A smaller proportion of people in their prime working years (25-54) are employed today than in decades past, and some have wondered whether disability and health problems contributed to this decline. People with disabilities have much lower employment rates than people without disabilities, and disability is one of the most frequently cited reasons why they do not work. In addition, a recently published Brookings report identified certain subgroups among the unemployed with disproportionately high disability rates.
With this in mind, we aim to better understand the role of geography and demographics in disability patterns in prime-age adults. Disability can take many forms, but the Centers for Disease Control provide a useful general definition: Disability is any state of the body or mind that makes it more difficult for the person to do certain activities and interact with the world around them. The onset of a disability can also take many forms: it can appear at birth, it can be due to an accident or injury, or it can be due to, among other things, a longstanding condition or illness.
Nine percent of adults ages 25 to 54, or 11 million Americans, had at least one in six disabilities in 2016.[1] Some patterns by location and demographics are already well established: disability is disproportionately concentrated in the Southeast, the Midwest and the Appalachians (the so-called “disability belt”), and people with disabilities disproportionately include people with low levels of education and income. However, metropolitan level analysis is less common and given the regional nature of labor markets, data at the regional level should influence efforts to support people with disabilities.
This analysis uses data from the American Community Survey (ACS) to examine the disability rates of the 100 largest metropolitan areas, as well as differences by education and race / ethnicity. We do not limit our analysis to individuals receiving disability benefits, but include all individuals who report a disability in order to get a complete picture of people with disabilities in the US and where they live.
Metros show great differences in disability rates
The disability rates in the 100 largest metropolitan areas in the country range considerably from just under 4 to 13 percent.
Locations with the lowest disability rates have strong economies and well-educated populations such as San Jose, Los Angeles, and San Francisco, California. Madison, Wisc .; Austin, Texas; and Washington, DC metropolitan areas with the highest disability rates are both inside and outside the disability belt. Some have historically manufacturing or industrial economies, such as Scranton, PA; Birmingham, Ala .; Toledo, Ohio; and Spokane, Wash. Others such as Tucson, Ariz .; Deltona, Fla .; and El Paso, Texas have large tourism or agricultural sectors that employ many low-educated workers.
Disability by race / ethnicity varies within and between metros …
At the national level, Indians have the highest disability rate among working-age adults (16 percent), followed by blacks (11 percent), whites (9 percent), Hispanics (7 percent), and Asians (4 percent).
However, disability rates by race and ethnicity also vary widely between metropolitan areas. As Figure 1 shows, Asians have both low disability and relatively small differences between the locations, ranging between 2 and 13 percent. Blacks and Hispanics both have larger ranges, from the low single digits to around 20 percent. In most countries as well as at the national level, blacks have a disability rate up to 2.5 times higher than whites. However, in a number of metropolitan areas (concentrated in Florida, North Carolina, and Connecticut) blacks have the same or lower disability rates than whites. While Hispanics have a lower national disability rate than most other races / ethnicities, they are more likely to be disabled than whites and blacks in metropolitan areas like Spokane, Washington. Springfield, Mass .; Deltona, Fla .; and Allentown and Pittsburgh in Pennsylvania.
… But the educational differences are much greater
Among the entire prime-age population in the United States, the disability rate for people with only a high school degree is three times higher than for people with a bachelor’s degree (12 percent and 4 percent, respectively). However, in some places this gap is even wider, particularly in formerly industrial metropolitan areas in Ohio (Akron, Cincinnati, Columbus, Toledo, Youngstown), Pennsylvania (Scranton and Pittsburgh), and Massachusetts (Springfield and Worcester).
In a way, these data are not surprising. As mentioned above, people with disabilities have a lower level of education than people without disabilities, and education is a strong predictor of health in general. However, the size of the gap is sobering, and suggests a complicated relationship between education and disability. Even in a post-ADA world, people with disabilities can have difficulty completing their education, and education is linked to general health in a variety of ways, including individual health knowledge and behavior, access to health care, exposure to environmental toxins, and jobs that are physical more strenuous or dangerous.
Geography also interacts with education and disability. Low education is more strongly associated with disability in some regions than in others, suggesting that education is one of several factors influencing local disability rates. However, the relationship between disability and geography has long been established: researchers have noted this for decades, suggesting that the patterns are deeply ingrained in industrial and sociocultural conditions.
Our next post delves into the employment trends of people with disabilities in their prime working years, with a continued focus on trends by race, education, and geography. Both job availability and demographic trends vary widely across the country. Therefore, local managers need to implement employment and service policies that are tailored to local needs.
The authors thank Cecile Murray for help designing and performing the data analysis for this blog.
[1]Disabilities are defined as difficulties in the following areas: seeing, hearing, walking or climbing stairs, cognition (remembering, concentrating or making decisions), self-care (getting dressed or bathing), and living independently (running errands on your own such as going to a doctor’s office or shopping).
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