off label.
menu ▾
Filters
State
charts re-slice where a pre-computed view exists

Disability access

Do disabled adults hit cost barriers to care at higher rates than everyone else, and by how much?

More than one in four US adults, over 70 million people, reported a disability in 2022, ranging from 21.1% in DC to 38.1% in Arkansas. Roughly a quarter of adults across cognitive, mobility, and vision disabilities could not see a doctor because of cost.

Question

The problem

Disability access is often treated as a compliance accommodation, but in the national care landscape it is a mainstream access and affordability problem. Disabled adults interact with hospitals, specialists, transportation systems, insurance benefits, and home supports more often, so small barriers compound into delayed or forgone care.

The recommendation

Elevate disability access into the core equity scorecard for care delivery. The recommended model is to measure cost and access barriers by disability type, fund accessible clinical operations and transportation, and require payers and providers to close gaps in routine, specialty, and follow-up care.

The access gap

Does disability itself block care, and for whom worst. The disabled-vs-general cost-barrier gap, with the two disability types CDC never measures flagged.

~2.7x
disabled adults skip needed care over cost about 2.7 times as often
vision 27.3% vs working-age adults about 10%, range about 2.2x to 2.8x by type (computed)

Could not see a doctor due to cost, by disability type, 2022

Share reporting a cost barrier in the past 12 months. The dashed line is the general working-age adult rate, so the space to the right of it is the disability penalty.

Read it this way Every disability-type bar sits well to the right of the dashed working-age-adult reference line near 10%, with vision and cognitive disabilities showing the largest cost barrier at around 26 to 27 percent. The reference line comes from a different survey than the disability bars, so treat the gap size as approximate rather than an exact same-survey comparison. Use this chart to identify which disability-related barrier is being measured and how it supports the recommendation to treat accessible care as a systemwide equity requirement.

Caveat The four disability rates are CDC DHDS 2022 BRFSS estimates. The reference line is the general working-age adult rate from a different survey, CDC NHIS 2023 (10.1% for ages 18 to 44 and 9.6% for 45 to 64), because CDC does not publish a non-disabled baseline for this exact indicator, so read the gap as indicative. CDC also does not publish this indicator for the self-care and independent-living disability types, so those two are omitted rather than estimated.

0.0% 12.5% 25.0% 37.5% 50.0% Vision 27.3% Cognitive 26.0% Mobility 26.0% Hearing 21.9% Working-age adults ~10%
⊞ data table⬇ CSV
Disability typeCost barrier or unmet need (%)
Vision27.3
Cognitive26
Mobility26
Hearing21.9
Working-age adults 18 to 44 (baseline)10.1
Working-age adults 45 to 64 (baseline)9.6

CDC Disability and Health Data System (2022 BRFSS) · 2022 · source

How many, and where

Disability is mainstream in every state. The size and shape of the population, then the geographic concentration and the states at the extremes.

28.7%
of US adults reported a disability in 2022
Over 70 million people
38.1%
Arkansas, the highest-prevalence state, 2022
vs 21.1% in DC, a 17-point spread, with a national median of 28.7%

Even the lowest-prevalence state is above 1 in 5 adults

Each bar counts how many of the 51 states and DC fall in that prevalence range. The entire distribution sits above 20 percent.

Read it this way Each bar counts how many states fall into a three-point prevalence band, and every bar sits above 20 percent, meaning no state reports disability prevalence below one in five adults. The tallest bars cluster in the 24 to 30 percent range rather than spreading evenly across the full range. Use this chart to identify which disability-related barrier is being measured and how it supports the recommendation to treat accessible care as a systemwide equity requirement.

0 5 10 15 20 21-24 24-27 27-30 30-33 33-36 36-39 ADULTS REPORTING A DISABILITY (%)
⊞ data table⬇ CSV
Prevalence range (%)Number of states
21 to 244
24 to 2715
27 to 3017
30 to 337
33 to 364
36 to 394

CDC Disability and Health Data System (2022 BRFSS) · 2022 · source

Adults reporting a disability by state, 2022

Share of adults reporting any disability. Darker means a higher share. The South and Appalachia cluster highest.

Read it this way Darker states report a higher share of adults with a disability, and the darkest cluster runs through the South and Appalachia, topping out at 38.1% in Arkansas. All figures are self-reported survey estimates, so state-to-state differences of only a point or two should not be read as precise rankings. Use this chart to identify which disability-related barrier is being measured and how it supports the recommendation to treat accessible care as a systemwide equity requirement.

Caveat All figures are self-reported, age-adjusted survey estimates, not administrative counts, and carry state-level sampling uncertainty.

