disabilities and health in utah€¦ · ɠ ask questions about healthy lifestyle changes when...
TRANSCRIPT
1
9.1% 8.8%4.5% 2.8% 2.3%
17.8%
Mobility Cognitive IndependentLiving
Vision Self-care Any
IntroductionThis report provides an overview of disability and health in Utah. You can use this information to become aware of the percent and characteristics of adults with disabilities in Utah. The data throughout this overview came from the Behavioral Risk Factor Surveillance System (BRFSS) which surveys people aged 18 and older, not including people living in group settings.
Percent of Utah adults in 2015 with select functional disability types1
Mobility: Serious difficulty walking or climbing stairsCognitive: Serious difficulty concentrating, remembering, or making decisionsIndependent Living: Difficulty doing errands alone such as visiting a doctor’s office or shopping Vision: Blind or serious difficulty seeing, even when wearing glassesSelf-care: Difficulty dressing or bathing
The percent of persons with a mobility disability increases as people age, whereas the percent of persons with a cognitive disability stays stable. Each of us may experience a disability at some point in our lifetime, especially as we age.
Percent of Utah adults who reported functional disability types by age group (BRFSS 2013-2015 Combined Data)
Disability and Health in Utah
0%
10%
20%
30%
40%
18-24 25-34 35-44 45-54 55-64 65+
AnyDisability
Mobility
Cognitive
Note: “Deaf or difficulty hearing” data was not collected by the BRFSS in 2015.
Age Group
2
18.2% 18.1%
19.4%
30.0%
10.7%
22.4%
17.9%
Total White Black NativeAmerican
Asian PacificIslander
Other
Males FemalesMobility 7.6% 11.7%
Cognitive 8.1% 10.6%Any Disability 15.8% 21.1%
Native Americans/Alaska Natives are significantly more likely to have a disability (30.0%) than all races combined (18.2%).2
Disability and Demographics
Local health districts with disability rates higher, the same, and lower than the state rate.2
Who is more likely to have a disability?
Women are significantly more likely than men to report having a disability.2
See Summary Table 1 (page 10) and Figure 1 (page 11) for more details.
Note: Native Americans/Alaska Natives are often underrepresented and oversampled. Cognitive DisabilityMobility Disability Any Disability
Mobility Disability Cognitive Disability Any Disability
3
Education, Income, and Health Care
MobilityDisability
CognitiveDisability
Any Disability
No Disability
Less than $25,000 44.6% 45.6% 41.5% 17.1%
More than $75,000 14.6% 14.6% 16.7% 37.2%
Persons with disabilities are more likely to make less than $25,000. They are also less likely to make more than $75,000.2
MobilityDisability
CognitiveDisability
Any Disability
No Disability
Less than High School
Education19.6% 18.5% 17.3% 8.1%
College Graduate 15.6% 13.2% 14.9% 28.8%
MobilityDisability
CognitiveDisability
Any Disability
No Disability
No Insurance 17.0% 19.1% 18.3% 12.3%
Could Not See Doctor Due to
Cost32.1% 34.0% 30.2% 10.4%
Persons with disabilities are less likely to graduate from high school or college than persons without a disability.2
Persons with disabilities are less likely to have health care insurance.
They are also more likely to say they could not see a doctor in the past 12 months due to cost.2
4
Any Disability No Disability
19.9% Current smoker 7.6%
12.8% Binge drinking 11.3%
34.6% Obese 22.7%
42.6% Meets recommendations for aerobic activity 58.4%
28.6% Eats 2 or more servings of fruit each day 32.4%
14.7% Eats 3 or more servings of vegetables each day 17.8%
52.6% Prescribed pain medications by doctor 27.6%
5.6%Used pain meds more
frequently than directed by doctor
2.5%
Despite progress, adults with disabilities in Utah and across the country continue to experience significant differences in their health behaviors and overall health compared to adults without disabilities.
