Social determinants of unmet medical needs among adults with disabilities: A national cohort study

Objectives: The rapid aging of the population with disabilities, combined with rising national healthcare expenditures, presents a significant public health challenge. Understanding the multidimensional social and community factors influencing unmet healthcare needs is crucial, as they are closely linked to the health outcomes of people with disabilities. Methods: We conducted hierarchical logistic regression using data from 4,254 adults with disabilities who participated in the 2021 4th Disability Life Panel Survey. Variables related to unmet healthcare needs were categorized based on the World Health Organization’s social determinants of health framework. Results: In addition to individual factors, which have been the focus of previous studies, social and community contexts, as well as access to quality healthcare systems, were key determinants of unmet healthcare needs among people with disabilities. Interestingly, individual factors lost statistical significance when social factors were included in the hierarchical analysis. Conclusion: The findings highlight the impact of social and structural determinants on unmet healthcare needs. Targeted policies and public health interventions should address these determinants to reduce unmet medical needs and improve the health outcomes of people with disabilities.