AK 29.3% ME 30.9% WA 26.8% ID 30.3% MT 28.7% ND 25.6% MN 24.9% WI 28.1% MI 28.7% NY 26.9% VT 25.0% NH 27.2% OR 28.3% NV 32.5% WY 28.2% SD 24.0% IA 26.0% IL 23.7% IN 29.3% OH 31.2% PA 27.7% NJ 23.1% MA 26.4% CA 26.6% UT 26.7% CO 24.2% NE 24.5% MO 31.3% KY 34.3% WV 36.6% VA 28.7% MD 24.0% CT 25.7% RI 28.3% AZ 31.0% NM 29.1% KS 28.8% AR 38.1% TN 33.4% NC 32.1% SC 29.7% DC 21.1% DE 25.1% OK 37.8% LA 36.0% MS 35.8% AL 33.5% GA 28.7% TX 29.0% FL 29.1% HI 22.0% 0.0% 38.1%
⊞ data table⬇ CSV
StateAdults with a disability (%)
Arkansas38.1
Oklahoma37.8
West Virginia36.6
Louisiana36
Mississippi35.8
Kentucky34.3
Alabama33.5
Tennessee33.4
Nevada32.5
North Carolina32.1
Missouri31.3
Ohio31.2
Arizona31
Maine30.9
Idaho30.3
South Carolina29.7
Alaska29.3
Indiana29.3
Florida29.1
New Mexico29.1
Texas29
Kansas28.8
Georgia28.7
Michigan28.7
Montana28.7
Virginia28.7
Oregon28.3
Rhode Island28.3
Wyoming28.2
Wisconsin28.1
Pennsylvania27.7
New Hampshire27.2
New York26.9
Washington26.8
Utah26.7
California26.6
Massachusetts26.4
Iowa26
Connecticut25.7
North Dakota25.6
Delaware25.1
Vermont25
Minnesota24.9
Nebraska24.5
Colorado24.2
Maryland24
South Dakota24
Illinois23.7
New Jersey23.1
Hawaii22
District of Columbia21.1

CDC Disability and Health Data System (2022 BRFSS) · 2022 · source

State disability prevalence, ranked

One dot per state on a shared axis, ranked from Arkansas at 38.1% down. The dashed line is the national median of 28.7%. The full 51-row ranking is in the table.

Read it this way Each dot is one state, ordered from Arkansas at 38.1% down, with the dashed line marking the 28.7% national median; the chart displays only the top 15 states by default while the full 51-state ranking sits in the table below. Its purpose is to show relative rank and spread, not to plot every state at once. Use this chart to identify which disability-related barrier is being measured and how it supports the recommendation to treat accessible care as a systemwide equity requirement.

0.0% 12.5% 25.0% 37.5% 50.0% Arkansas 38.1% Oklahoma 37.8% West Virginia 36.6% Louisiana 36.0% Mississippi 35.8% Kentucky 34.3% Alabama 33.5% Tennessee 33.4% Nevada 32.5% North Carolina 32.1% Missouri 31.3% Ohio 31.2% Arizona 31.0% Maine 30.9% Idaho 30.3% US median 28.7% + 36 more in the table below
⊞ data table⬇ CSV
StateAdults with a disability (%)
Arkansas38.1
Oklahoma37.8
West Virginia36.6
Louisiana36
Mississippi35.8
Kentucky34.3
Alabama33.5
Tennessee33.4
Nevada32.5
North Carolina32.1
Missouri31.3
Ohio31.2
Arizona31
Maine30.9
Idaho30.3
South Carolina29.7
Alaska29.3
Indiana29.3
Florida29.1
New Mexico29.1
Texas29
Kansas28.8
Georgia28.7
Michigan28.7
Montana28.7
Virginia28.7
Oregon28.3
Rhode Island28.3
Wyoming28.2
Wisconsin28.1
Pennsylvania27.7
New Hampshire27.2
New York26.9
Washington26.8
Utah26.7
California26.6
Massachusetts26.4
Iowa26
Connecticut25.7
North Dakota25.6
Delaware25.1
Vermont25
Minnesota24.9
Nebraska24.5
Colorado24.2
Maryland24
South Dakota24
Illinois23.7
New Jersey23.1
Hawaii22
District of Columbia21.1

CDC Disability and Health Data System (2022 BRFSS) · 2022 · source

The blind spots

This view is intentionally empty. Two accountability questions cannot be answered from the current data. There is no multi-year series for the disability cost-barrier rate, since every CDC DHDS figure here is from 2022, so the direction of travel is unknown. And no citable federal series of healthcare-specific ADA complaints was found from the HHS Office for Civil Rights or the Department of Justice, so enforcement volume cannot be charted without an unverifiable proxy. Both are documented gaps, shown here rather than silently omitted.

