2019 Annual Disability Statistics Compendium

Rural

Section 10: Rural

Sponsored by The Research and Training Center on Disability in Rural Communities (RTC:Rural) at the Rural Institute for Inclusive Communities at the University of Montana

The Office of Management and Budget (OMB) separates U.S. counties into metropolitan and non-metropolitan counties based on population thresholds and commuting patterns (shown in the map below). Counties are classified metropolitan if they contain an urban core of at least 50,000 people or if a significant proportion of the population commutes into an adjacent urban core. Non-metropolitan counties can be further classified into micropolitan and noncore counties, with micropolitan counties having an urban core of 10,000 to 50,000 people and noncore counties being those that remain. Although metropolitan, micropolitan, and noncore designations do not fully describe the varied conditions across place, they suggest that infrastructure and associated economic and demographic factors contribute to the rural experience. 

A map showing the distribution of metropolitan, micropolitan and noncore counties across the US (including Puerto Rico). There are 1,236 metropolitan counties which are shown in yellow. There are fewer metropolitan counties, 663 and these are shown in light green. More counties are noncore, the most "rural", with 1,334 dark green counties.

Map Description: A map showing the distribution of metropolitan, micropolitan and noncore counties across the US (including Puerto Rico). There are 1,236 metropolitan counties which are shown in yellow. There are fewer micropolitan counties, 663 and these are shown in light green. More counties are noncore, the most "rural", with 1,334 dark green counties. 


Contextual differences between metropolitan and non-metropolitan counties shape both the experiences and outcomes of people with disabilities and often result in inequities across place. As counties become more rural (non-metropolitan), a wide range of disparities grow.

Data representative of the U.S. population are used to inform the development of policies and programs at the local, state, and national levels. Available data on rural disability, however, is limited and frequently imprecise.  For instance, the American Community Survey (ACS) uses a continuous data collection timeline, where new data are added every month to generate a sample equal to 12.5% of the total population every five years. The continuous nature of ACS data collection and resulting sample size affects the availability and validity of rural data. For counties with populations of 65,000 or less, raw data must be aggregated across five years before it is released.  This constitutes 74% percent of U.S. counties. Due to a change in disability indicator questions in 2008, the first 5-year data file with rural disability indicators was not available until December 2013. To avoid overlapping data collection periods, it wasn’t until 2018 that rural outcomes could be compared over time using ACS data.

Additionally, analyses of rural data are limited because of smaller sample sizes and high margins of error (MOE). This is a particular problem for examining rural subgroup data such as rural disability rates by race. High MOE make data less reliable for smaller geographies and necessitates that researchers aggregate data across counties or years to increase precision. Because of these types of limitations, there is a need to expand the availability and quality of rural data for policy and program development, using a tailored approach.

The goal of providing rural annual and trend data in collaboration with the StatsRRTC is to improve access to accurate and current data about the disability experience in rural communities. These data can be used by advocates, service providers, researchers, and policy makers for making informed arguments, developing sound decisions, building hypotheses, and understanding policy impacts. This effort will raise awareness of how rural people with disabilities are similar to and different from their urban counterparts.  It will allow stakeholders to more easily access a wide range of information about the disability experience in rural communities to make informed decisions about programs and policies likely to benefit rural people with disabilities.

Methods

The Rural Addendum provides data on key sociodemographic characteristics for people with and without disabilities residing in metropolitan, micropolitan, and noncore counties. Data come from the 2013-2017 American Community Survey (ACS) 5-year summary files. To calculate metropolitan, micropolitan, and noncore populations, we first classified county-level data based on OMB classifications. We then aggregated populations across these metropolitan, micropolitan, and noncore designations to explore geographic differences. For all tables, disability status is based on having responded “yes” to at least one of a series of six disability indicator questions in the ACS. The glossary contains the questions used in the ACS to arrive at the disability estimates. Note that all table estimates exclude persons living in institutions and active duty military personnel. Some questions are asked only of people of certain ages.

Tables

Table 10.1 reports on the prevalence of disability in the United States. For the 5-year period from 2013-2017, the estimated rate of disability was 12.0% for metropolitan, 15.8% for micropolitan, and 17.9% for noncore counties.  Estimated rates were higher in noncore counties for all reported disabilities, including hearing, vision, cognitive, ambulatory, self-care, and independent living disabilities.

Tables 10.2a & 10.2b provide demographic information for people with and without disabilities living in metropolitan, micropolitan, and noncore counties. Trends in the data show that as counties become more rural there are higher rates of White and American Indian or Alaska Native (AIAN) populations, and lower rates of Black, Asian, Native Hawaiian or Other Pacific Islander (NHPI), multi-racial, and Hispanic populations for both people with and without disabilities.  

 

 

 

Table 10.3 compares employment and work experience rates for people with and without disabilities.  As counties become more rural, the employment rate decreases and the “not in the labor force” rate increases for people with and without disabilities.  Notably, 65.0% of the population with disability living in noncore counties was not in the labor force, and 63.1% did not work in the past 12 months.  

