Originally published here.

Disability is a critical and growing public health issue that must be addressed as part of this nation's blueprint to improve health. Public health data reveal that the number of adults living with disabilities continues to increase. Nearly 50 million American adults aged 18 years and older are affected by disabilities, with more than 10 million persons living with physical or mental disabilities necessitating ongoing assistance with day-to-day or other instrumental activities. Costs exceed more than $300 billion annually as a result of medical care and lost productivity related to disabilities. Although disabilities can have a major impact on health, quality of life, and full participation in society, people with disabilities remain one of the most underserved populations in the United States.

The Centers for Disease Control and Prevention's (CDC's) Health Disparities and Inequalities Report—United States, 2011 identifies disparities related to disability and sexual orientation as the 2 main gaps in current health disparities research. To date, existing research has not comprehensively examined the prevalence and covariates of disability among lesbian, gay, and bisexual (LGB) adults. Multiple health-related behaviors such as smoking, lack of exercise, obesity, health conditions (including arthritis and asthma), and mental distress have been found to be associated with limitations in physical functioning and disabilities among the general population.

Previous studies have also consistently found that LGB adults experience disparities in smoking. Furthermore, higher rates of asthma, arthritis, and obesity among lesbians and bisexual women and frequent mental distress among LGB adults are of concern. A few studies examining correlates of poor health among LGB adults have documented that, compared with their heterosexual counterparts, these groups may be more likely to experience some physical limitations. Although such findings suggest that LGB adults may be at an elevated risk for disability, the prevalence and covariates of disability within these groups have not been comprehensively examined with population-based data.

Adults living with disabilities are also at risk for health disparities because they tend to receive fewer preventive health services and have poorer health than do those without disabilities. Because LGB adults are a health-disparate population and those living with disabilities often do not have access to adequate health care services, LGB adults with disabilities may face multiple and serious health risks. The early detection and identification of the most at-risk groups will enable public health initiatives to expand the reach of strategies and interventions to prevent the progression to disability as well as to tailor disability management programs to meet the unique needs of such diverse populations.

We analyzed disability among LGB adults by utilizing standardized measures developed by the CDC and assessed in the Behavioral Risk Factor Surveillance System (BRFSS). We disaggregated data (n = 82 531) from the Washington State BRFSS by gender and examined patterns of disability by sexual orientation. Based on this population-based sample, we examined the following: (1) prevalence of disability by sexual orientation; (2) the age-adjusted relationship between sexual orientation and covariates of disability, including chronic health conditions, health risk behaviors, and physical and mental health status; and (3) the relationship between disability and sexual orientation after we controlled for covariates of disability.

Findings indicated that the prevalence of disability is higher among lesbian, gay, and bisexual adults compared with their heterosexual counterparts; lesbian, gay, and bisexual adults with disabilities are significantly younger than heterosexual adults with disabilities. Higher disability prevalence among lesbians and among bisexual women and men remained significant after we controlled for covariates of disability.

Higher rates of disability among lesbian, gay, and bisexual adults are of major concern. Efforts are needed to prevent, delay, and reduce disabilities as well as to improve the quality of life for lesbian, gay, and bisexual adults with disabilities. Future prevention and intervention efforts need to address the unique concerns of these groups.

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