The Impact of Cognitive, Social and Physical Limitations on Income in Community Dwelling Adults With Chronic Medical and Mental Disorders

INTRODUCTION: As much as 45% of the US population has at least one chronic condition while 21% have multiple chronic diseases. The study examined the impact of cognitive, social and physical limitations on the personal income of U.S. adults with seven chronic diseases.

METHODS: A cross-sectional analysis of 19,357 US adults with seven chronic diseases (diabetes, hypertension, heart disease, stroke, depression, emphysema and joint disease) from the 2006 Medical Expenditure Panel Survey (MEPS) was performed. The effect of seven chronic diseases and their associated cognitive, social, and physical limitations on personal income was assessed using a two-stage Heckman model.

RESULTS: Depression emerged as the only chronic disease that was independently associated with a significant $1,914 decrease in personal income (95% CI -$2,938--$890). Social and cognitive limitations resulted in $1,944 (95% CI -$3,378--$511) and $3,039 (95% CI -$4,418-$1,659) decreases in personal incomes respectively while physical limitations did not result in a statistically significant reduction. Being Non-Hispanic Black, Hispanic, Other Race, female, never married, married, less than a bachelor’s degree, publicly insured, uninsured, or having a health status less than very good were also associated with significant reductions in personal income.

CONCLUSIONS: The findings of this study suggest a need to determine the specific limitations associated with common chronic diseases and identify appropriate compensatory strategies to reduce their impact on income.