Geography of Disability. an Analysis Based on the Socioeconomic Levels of Two Metropolitan Areas Dallas, Texas and Monterrey Nuevo Leon

Purpose: Disability is a global concern disproportionately affecting over 650 million people worldwide (WHO, 2000). Studies have noted the enhanced vulnerability of people with disability leading to severe poverty (Mitra, Posarak & Vick, 2011; Lusting & Strauser, 2007). Yet, identifying the common predictors and patterns of disability for people living in both low and high economies remain a challenge (WHO, 2011). The purpose of this study is to provide information and knowledge of disability gradient to accurately predict areas and conditions of people living  in the cities of Monterrey, Nuevo Leon and Dallas, Texas.

Methods: A cross-sectional study design was employed using census track level data for both cities from Mexico 2010 and USA 2000 census data collections. Construct validity was used to check the level of synchronization of the variables in both census data. Poverty as income and non-income measure was used as a proxy explanatory variable of disability in disadvantaged contexts. A set of explanatory factors were selected and placed in the following four chief research domains: health coverage and access, education, employment, and living standards. Data analysis included three sub-stages: 1) socio-demographic description; 2) spatial dependence analysis and 3) geographically weighted regression analysis. Appropriate statistical procedures using GeoDa software for geospatial analysis and computation (version 13.0), and ArcGIS software for mapping and spatial analysis (version 10.1) were used.

Results: Demographic profiles of people with disability in Dallas comprised of 46% White, 25% Hispanic and 23% Black elderly (above 65years) men and women with primarily mental health and self-care problems. The spatial dependent analysis indicated  high segregation levels of Black people with disability living below the poverty line in the semi-central zones of Dallas. In Monterrey, the biggest number of people with disability were both elderly and working age (16-64) men and women with physical or sensory disability clustered in central areas of the city. Geographically Weighted Regression (GWR) from both data analysis reported high model fit (R≥0.8 for Dallas data and R ≥0.7 for Monterrey data) and predictability of disability prevalence when social disadvantage factors such as unemployment, housing security, household living conditions and lack of education were present. Ethnicity and race significantly increased the predictability of disability in both metropolitan areas. Disability among females in Dallas County had a slight higher predictability (R=0.83) than disability among males (R=0.81). While for Monterrey, the opposite trend was observed.   

Implications: Despite the fundamental differences in the level of social development in low and high income countries, disability seems to be an equalizer that resonates in alarming ways for people living in these two different economies. Given the divergent and sometimes conflicting trends in practices and policies addressing disability in low and high income environments, it becomes crucial to re-examine the framework of disability by gauging local characteristics and by infusing a grounded socio-cultural understanding of the various contexts that consequently shape place-based social behaviors and political decisions.