascular diseases, chronic lower respiratory diseases, unintentional accidents, and suicide or assaults than those without any disability. This is important information for public health officials, as it shows that people with disabilities have an increased risk of premature death.

You can read the abstract of the article here.

Main Findings

• Adults with any disability were more likely to die of any cause during the study follow-up period than adults without any disability.
• When examining the populations of adults with disabilities and adults without disabilities separately, the leading cause of death for adults with disabilities during the follow-up period was heart disease, while the leading cause of death among adults without disabilities was cancer.
• Adults with some of the specific types of disabilities were more likely to die from certain causes, than adults without any disability.
  • In terms of disability type, adults with movement disabilities were more likely to die from any cause, followed next by adults with mental or substance use disorders, and then adults with sensory disabilities.
• Adults with multiple disabilities were most likely to die from any cause during the follow-up period, followed by adults with a single disability, then those with no disability.
• The relationship between having a disability and premature death appeared to be more common among the working-age population, ages 18-64 years.

Leading Causes of Death in Adults with and without Disabilities in the United States

Text Version

Implications

• Improvements in the availability of and access to preventive services, and inclusion in public health interventions are needed to potentially reduce the differences in risk of death between adults with and without disabilities.
• The overall results suggest that adults with disabilities might have more health risks or unmet health care needs compared to adults without disabilities.
  • Factors potentially contributing to these increased health risks or unmet health care needs among adults with disabilities include:
    • Behavioral health risks (such as physical inactivity or smoking)
    • Secondary conditions (such as bladder or kidney infections)
    • Not receiving preventive services (such as mammograms)
    • Lower quality of care
  • Interventions that address these factors are needed to effectively address the needs of people with disabilities and reduce their risk of premature death.
• Understanding the differences in the risk of death in relation to the type of disability is necessary because different groups may need tailored interventions to reduce their risk of premature death.

What is known about disability and death, and what does the study add?

• In 2010, 56.7 million people (18.7% of the community-dwelling population) had some level of disability, and 38.3 million (12.6% of the same population) had a severe disability.¹
• Most studies examining the link between disability and death have only focused on a single type of disability, or disability in general, or only on all causes of death.
• People with disabilities are more prone to having behavioral health risks such as obesity,^{2 -4} smoking,⁴ and being physically inactive,⁵ all of which can lead to poorer health and premature death.

What Can Be Done?

• Develop strategies with an aim of reducing the risk of premature death in adults with disabilities by addressing their poorer health as compared to adults without disabilities.
• Realize that health care, health promotion, and preventive services must be tailored to the needs of people with disabilities to effectively modify some factors that increase their risk for premature death (for example, efforts to improve physical activity may require specific assistance in determining safe ways to exercise).
• Improve availability of and access to preventive services and inclusion in behavioral health interventions to potentially reduce the risk for premature death among adults with disabilities.
• Apply additional focus on care and case management for people with disabilities if they become seriously ill, to aid in timely and appropriate receipt of urgent care, which may help delay or reduce premature death.

What CDC is doing

CDC monitors the health of people with and without disabilities, and supports the inclusion of people with disabilities in public health programs that prevent disease and promote healthy behaviors. CDC also works to eliminate barriers to health care and improve access to routine preventive services.

CDC supports 18 state-based disability and health programs and four National Public Health Practice and Resource Centers, which promote healthy lifestyles and work to improve quality of life for people with disabilities.  The primary goals of the state programs are to:

• Increase health promotion opportunities for people with disabilities.
• Improve access to health care services for people with disabilities.
• Improve emergency preparedness for people with disabilities.

CDC also maintains the Disability and Health Data System (DHDS), an online interactive tool that provides instant access to state-level, disability-specific health data. Users can customize the disability and health data they view, making it easy to identify health differences between adults with and without disabilities.

Additional Resources

Click here to learn more about what doctors and health professionals can do to help adults with disabilities increase physical activity.

References

1. Brault MW. “Americans With Disabilities: 2010,” Current Population Reports. Washington, DC: U.S. Census Bureau; 2012.
2. Coyle CP, Santiago MC, Shank JW, Ma GX, Boyd R. Secondary conditions and women with physical disabilities: a descriptive study. Arch Phys Med Rehabil. Oct 2000; 81 (10):1380-1387.
3. Kinne S, Patrick DL, Doyle DL. Prevalence of secondary conditions among people with disabilities. Am J Public Health. Mar 2004; 94 (3):443-445.
4. Armour BS, Campbell VA, Crews JE, Malarcher A, Maurice E, Richard RA. State-level prevalence of cigarette smoking and treatment advice, by disability status, United States, 2004. Prev Chronic Dis. Oct 2007; 4 (4):A86.
5. Rantanen T, Guralnik JM, Sakari-Rantala R, Leveille S, Simonsick EM, Ling S, et al. Disability, physical activity, and muscle strength in older women: the Women’s Health and Aging Study. Arch Phys Med Rehabil. Feb 1999; 80 (2):130-135.