Table 10.4 shows poverty rates by age and median earnings for people with and without disabilities.  Poverty rates for people with and without disability increase for all age groups as counties become more ruralPoverty rates are most pronounced for individuals living in noncore counties, where 37.1% of the population less than 18 years, 31.4% of the population 18 to 64, and 14.1% of the population 65 years and older lives at or below the poverty level.  When comparing median earnings, people with disabilities receive significantly less income in metropolitan, micropolitan, and noncore counties when compared to those without disabilities.  The median earnings difference between people with and without disabilities, however, is smallest in noncore counties.

Table 10.5 shows health insurance coverage and type for people with and without disabilities. As places become more rural, people with and without disability report lower rates of insurance coverage. For all geography (metropolitan, micropolitan, and noncore), people with disabilities report lower rates of private insurance, and higher rates of public insurance, relative to those without disabilities.

Table 10.1 Rural Comparison — Prevalence and Population of Civilians Living in the Community with and without Disabilities, by Metropolitan, Micropolitan, and Noncore Status for the United States
Metropolitan Classifications Any Disability [2] Disability Type [1]
Vision Hearing Cognitive Ambulatory Self-Care Independent Living
Metropolitan                                                                           
     Disability                                                                           
         Count  33,053,643 6,165,864 9,061,715 12,569,541 17,181,251 6,641,183 11,840,444
         Rate (%)        12.0       2.2       3.3        4.6        6.3       2.4        4.3
     No Disability                                                                           
         Count 241,454,885     X         X         X          X          X         X     
         Rate (%)        88.0     X         X         X          X          X         X     
                                                                            
Micropolitan                                                                           
     Disability                                                                           
         Count   4,280,802   814,010 1,320,821  1,579,638  2,253,850   807,708  1,437,098
         Rate (%)        15.8       3.0       4.9        5.8        8.3       3.0        5.3
     No Disability                                                                           
         Count  22,834,064     X         X         X          X          X         X     
         Rate (%)        84.2     X         X         X          X          X         X     
                                                                            
Noncore                                                                           
     Disability                                                                           
         Count   3,192,426   624,567 1,037,573  1,137,728  1,743,885   607,204  1,072,350
         Rate (%)        17.9       3.5       5.8        6.4        9.8       3.4        6.0
     No Disability                                                                           
         Count  14,654,014     X         X         X          X          X         X     
         Rate (%)        82.1     X         X         X          X          X         X     
Table 10.2a Rural Comparison — Demographics of Civilians Living in the Community with and without Disabilities, by Metropolitan, Micropolitan, and Noncore Status for the United States
Metropolitan Classifications Total (overall prevalence) Age Groups Sex [1]
Less than 18 years 18 to 64 years 65 years and over Male Female
Metropolitan                                                                      
     Disability                                                                      
         Count  33,053,643  2,602,812  16,824,827 13,626,004  15,813,310  17,240,333
         Rate (%)        12.0        7.9        50.9       41.2        47.8        52.2
     No Disability                                                                      
         Count 241,454,885 61,345,021 154,739,026 25,370,838 118,059,383 123,395,502
         Rate (%)        88.0       25.4        64.1       10.5        48.9        51.1
                                                                       
Micropolitan                                                                      
     Disability                                                                      
         Count   4,280,802    304,352   2,215,217  1,761,233   2,135,987   2,144,815
         Rate (%)        15.8        7.1        51.7       41.1        49.9        50.1
     No Disability                                                                      
         Count  22,834,064  5,913,156  14,079,173  2,841,735  11,212,512  11,621,552
         Rate (%)        84.2       25.9        61.7       12.4        49.1        50.9
                                                                       
Noncore                                                                      
     Disability                                                                      
         Count   3,192,426    206,890   1,605,625  1,379,911   1,628,683   1,563,743
         Rate (%)        17.9        6.5        50.3       43.2        51.0        49.0
     No Disability                                                                      
         Count  14,654,014  3,822,435   8,763,836  2,067,743   7,204,406   7,449,608
         Rate (%)        82.1       26.1        59.8       14.1        49.2        50.8
Table 10.2b Rural Comparison — Demographics of Civilians Living in the Community with and without Disabilities, by Metropolitan, Micropolitan, and Noncore Status for the United States
Metropolitan Classifications Race and Ethnicity [1]
White African American American Indian/Alaska Native Asian Native Hawaiian /Pacific Islander Other Two or more races Hispanic/Latino (of any race)
Metropolitan                                                                                    
     Disability                                                                                    
         Count  24,363,450  4,950,598   269,226  1,161,524  52,103  1,281,459   975,283  5,267,035
         Rate (%)        73.7       15.0       0.8        3.5     0.2        3.9       3.0       15.9
     No Disability                                                                                    
         Count 170,993,727 31,265,521 1,345,640 15,520,425 445,588 13,777,061 8,106,923 50,116,398
         Rate (%)        70.8       12.9       0.6        6.4     0.2        5.7       3.4       20.8
                                                                                     
