Social Risks Among Adults With Communication Disabilities: Findings From the National Health Interview Survey (2020-2023).

OBJECTIVE

To compare the prevalence of health-related social risks (eg, food insecurity, unreliable transportation) among adults with and without hearing, speaking, and/or understanding difficulties (collectively called communication disabilities [CDs]).

DESIGN

Cross-sectional study.

SETTING

Pooled data from the 2020-2023 National Health Interview Survey.

PARTICIPANTS

A nationally representative sample (N = 118,223) of community-dwelling, US adults.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Self-reported experiences of social risks in food, housing, transportation, and access to medical care and medications were assessed. Separate multivariate logistic regressions, with survey weighting, were conducted for each social risk factor, adjusted for age, sex, race, ethnicity, health insurance, education, employment, and rurality.

RESULTS

Of 118,158 adults, 18.1% reported having a CD, including 14.8% with hearing difficulties, 5.3% with difficulty speaking or understanding others, and 2.0% who experienced both. One in 3 adults with CDs (33.2%) reported at least 1 social risk, compared with 1 in 4 (24.3%) among those without CDs. In adjusted analysis, adults with any CDs had significantly higher rates of all social risks (risk difference, 0.030-0.059; P<.001 in all cases).

CONCLUSIONS

One in 3 adults with CDs experienced social risks related to food insecurity, housing instability, unreliable transportation, and access to medical care and medications. Their likelihood of experiencing social risks across multiple domains was consistently higher than for adults without CDs. These findings suggest that systemic barriers tied to CDs contribute to social risk vulnerability and highlight the need to address social risks in healthcare settings commonly serving adults with CDs, and to do so in communication accessible ways.