Factors associated with morbidities among persons with disabilities in Malaysia

Persons with disabilities (PWDs) face disproportionate health risks, particularly from non-communicable diseases (NCDs) such as diabetes and hypertension, which remain leading causes of mortality globally. In lower-middle-income countries (LMICs) like Malaysia, disability and NCDs perpetuate a cycle of vulnerability, yet evidence on morbidity patterns among PWDs remains limited. This study aimed to determine the prevalence and factors associated with morbidity among PWDs in Malaysia. Data were drawn from the National Health and Morbidity Survey (NHMS) 2023: Non-Communicable Diseases, a nationally representative cross-sectional survey of adults aged ≥ 18 years, using a multi-stage stratified sampling design. Disability was assessed with the locally validated Washington Group Short Set, and morbidity was defined as the presence of either diabetes, hypertension or hypercholesterolemia. Multivariate binary logistic regression with complex sample analysis was performed using SPSS v25.0. The prevalence of disability among Malaysian adults was 8.2% (95% CI: 7.37-9.17). Among PWDs, 73.9% reported comorbidities, with hypertension (56.9%) being most prevalent. Compared with older PWDs, those aged 18-35 years (aOR = 0.123; 95% CI: 0.052-0.300) and 36-59 years (aOR = 0.443; 95% CI: 0.247-0.739) had significantly lower odds of morbidity. Education was protective, with secondary (aOR = 0.608; 95% CI: 0.350-1.057) and tertiary education (aOR = 0.270; 95% CI: 0.104-0.586) associated with reduced odds compared with no formal education. Ethnicity also emerged as a determinant, with those categorised as "Others" showing lower morbidity risk than Malays (aOR = 0.360; 95% CI: 0.111-1.166). While the prevalence of disability in Malaysia mirrors international estimates, the burden of morbidity among PWDs is alarmingly high. Targeted strategies, including enhanced screening, health literacy initiatives, and equitable access to care, are urgently needed, particularly for ethnic minorities and individuals with lower educational attainment, to reduce health disparities and improve outcomes for this vulnerable population.