Association between social determinants of health and physical disability: Findings from NHANES

Physical disabilities are a major determinant affecting the quality of life across populations. The relationship between social determinants of health (SDoH) and physical disabilities is well-established, although research on the specific correlation between these factors remains limited. This paper focuses on analyzing the specific association between the SDoH and physical disabilities in American adults. Information was sourced from National Health and Nutrition Examination Survey datasets spanning the years 2013 to 2018. Physical disabilities were evaluated using 6 questions: "Do you have serious hearing difficulties?," "Do you have serious vision impairment?," "Do you experience serious difficulties concentrating?," "Do you experience serious walking difficulties?," "Do you encounter problems with personal care tasks such as dressing or bathing?," and "Do you struggle with independently completing everyday tasks or errands." Responses to these questions were recorded as "Yes" or "No." Individuals were classified as having a physical disability if they answered "Yes" to any of the 6 questions. The SDoH included education, marital status, family income, food security, health insurance, employment status, homeownership, and healthcare accessibility. Controlling for confounding variables, we employed multivariable logistic regression to investigate the connection between SDoH and physical disabilities. A sample of 11,822 participants was used for the final analysis. A significant association was found between unfavorable SDoH and physical disability. For continuous variables, with an increase in the SDoH score, the risk of physical disability was significantly higher (odds ratio = 1.322, 95% confidence interval: 1.259-1.388, P < .0001). When categorized, participants with higher SDoH scores (category: ≥6) were more likely to experience physical disabilities compared with those with lower SDoH scores (category: 0), with an odds ratio of 6.479 (95% confidence interval: 4.643-9.041, P < .0001). Cross-sectional population studies have demonstrated that adverse SDoH are key contributors to physical disability across diverse demographic groups in the United States, encompassing both younger and older individuals. Moreover, the likelihood of physical disability increases markedly with the accumulation of multiple unfavorable SDoH at the individual level, rather than the presence of a single factor.