Utah adults with a disability are more likely to report engaging in behaviors that are harmful to their health, such as smoking. They also report eating less fruits and vegetables on a daily basis and getting less exercise than adults without a disability. There are also important differences between people with different types of disabilities. Utahns with a mobility disability are less likely to binge drink whereas persons with a cognitive disability are more likely to binge drink than those without a disability. Lastly, persons with disabilities are much more likely to have been prescribed pain medications. See Summary Table 2 for data by mobility and cognitive disability status.
Health Risk Factors and Behaviors
5
Any Disability No Disability
38.6% High Blood Cholesterol 28.5%
6.2% Heart Attack 2.3%
5.4% Coronary Heart Disease 2.0%
5.5% Stroke 1.5%
10.2% Cancer (not including skin) 5.0%
10.9% COPD, Chronic Bronchitis, or Emphysema 2.1%
39.5% Arthritis 16.6%
17.7% Asthma 7.1%
6.8% Kidney Disease 1.9%
13.3% Diabetes 5.9%
Health ConditionsCostly and debilitating health events and chronic conditions are more common for persons with disabilities. While it is clear that persons with disabilities have worse health outcomes than persons without disabilities, it cannot be said without more information whether the disability or the health condition occurs first in most situations.
Persons with disabilities are about three times more likely to have a heart attack, twice as likely to have been diagnosed with cancer (not including skin cancer), and more than twice as likely to have asthma or arthritis than those without a disability. Many of the health outcomes that persons with disabilities are more likely to experience either contribute to the top causes of death or are one of the leading causes of death in the U.S. Focusing on improving health through exercise, proper nutrition, and preventive health check-ups often takes a backseat to the challenges faced in everyday life. Unfortunately, poor health can make the challenges of everyday life more stressful and may result in increased physical, mental, and emotional demands as diseases develop. See Summary Table 3.
6
Any Disability No Disability
36.9% Fair or Poor Health 6.7%
41.9% More than 7 days of poor mental health 10.9%
39.3% More than 7 days of poor physical health 9.0%
62.8% More than 7 days of poor health 26.5%
49.9% Ever diagnosed with depressive disorder 15.5%
General Mental and Physical HealthMore than one-third of persons with disabilities report having “fair” or “poor” health. This is significantly more than the amount of persons without disabilities that report fair or poor health (roughly one-fifteenth).
When thinking about a 30-day span in time, about 40% of persons with disabilities report having more than 7 days of poor mental health compared to 11% for persons without a disability. About 40% of persons with disabilities also report having more than 7 days of poor physical health whereas 9% of those without a disability report the same.
When asked about health in general, more than 60% of persons with disabilities report having more than 7 days of poor health within the past month compared to about 25% of persons without disabilities reporting the same.
Lastly, adults with disabilities are much more likely to report ever having a diagnosis of depressive disorder (49.9%) compared to those without a disability (15.5%). See Summary Table 4.
7
What Can Be Done?The Utah Department of Health can
ɠ Increase health promotion opportunities for persons with disabilities. ɠ Support health promotion programs, health education workshops, and screenings. See http://livingwell.utah.gov/ for more information on these programs.
ɠ Raise awareness of health promotion and health-related disability policy initiatives. ɠ Invite disability advisors and persons with disabilities to participate in program planning groups.
ɠ Train staff and community partners on disability literacy, inclusion strategies relating to inclusive meetings, communications, accessibility, and health promotion.
Health care providers can3
ɠ Educate patients with disabilities about health screenings and provide health screenings. ɠ Urge and educate patients with disabilities to make positive lifestyle changes and avoid risky health behaviors like smoking, poor nutrition, unhealthy sexual relationships, and sedentary lifestyles.
ɠ Avoid making assumptions about a person’s abilities. ɠ Modify communication strategies to meet the needs and abilities of the patient. ɠ Include quality of life in the care of persons with disabilities, which addresses social, economic, and environmental issues.
ɠ Recognize that persons with disabilities experience the same conditions as persons without disabilities, but an individual’s disability may impact signs, symptoms, and diagnoses.
ɠ Recommend and refer patients to Living Well Utah programs to help manage their condition when appropriate (http://livingwell.utah.gov/).
State officials and community leaders can ɠ Reach out to and include Utahns with disabilities when developing policy related to health care.
