Health-Related Quality of Life, Health Care Access, and Health Behaviors Among Parents with Disabilities

Background and Purpose: Parents with disabilities experience unique attitudinal and legal discrimination, and its subsequent perceived stress and social barriers likely increase health disparities of parents with disabilities. However, there is a paucity of research on the health needs, barriers to health care, and health outcomes of parents with disabilities. A recent study used nationally-representative data to examine the prevalence rates of chronic physical health conditions among parents with disabilities and compared them to parents without disabilities. However, most of the existing research have been limited to small, non-representative samples. The aim of this study is to examine the health-related quality of life, health care access, and health behaviors of parents with disabilities using population-based, nationally representative data. 

Methods: Using data from the 2016 Behavioral Risk Factor Surveillance System, we identify 9,117 parents aged 18 -64 with disabilities who co-reside with a child aged 18 or younger. Disability is defined as experiencing at least one of the six types of disabilities, including hearing, vision, cognitive, ambulatory, self-care, and independent living difficulties. For descriptive statistics, the weighted prevalence of key health indicators of parents with disabilities are compared with parents without disabilities, non-parents with disabilities, and non-parents without disabilities in the same age range. A series of adjusted logistic regression analyses are applied to examine the health and health care outcomes of parents with disabilities compared with those of parents without disabilities and non-parents with disabilities, controlling for confounding variables.

Results: Parents with disabilities are estimated to account for 16% of all U.S. parents of a co-residing child younger than age 18. Compared with parents without disabilities, parents with disabilities are likely to experience poorer health-related quality of life (e.g., poorer self-rated health [adjusted odds ratio or aOR = 3.74], frequent physically unhealthy days [aOR = 5.25], and frequent mentally unhealthy days [aOR = 3.76]), more limited health care access (e.g., greater financial barrier to health care [aOR = 1.81]), and higher prevalence of adverse health behaviors (e.g., heavy drinking [aOR = 1.36], currently smoking [aOR = 1.42], obesity [aOR = 1.15], no exercise in past month [aOR = 1.34]) after controlling for individuals' socio-demographic characteristics and history of chronic medical conditions. Parents with disabilities are also likely to show worse health outcomes on self-rated health [aOR = 1.13], physically unhealthy days [aOR = 1.36], financial barriers to health care [aOR = 1.17], and obesity [aOR = 1.24] compared with non-parents with disabilities, although they are less likely to show unhealthy drinking habits and more likely to have personal doctors.

Conclusions and Implications: Parents with disabilities experience elevated risks of health disparities across key health indicators, many of which are preventable and modifiable. This finding underscores the importance of developing social work interventions and policies targeting unique health-related needs of parents with disabilities to improve their health and quality of life.