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Social Risks Among Adults with Communication Disabilities: Findings from the National Health Interview Survey

Jennifer Y Oshita¹, Megan A Morris¹, Benjamin Littenberg²

¹NYU Langone Health, New York, NY.

Archives of Physical Medicine and Rehabilitation

|March 12, 2026

Summary

Adults with communication disabilities (CDs) face higher rates of social risks like food insecurity and transportation issues. These findings highlight the need for integrated social risk assessments in healthcare for equitable outcomes.

Keywords:

Acquired communication disorder Brain injuries Communication Disorder Developmental disability Intellectual disability Learning disability Persons with Disabilities Social Determinants of Health Speech disorder

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Area of Science:

Public Health
Health Services Research
Social Determinants of Health

Background:

Health-related social risks significantly impact health outcomes.
Communication disabilities (CDs) affect a substantial portion of the adult population.
Understanding the intersection of CDs and social risks is crucial for health equity.

Purpose of the Study:

To compare the prevalence of health-related social risks among US adults with and without communication disabilities.
To identify specific social risks disproportionately affecting individuals with hearing, speaking, or understanding difficulties.

Main Methods:

Cross-sectional study utilizing pooled data from the 2020-2023 National Health Interview Survey (NHIS).
Analysis of a nationally representative sample of 118,158 community-dwelling US adults.
Multivariate logistic regressions adjusted for demographic and socioeconomic factors to assess social risks (food insecurity, housing instability, transportation, medical cost barriers).

Main Results:

18.1% of adults reported having a communication disability (CD).
Adults with CDs experienced social risks at higher rates (33.2%) compared to those without CDs (24.3%).
Adjusted analyses revealed significantly higher rates of all examined social risks for adults with any CDs.

Conclusions:

One in three adults with CDs encounter social risks, including food insecurity, housing instability, transportation barriers, and financial difficulties accessing care.
Structural barriers associated with CDs may exacerbate social vulnerability.
Rehabilitation providers should integrate social risk assessments into treatment planning to promote equitable health outcomes for individuals with CDs.