R-4: Multiple Chronic Conditions
Among People with Disabilities
The Bottom Line
Good health allows people to participate fully in the most important aspects of their lives. But people with disabilities have higher rates of disease than people without disabilities, with more multiple chronic conditions (one or more diseases), such as diabetes and heart disease. This project increases our understanding of the relationship between health care services and a person’s socio-demographic, geographic and disability factors. New information can lead to targeted preventive strategies to improve health care, as well as changes in policies and programs.
When a person has more than one chronic health conditions, such as high blood pressure and diabetes, she is considered to have multiple chronic conditions (MCC). With the addition of each health condition, an individual's risk for negative health outcomes increases, including preventable hospitalizations, duplicative tests, impaired function, adverse drug events, conflicting medical advice and even death. Each additional chronic condition and/or failure to manage existing conditions also threatens quality of life and independent living. For people with disabilities, MCC increase the likelihood that they will need assistance with activities of daily living, reduce participation in community activities, need to move out of the community into a more restrictive setting and require increased and more costly medical care.
This project used Medical Expenditure Panel Survey (MEPS) data to examine the distribution of MCC across five disability subgroups (physical, cognitive, visual, hearing, multiple), comparing and contrasting these rates to those with no disability. MCC were defined as having two or more of the following: high blood pressure, heart disease, stroke, high cholesterol, diabetes, arthritis, emphysema, or asthma.
This research adds to the literature that demonstrates that people with disabilities have higher chronic disease rates than those without a disability by showing that people with disabilities also have higher rates of MCC. All disability groups had a greater rate of MCC, with highest rates experienced by those with physical or multiple disabilities. Moreover, people with multiple disabilities or physical disabilities were also more likely to have a greater number of MCC than those with no disability.
These findings confirm that rates of MCC vary according to disability status and type. This has implications for policy and practice, and demonstrates a need to continue to research means for better addressing disparities in access, care and disease management that are specific to different disability subgroups.
Principal Investigator: Amanda Reichard, PhD