Geography

The same question, state by state and then county by county. Pick a state in the filter above to drill into its counties.

Any disability

County · modeled prevalence (95% CI)

Each tile is a state. Pick a state in the Scope control above to drill into its counties.

AK 29.7% ME 30.9% WA 26.8% ID 34.1% MT 30.1% ND 27.1% MN 26.8% WI 28.6% MI 30.3% NY 26.5% VT 25.4% NH 25.2% OR 29.3% NV 33.2% WY 30.0% SD 29.5% IA 27.3% IL 27.0% IN 30.5% OH 28.7% PA NJ 24.2% MA 26.7% CA 30.0% UT 28.5% CO 26.9% NE 26.8% MO 35.4% KY WV 38.0% VA 29.3% MD 25.8% CT 24.6% RI 27.2% AZ 30.6% NM 33.3% KS 29.8% AR 37.3% TN 35.1% NC 31.4% SC 30.7% DC 21.8% DE 29.6% OK 38.3% LA 37.4% MS 37.3% AL 35.7% GA 29.2% TX 30.8% FL 30.1% HI 27.8% better than benchmark worse

CDC PLACES (model-based small-area estimates) · 2024 · source

Mobility disability

County · modeled prevalence (95% CI)

Each tile is a state. Pick a state in the Scope control above to drill into its counties.

AK 11.8% ME 12.6% WA 10.4% ID 13.8% MT 12.0% ND 10.8% MN 10.7% WI 12.4% MI 13.0% NY 12.6% VT 10.0% NH 10.3% OR 12.2% NV 14.5% WY 12.4% SD 12.2% IA 11.8% IL 12.1% IN 13.4% OH 12.9% PA NJ 10.6% MA 10.9% CA 13.3% UT 10.5% CO 10.1% NE 11.3% MO 14.8% KY WV 17.1% VA 12.8% MD 11.7% CT 10.5% RI 11.6% AZ 13.0% NM 14.6% KS 12.8% AR 16.6% TN 15.4% NC 13.4% SC 14.3% DC 9.6% DE 13.5% OK 16.4% LA 16.7% MS 17.8% AL 16.0% GA 13.4% TX 13.9% FL 13.8% HI 12.2% better than benchmark worse

CDC PLACES (model-based small-area estimates) · 2024 · source

Cognitive disability

County · modeled prevalence (95% CI)

Each tile is a state. Pick a state in the Scope control above to drill into its counties.

AK 14.2% ME 16.1% WA 13.8% ID 16.2% MT 14.7% ND 12.7% MN 13.0% WI 13.1% MI 14.6% NY 12.4% VT 12.9% NH 12.3% OR 14.9% NV 15.9% WY 14.5% SD 14.0% IA 13.8% IL 12.8% IN 15.3% OH 14.2% PA NJ 11.8% MA 13.9% CA 14.8% UT 15.1% CO 14.0% NE 12.3% MO 17.5% KY WV 19.1% VA 14.2% MD 12.4% CT 12.6% RI 14.1% AZ 14.5% NM 15.9% KS 14.6% AR 18.4% TN 17.7% NC 15.1% SC 14.7% DC 11.8% DE 13.4% OK 17.5% LA 18.7% MS 17.8% AL 16.4% GA 14.5% TX 15.2% FL 14.1% HI 12.9% better than benchmark worse

CDC PLACES (model-based small-area estimates) · 2024 · source

Why this matters

Disability prevalence varies by 17 points across states (21.1% to 38.1%), while the cost-barrier data is not tracked over time and is not broken out for the self-care and independent-living disability types. Resource planners cannot currently tell whether the access gap is improving, worsening, or worse for the two untracked types, which makes the measurement gap itself a policy problem, not only a data one.

Recommended actions

  • Extend CDC's cost-barrier indicator to the self-care and independent-living disability types it currently omits, so the full disabled population is measured.
  • Establish a multi-year cost-barrier series; the current data is single-year (2022 only), so trend direction cannot yet be assessed.
  • Target cost-barrier relief first at vision and cognitive disability types, where the measured gap (26% to 27%) is largest.
  • Direct prevalence-adjusted resources toward the highest-prevalence states (Arkansas 38.1%, Oklahoma 37.8%, West Virginia 36.6%), concentrated in the South and Appalachia.
  • Pursue a citable federal series on healthcare-specific ADA complaint volume, currently unavailable from HHS OCR or DOJ, so enforcement activity can be monitored alongside prevalence and cost data.

The recommendation

Therefore, elevate disability access into the core equity scorecard for care delivery. The recommended model is to measure cost and access barriers by disability type, fund accessible clinical operations and transportation, and require payers and providers to close gaps in routine, specialty, and follow-up care.

Demographic slice disability type, state. CDC DHDS.

Sources