Age at disability onset and self-reported health status
1 College of Public Health and Health Professions, University of Florida, PO Box 100231 Gainesville, FL 32610, USA
2 RRTC: Health & Wellness, Oregon Health & Science University, CDRC – PO Box 574, Portland, OR 97207, USA
3 National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd.; MS-E-88; Atlanta GA 30333, USA
BMC Public Health 2008, 8:10 doi:10.1186/1471-2458-8-10Published: 9 January 2008
The critical importance of improving the well-being of people with disabilities is highlighted in many national health plans. Self-reported health status is reduced both with age and among people with disabilities. Because both factors are related to health status and the influence of the age at disability onset on health status is unclear, we examined the relationship between disability onset and health status.
The U.S. 1998–2000 Behavioral Risk Factor Surveillance system (BRFSS) provided data on 11,905 adults with disability. Bivariate logistic regression analysis modeled the relationship between age at disability onset (based on self-report of duration of disability) and fair/poor self-perceived health status, adjusting for confounding variables.
Key variables included demographics and other measures related to disability and general health status. Disability onset after 21 years of age showed significant association with greater prevalence of fair/poor health compared to early disability onset, even adjusting for current age and other demographic covariates. Compared with younger onset, the adjusted odds ratios (OR) were ages 22–44: OR 1.52, ages 45–64: OR 1.67, and age ≥65: OR 1.53.
This cross-sectional study provides population-level, generalizable evidence of increased fair or poor health in people with later onset disability compared to those with disability onset prior to the age of 21 years. This finding suggests that examining the general health of people with and those without disabilities might mask differences associated with onset, potentially relating to differences in experience and self-perception. Future research relating to global health status and disability should consider incorporating age at disability onset. In addition, research should examine possible differences in the relationship between age at onset and self-reported health within specific impairment groups.