Social Risk Factors Are Associated With Disability Prevalence – Results From 17 States in the 2017 Behavioral Risk Factor Surveillance System

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 χ 2 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.