ɠ Understand disability literacy and apply it by incorporating disability etiquette, inclusion, and recognition of cultural differences as well as providing full accessibility and accommodations in policy work, media, and publications.
ɠ Recognize that people with disabilities are a valuable source of information and expertise. ɠ Develop cost saving strategies by supporting health promotion.
8
Adults with disabilities can4
ɠ Be a part of your health care team by asking questions about your health and sharing your feelings and concerns. Write down questions before going to the doctor.
ɠ Take someone you trust with you to help ask questions or tell the doctor your concerns. They can also help you understand the information you are given or can write down what the doctor says. Don’t take someone who will talk with the doctor like you aren’t there, ignores what you want, or makes decisions for you. Remember that it is your body and your health.
ɠ Talk to your doctor or health care provider about healthy lifestyle changes including exercise, healthy eating, and quitting tobacco products.
ɠ Talk to your doctor or health care provider about managing pain, stress, anxiety, and depression.
ɠ Talk to your doctor or health care provider about routine and preventative health screenings.
ɠ Participate in a Living Well Utah workshop to manage chronic conditions with a supportive peer group (http://livingwell.utah.gov/).
ɠ Ask questions about healthy lifestyle changes when talking to trusted friends, family, support staff, or your health care team.
ɠ Advocate for better health! Talk with your state and local government about ways to improve health for persons with disabilities.
References1. Utah Department of Health. Behavioral Risk Factor Surveillance System (BRFSS), Age-adjusted to the 2000 standard population using three age groups, 18-44, 45-64, 65+. Salt Lake City: Utah Department of Health, Center for Health Data.2. Utah Department of Health. Behavioral Risk Factor Surveillance System (BRFSS) 2013-2015 combined data, Age-adjusted to the 2000 standard population using three age groups, 18-44, 45-64, 65+. Salt Lake City: Utah Department of Health, Center for Health Data.3. Core Competencies on Disability for Health Care Education. Alliance for Disability in Health Care Education. Published August 2016.4. Roberson, K. Being a Healthy Adult: How to Advocate for Your Health and Health Care. Elizabeth M. Boggs Center on Developmental Disabilities at the University of Medicine and Dentistry of New Jersey. 2010.5. Icons came from Piktochart.
What Can Be Done?
This report was prepared by the following staff at the Utah Department of Health:Michael Friedrichs, MS, Epidemiologist, Bureau of Health PromotionStephanie George, MPH, Epidemiologist, Utah Disability and Health ProgramLibby Oseguera, MPA, Program Coordinator, Utah Disability and Health Program
9
SummaryTables and Figures
For all tables, values were compared to either the state rates or “no disability” rates to determine significant differences.
Rates significantly higher than the comparison group are indicated by bold orange text and rates significantly lower than the comparison group are indicated by bold grey text as shown below.
Higher than the state rate
Lower than the state rate
10
Table 1 Mobility Disability
Cognitive Disability
Any Disability
State of Utah9.7%
(9.3-10.0)9.3%
(8.9-9.7)18.5%
(18.0-19.0)
Bear River9.1%
(7.8-10.6)9.6%
(8.2-11.1)17.6%
(15.9-19.6)
