Disparities in Housing Challenges Between Disabled and Non-disabled Adults in the U.S.: A State-level Analysis (2019-2022)

Research Objectives: To demonstrate disparities in housing issues and housing types between disabled and non-disabled adults across states from 2019-2022.

Design: Testing of US Census American Community Survey data, using paired sample t-tests.

Setting: State-level aggregated measures from the Annual Disability Statistics Compendium using the ACS.

Participants: Disabled and non-disabled adults via the ACS.

Interventions: None.

Main Outcome Measures: Disparities between disabled adults and non-disabled adults are measured by comparing the prevalence of housing issues and housing type. Housing issues include incomplete kitchen, incomplete plumbing, overcrowding, housing cost burden, poor housing, and old housing. Housing type is measured by the percent adults residing in houses, apartments, and mobile homes by disability status. Both housing issues and housing type are annual state-level measures.

Results: Overall, disabled adults overwhelmingly experience more housing issues than non-disabled adults. From 2019-2022, the prominent housing issue was high housing cost burden (2019-33.30%,2020-32.75%,2021-33.81%,2022-28.24%). Additional significant issues were consistently observed.

In 2019, disabled adults were more likely to experience all housing issues, except old housing (t=10.81,p < 0.001): incomplete kitchen (t=-0.8755, p< 0.001), incomplete plumbing (t=-8.345,t < 0.001), and poor housing (t=-26.556, p< 0.001). 

In 2020, non-disabled adults were more likely to live in old housing (t=16.699, p< 0.001). Disabled adults were more likely to face incomplete kitchens (t=-10.114,p < 0.001), incomplete plumbing (t=-5.134,p < 0.001), poor housing (t=-26.556,p < 0.001), and live in apartments (t=-10.753,p < 0.001) and mobile homes (t=-10.726,p < 0.001). 
 
In 2021, prevalence of incomplete kitchen (t-8.424,p < 0.001), incomplete plumbing (t=-0.569,p < 0.0001), and poor housing (t=-23.452,p < 0.001) was higher for disabled adults. They were also more likely to live in apartments (t=-9.892,p < 0.001), and mobile homes (t=-13.301,p < 0.001). 

In 2022, disabled adults were less likely to live in old housing (t=17.572,p < 0.001), but more likely to experience all other housing issues: incomplete kitchen (t=-5.325,p < 0.001), incomplete plumbing (t=4.782,p < 0.001), and poor housing (t=-4.197,p < 0.001).

Conclusions: Over time, disabled persons were consistently more likely to face housing issues and live in apartments and mobile homes than non-disabled persons – indicating consequential geographic and livability disparities. 

Persistent disparities underscore the need for rehabilitative professionals to consider these housing challenges when planning care and services. Awareness of housing types and issues allows occupational therapists to adapt interventions to fit the realities of patients’ environments. Case managers and clinicians can ensure that discharge plans are not merely medically appropriate, but also account for social determinants of health, including housing issues. A home that lacks accessibility or amenities can impede recovery, and daily functioning.

Author(s) Disclosures: None.