Trends in disability and limitations among US adults aged 18-44 years, 2000-2018

Understanding disability trends is critical for health care and social policy. Although trends in disability and limitations have been studied extensively among older and middle-aged adults, little is known about trends in younger Americans, despite their importance for current and future population health. We present the first comprehensive evidence on disability trends among US adults age 18-44. We analyze 20 measures of disability and limitations collected in the nationally representative National Health Interview Survey 2000-2018 (n = 261 505). Robust Poisson models estimate age- and sex-adjusted trends and their covariates. Over one-quarter (27.4%) reported at least 1 disability or limitation; the age-adjusted prevalence increased by 5% from 2000 to 2018. However, trends for specific disabilities and limitations varied tremendously. Activities of daily living and instrumental activities of daily living limitations, cognitive, and social disabilities increased steeply (by 65%-89% over the study period). Mobility limitations were generally unchanged or increased modestly. Hearing and "other" limitations decreased significantly (25%-48% decrease). The trends are only partly explained by education, health behaviors, chronic conditions, and other covariates. Disability trends research must not be limited to older adults. Researchers and policy makers interested in health care policy, planning, and caregiving should pay attention to disability trends among young adults in the United States.