Central Utah13.0
(11.3-15.0)9.1%
(7.2-11.5)20.8%
(18.4-23.6)
Davis County8.3
(7.4-9.4)8.7%
(7.6-10.0)17.0%
(15.6-18.6)
Salt Lake County
9.9%(9.3-10.5)
9.7%(9.1-10.4)
19.0%(18.2-19.8)
San Juan5.2%
(3.1-8.7)11.5%
(6.9-18.6)21.1%
(13.8-30.8)
Southeast Utah
14.9%(12.2-18.0)
15.1%(11.6-19.3)
28.4%(24.2-33.0)
Southwest Utah
9.5%(8.3-10.9)
8.7%(7.4-10.2)
18.0%(16.2-19.9)
Summit County
6.2%(4.7-8.1)
7.2%(5.0-10.2)
14.3%(11.3-17.8)
Tooele County
13.1%(10.8-15.7)
12.7%(10.2-15.8)
23.2%(20.1-26.6)
TriCounty12.5%
(10.7-14.7)9.9%
(8.0-12.2)21.5%
(18.9-24.3)
Utah County8.4%
(7.5-9.3)7.5%
(6.7-8.4)15.9%
(14.8-17.1)
Wasatch County
8.0%(6.2-10.4)
5.6%(4.2-7.6)
14.5%(11.7-17.8)
Weber-Morgan
10.4%(9.3-11.7)
10.5%(9.3-11.9)
20.1%(18.5-21.7)
Disability Status by Local Health District2
Ninety-five percent confidence intervals given in parantheses. BRFSS 2013-2015 Combined Data, Age-adjusted.2
1111
KANE
MILLARD
SANPETE
CARBON
CACHE
WASHINGTON
GRAND
UINTAH
TOOELE
SEVIER
GARFIELD
BOX ELDER
IRON
WEBER
EMERY
RICH
BEAVER
DAGGETT
WAYNEPIUTE
MORGAN
DUCHESNE
JUAB
SAN JUAN
SouthwestUtah
Central Utah
SoutheastUtah
Utah County
Bear River
Summit County
TriCounty
Tooele County
Weber-Morgan
WasatchCounty
Davis County
Salt LakeCounty
San Juan
Esri, HERE, Garmin, USGS, NGA, EPA, USDA, NPS
Figure 1: Map of Utah Local Health Districts and their Counties
Local Health Districts are indicated by black bold font (Local Health District) and Counties are indicates by grey italicized font (COUNTY). Some counties have the same name and boundaries as the Local Health District, such as, Salt Lake, Summit, Davis, Tooele, Utah, and San Juan Counties.
12
Health Risks or Behaviors by Disability Status1
Table 2 Mobility Disability
Cognitive Disability
Any Disability
No Disability
Year(s)
Current Smoker23.6%
(21.1-26.2)22.0%
(20.2-23.8)19.9%
(18.5-21.2)7.6%
(7.2-8.0) 2013-2015
Binge Drinking8.8%
(7.2-10.7)14.2%
(12.7-15.9)12.8%
(11.6-14.1)11.3%
(10.8-11.7) 2013-2015
Obese43.4%
(40.6-46.2)33.0%
(31.1-35.1)34.6%
(33.0-36.1)22.7%
(22.2-23.3) 2013-2015
Meets Aerobic Activity Recommendations
34.9%(31.4-38.6)
41.9%(39.1-44.8)
42.6%(40.5-44.9)
58.4%(57.5-59.3)
2013, 2015
Eats 2 or More Fruits per Day
29.4%(26.1-32.9)
27.2%(24.8-29.8)
28.6%(26.7-30.5)
32.4%(31.6-33.3) 2013, 2015
Eats 3 or More Vegetables per Day
15.7%(13.2-18.6)
14.2%(12.3-16.3)
14.7%(13.2-16.3)
17.8%(17.1-18.5)
2013, 2015
Prescribed and Using Pain Medications
62.6%(59.4-71.3)
54.3%(49.6-58.9)
52.6%(48.9-56.2)
27.6%(26.1-29.1)
2014
Abusing Prescribed Pain Medications
5.1%(3.1-8.3)
5.7%(3.4-9.4)
5.6%(3.6-8.5)
2.5%(1.6-3.8)
2014
Definitions: Current smoker: Respondents that have ever smoked at least 100 cigarettes and reported smoking some days or every day.
Binge drinking: Women that reported having four drinks or more on one occasion and men that reported having five drinks or more on one occasion.
Obese: Respondents with a body mass index (BMI) greater than or equal to 30.
Eats 2 or more fruits per day: Respondents that reported that they eat at least two fruits per day.
Eats 3 or more vegetables per day: Respondents that reported that they eat at least three vegetables per day.
Meets physical activity recommendations: Respondents that met recommendations for aerobic physical activity by reporting 150 minutes or more of physical activity (or vigorous equivalent) per week.
Prescribed and using pain medications: Respondents that reported taking pain medications in the past year that were prescribed to them by a doctor.
