Prevalence and Features of Social Security Disability Insurance (SSDI) Utilization in a Sample of Women on Community Corrections

Background and Purpose: Women constitute a rapidly growing segment of the US criminal justice population. This population often presents with complex mental and physical health needs, including elevated levels of trauma exposure and substance use. However, the prevalence of disability among this vulnerable population is unclear. Such ambiguity suggests gaps in the identification of service needs and provision. This study used social security disability insurance (SSDI) status to explore the concept of disability among a sample of adult women (x=37.2) on probation/parole. The aim of the study was to determine the prevalence and correlates of SSDI status.

Methods:Data were collected as part of a longitudinal study exploring health behaviors in a sample of victimized women on probation/parole (N=404). Data were obtained from participants’ self-report via audio computer-assisted interviews conducted by trained female research staff. Measures included demographics, health symptomatology, substance use, locus of control (LOC), social support, and measures of post-traumatic stress disorder (PTSD). Analysis included bivariate and multivariate via logistic regression. Theoretically and statistically significant variables in the bivariate analyses were included into the multiple logistic regression model in order to identify correlates of SSDI status.

Results: One-fifth (20.5%) of the study sample received SSDI. Bivariate analysis showed SSDI recipients were older (x=41.6), more likely to be White (54.9%), to be living alone (31.3% vs. 12.8%), to have ever been employed (83.1 vs. 65.1), and to have higher past-month incomes (p<.001). SSDI recipients were also more likely to report severe bodily pain (43.4% vs. 20.2; p< .001) and to experience limitations in activity (38.6 vs. 23.1%; p <.005). Rates of bodily pain and limitations in activity were also high for non-SSDI recipients. Past 12-month healthcare visits (9.59 vs. 7.20), psychiatric service utilization (67.5%), and psychiatric medication use (61.4%) were higher for SSDI recipients. SSDI recipients reported less social support (p<.05), a greater inability to accomplish tasks compared to others (p<.001), and scored higher on measures indicating external LOC (p <.001). Statistically significant differences were found for PTSD measures and non-consensual first sexual encounters (p<.001). Variables which predicted SSDI status included older age, (OR= 1.06; p<.001), race (OR= 0.34; <.001), living alone (OR= 2.23; p<.001), HIV-positive status (OR=5.59; p<.05), past-year psychiatric medication use (OR= .335; p<.001), and a self-perceived inability to accomplish tasks as well as others (OR= 2.87; p<.01). Consensual first sexual encounters were negatively correlated with SSDI status (ß= -.614; OR=.541). Higher levels of social support (ß -.039; OR.962), and higher internal LOC (ß=0.39; OR= 1.04) were also associated with decreased likelihood for SSDI.

Conclusions and Implications:

Initial findings indicate that the relationship between trauma and disability is complex and likely mediated by multiple factors. SSDI rates are high in this sample, with recipients being younger relative to the national population of SSDI recipients. There are also indicators that some women in this sample not receiving SSDI may be eligible. Work to elucidate the non-linear relationship between trauma and SSDI should continue. Service utilization and points for potential intervention with this marginalized population should also be considered.