Health and independence of young adults with disabilities. Two years later

American culture expects young people to complete school, find satisfying work, develop social networks, stay healthy, contribute to the maintenance and support of households, and participate as citizens in their communities. We know little about the life trajectories of young adults with disabilities during emerging adulthood.

Four-page surveys were mailed to the 650 respondents of a 10-page survey sent to graduates of a state Children with Special Healthcare Needs program and a children's orthopaedic hospital 2 years earlier to determine changes in healthcare access and use, insurance status, health perceptions, education, work, and markers of independent living over those 2 years of maturation.

The study sample was 300 young people who completed both surveys. Respondents were 20-25 years of age, 95% White, 64% female, and 28% who reported that they were independent in all activities of daily living (ADL).

Compared with the initial survey, results for this group of young people who reported needing assistance in ADL showed that, 2 years later, fewer were living with their parents and even more were married. More of these young adults had children, although at only about half the rate of typical young adults. General health perceptions remained stable, with twice the percentage of respondents reporting fair or poor health compared with typical young adults. Only 17% of respondents reported not having a usual source of care compared with 27% of Kentuckians ages 18-24, but they continued to use the emergency room much more than did typical young adults. Twenty-five percent of survey respondents reported having no health insurance compared with 39% of Kentuckians ages 18-24 and 29% of young adults in the United States. More had completed high school, and 32% had college experience. Two years later, 51% were working compared with 45% initially; 63% of those not working would have liked to have been working, and 53% of those were looking for work. Of great concern is the increase from 23% to 29% of young adults not in school, not working, and not home with children. In general, the study shows that young people with disabilities show progress in markers of adulthood as they move through their 20s just as much as do typical young adults. Nurses can support healthy transitions through assistance in finding adult medical homes, doing preventive screening, teaching knowledge and skills for healthcare planning and management, and planning for continuous insurance.