Abusing prescribed pain medications: Respondents that reported taking their prescribed pain medications more frequently or in higher doses than directed by their doctor.
BRFSS Combined Data, Age-adjusted1
13
Table 3 Mobility Disability
Cognitive Disability
Any Disability
No Disability
Combined Years
High Blood Cholesterol
40.9%(37.1-44.8)
40.8%(37.9-43.8)
38.6%(36.4-40.9)
28.5%(27.7-29.4) 2013, 2015
Heart Attack7.4%
(6.4-8.6)6.5%
(5.6-7.5)6.2%
(5.6-6.9)2.3%
(2.1-2.5) 2013-2015
Coronary Heart Disease or Angina
7.1%(6.0-8.3)
6.1%(5.3-7.1)
5.4%(4.9-6.0)
2.0%(1.8-2.2) 2013-2015
Stroke6.9%
(5.7-8.2)6.9%
(6.0-8.0)5.5%
(4.9-6.1)1.5%
(1.3-1.6) 2013-2015
Ever Diagnosed with Cancer*
12.4%(10.8-14.1)
11.1%(9.9-12.4)
10.2%(9.4-11.0)
5.0%(4.7-5.2) 2013-2015
COPD, Chronic Bronchitis, or Emphysema
14.6%(12.8-16.4)
11.9%(10.6-13.2)
10.9%(10.0-11.8)
2.1%(1.9-2.3)
2013-2015
Arthritis55.2%
(52.4-57.9)38.2%
(36.4-40.1)39.5%
(38.1-40.9)16.6%
(16.2-17.1)2013-2015
Asthma19.9%
(17.8-22.2)19.0%
(17.3-20.7)17.7%
(16.5-19.0)7.1%
(6.8-7.5)2013-2015
Ever Diagnosed with Kidney Disease
8.7%(7.4-10.2)
7.2%(6.2-8.3)
6.8%(6.1-7.6)
1.9%(1.7-2.1)
2013-2015
Diabetes16.9%
(15.4-18.6)12.8%
(11.6-14.1)13.3%
(12.5-14.2)5.9%
(5.6-6.2)2013-2015
Definitions: For all of the listed health conditions, respondents reported being told by a doctor, nurse, or other health care professional that they ever had the health condition.Asthma: For those that were ever told by a doctor, nurse, or other health professional that they had asthma and said that they still had asthma.Cancer: For those that were ever told by a doctor, nurse, or other health professional that they had cancer, *not including skin cancer.
Health Conditions by Disability Status1
BRFSS Combined Data, Age-adjusted1
14
Table 4 Mobility Disability
Cognitive Disability
Any Disability
No Disability
Combined Years
Fair or Poor Health50.0%
(47.2-52.8)38.5%
(36.5-40.5)36.9%
(35.3-38.4)6.7%
(6.3-7.1) 2013-2015
More than 7 days of Poor Mental Health
41.7%(38.9-44.5)
54.1%(51.9-56.2)
41.9%(40.2-43.5)
10.9%(10.5-11.4) 2013-2015
More than 7 days of Poor Physical Health
57.9%(55.0-60.6)
39.8%(37.7-41.8)
39.3%(37.8-40.9)
9.0%(8.6-9.4) 2013-2015
More than 7 days of Poor Health
73.1%(69.9-76.1)
65.2%(62.4-67.9)
62.8%(60.6-65.0)
26.5%(25.0-28.0) 2013-2015
Ever Diagnosed with Depressive Disorder
48.6%(45.8-51.4)
62.1%(60.0-64.2)
49.9%(48.3-51.5)
15.5%(15.0-16.0) 2013-2015
Definitions: Fair or Poor Health: Respondents that said their general health was fair or poor.More than 7 Days of Poor Health (mental, physical, and in general): Respondents that said they experienced more than seven days of poor health out of the past 30 days.Ever Diagnosed with Depressive Disorder: Respondents that said they were ever told by a doctor, nurse, or other health professional that they had a depressive disorder (including depression, major depression, dysthymia, or minor depression).
General Health by Disability Status2
BRFSS Combined Data, Age-adjusted2