Functional disability, diabetes and hypertension among adults in the United States, August 2021-August 2023.

OBJECTIVE

To describe diabetes and hypertension prevalence, diagnosis status and measured-threshold outcomes by functional disability.

METHODS

We analyzed the National Health and Nutrition Examination Survey conducted in the United States during August 2021-August 2023. Adults aged 18 years or older were classified using six Washington Group functioning domains. Outcome-specific weights and direct age standardization were used. Disability-minus-no-disability differences and 95% confidence intervals accounted for the complex survey design.

RESULTS

Among 8101 adults with complete functioning data, total diabetes and hypertension were classifiable in 5974 and 6172. Standardized total-disease differences were 9.3 percentage points (5.8, 12.7) for diabetes and 8.3 (3.1, 13.6) for hypertension. Undiagnosed-disease differences among eligible adults were 0.6 (-0.4, 1.7) and -3.4 (-7.2, 0.5), respectively. Among hypertension cases with known diagnosis status, the undiagnosed fraction was lower with disability: -14.1 (-19.9, -8.3). Conditional diabetes estimates were imprecise and sensitive to sparse younger-age cells.

CONCLUSIONS

Adults with functional disability had higher standardized total diabetes and hypertension prevalence. Diagnosis-status and measured-threshold findings depended on the condition and denominator; they do not establish equivalent care or explain the origins of prevalence differences.