摘要：Objectives. We sought to provide estimates of disability prevalence for states and metropolitan areas in the United States. Methods. We analyzed Behavioral Risk Factor Surveillance System data from 2001 for all 50 states and the District of Columbia and 103 metropolitan areas. We performed stratified analyses by demographics for 20 metropolitan areas with the highest prevalence of disability. Results. State disability estimates ranged from 10.5% in Hawaii to 25.9% in Arizona. Metropolitan disability estimates ranged from 10.2% in Honolulu, Hawaii to 27.1% in Tucson, Ariz. Regional metropolitan medians for disability (range, 17.0–19.7%) were similar across the Northeast, Midwest, and South and were highest in the West. In the 20 metropolitan areas with the highest disability estimates, the prevalence of disability generally increased with age and was higher for women and those with a high-school education or less. Conclusions. State and metropolitan-area estimates may be used to guide state and local efforts to prevent, delay, or reduce disability and secondary conditions in persons with disabilities. In 2000, disability affected an estimated 49.7 million persons in the United States, 1 and direct medical costs for persons with disability were $260 billion in 1996. 2 As the population ages and the prevalence of disability increases, annual disability-related costs to the US health care system can be expected to rise, with more than 56% paid by the US government. 3 Development of health promotion policies and disease prevention programs relating to people with disability would be aided by public health surveillance, but the lack of a brief case definition of disability has hindered efforts to obtain state and local estimates of the prevalence of this problem. One of the national objectives of Healthy People 2010 , published in 2000, is to “include in the core of all Healthy People 2010 surveillance instruments a standardized set of questions that identify ‘people with disabilities.’ ” 4 In 2001, 2 core questions were added to the Behavioral Risk Factor Surveillance System (BRFSS) to identify people with disabilities in all of the states that use the survey—one relating to activity limitation and the other to special equipment. 5 – 7 The BRFSS has a sufficiently large sample (more than 200 000) to allow analyses of disability data at the metropolitan level. We used 2001 BRFSS data to examine disability in all 50 states, the District of Columbia, and 103 metropolitan areas. The purposes of our study were to estimate the prevalence of disability at the state and metropolitan levels and to compare disability estimates by age, gender, race/ethnicity, and educational level for the 20 metropolitan statistical areas (MSAs) with the highest prevalence of disability.