Micropolitan                                                                                    
     Disability                                                                                    
         Count   3,654,571    349,314    87,245     27,886   5,866     53,674   102,246    284,108
         Rate (%)        85.4        8.2       2.0        0.7     0.1        1.3       2.4        6.6
     No Disability                                                                                    
         Count  19,282,510  1,720,259   405,312    300,482  42,998    498,544   583,959  2,357,510
         Rate (%)        84.4        7.5       1.8        1.3     0.2        2.2       2.6       10.3
                                                                                     
Noncore                                                                                    
     Disability                                                                                    
         Count   2,745,657    270,495    78,017      7,971   1,247     24,933    64,106    129,144
         Rate (%)          86        8.5       2.4        0.2     0.0        0.8       2.0        4.0
     No Disability                                                                                    
         Count  12,494,388  1,138,715   393,245     91,389   9,209    235,932   291,136  1,032,287
         Rate (%)        85.3        7.8       2.7        0.6     0.1        1.6       2.0        7.0
Table 10.3 Rural Comparison — Employment of Civilians Living in the Community with and without Disabilities, by Metropolitan, Micropolitan, and Noncore Status for the United States
Metropolitan Classifications Employment [1] Work Experience
Employed Unemployed Not in the labor force Worked full time Worked part time Did not work
Metropolitan                                                                  
     Disability                                                                  
         Count   6,080,372 1,021,066  9,723,389  3,741,958  3,513,433  9,569,436
         Rate (%)        36.1       6.1       57.8       22.2       20.9       56.9
     No Disability                                                                  
         Count 117,766,305 7,668,360 29,304,361 85,186,389 42,201,350 27,351,287
         Rate (%)        76.1       5.0       18.9       55.1       27.3       17.7
                                                                   
Micropolitan                                                                  
     Disability                                                                  
         Count     724,197   115,497  1,375,523    441,075    443,676  1,330,466
         Rate (%)        32.7       5.2       62.1       19.9       20.0       60.1
     No Disability                                                                  
         Count  10,507,603   677,180  2,894,390  7,559,150  3,971,278  2,548,745
         Rate (%)        74.6       4.8       20.6       53.7       28.2       18.1
                                                                   
Noncore                                                                  
     Disability                                                                  
         Count     484,434    77,084  1,044,107    305,095    287,541  1,012,989
         Rate (%)        30.2       4.8       65.0       19.0       17.9       63.1
     No Disability                                                                  
         Count   6,465,693   422,423  1,875,720  4,748,165  2,319,203  1,696,468
         Rate (%)        73.8       4.8       21.4       54.2       26.5       19.4
Table 10.4 Rural Comparison — Poverty and Median Earnings of Civilians Living in the Community with and without Disabilities, by Metropolitan, Micropolitan, and Noncore Status for the United States
Metropolitan Classifications Poverty [1] Earnings ($)
At or below Poverty Line Less than 18 years 18 to 64 years 65 years and older Total Male Female
Metropolitan                                                                
     Disability                                                                
         Count  7,042,435    776,156  4,490,115 1,776,164 22,493 27,410 18,495
         Rate (%)       21.4       30.5       26.8      13.0   X      X      X   
     No Disability                                                                
         Count 32,398,200 11,895,359 18,538,350 1,964,491 31,792 38,309 26,089
         Rate (%)       13.6       19.6       12.1       7.7   X      X      X   
                                                                 
Micropolitan                                                                
     Disability                                                                
         Count  1,002,147    103,608    668,950   229,589 19,981 25,017 15,752
         Rate (%)       23.6       35.0       30.4      13.0   X      X      X   
     No Disability                                                                
         Count  3,605,455  1,356,385  2,026,415   222,655 28,488 34,803 22,938
         Rate (%)       16.1       23.4       14.7       7.8   X      X      X   
                                                                 
Noncore                                                                
     Disability                                                                
         Count    770,625     74,506    502,023   194,096 21,087 26,569 16,651
         Rate (%)       24.2       37.1       31.4      14.1   X      X      X   
     No Disability                                                                
         Count  2,358,956    921,212  1,259,872   177,872 28,474 35,017 22,377
         Rate (%)       16.3       24.5       14.5       8.6   X      X      X   
Table 10.5 Rural Comparison — Insurance Coverage for Civilians Living in the Community with and without Disabilities, by Metropolitan, Micropolitan, and Noncore Status for the United States
Metropolitan Classifications Insurance Coverage [1]
Private Public None
Metropolitan                                  
     Disability                                  
         Count  16,480,417 23,968,767  2,151,083
         Rate (%)        49.9       72.5        6.5
     No Disability                                  
         Count 168,902,640 67,048,008 26,183,476
         Rate (%)        70.0       27.8       10.8
                                   
Micropolitan                                  
     Disability                                  
         Count   2,077,951  3,212,524    302,394
         Rate (%)        48.5       75.0        7.1
     No Disability                                  
         Count  15,397,110  7,317,743  2,626,410
         Rate (%)        67.4       32.0       11.5
                                   
Noncore                                  
     Disability                                  
         Count   1,483,911  2,452,647    236,171
         Rate (%)        46.5       76.8        7.4
     No Disability                                  
         Count   9,461,193  5,038,988  1,892,579
         Rate (%)        64.6       34.4       12.9
Map of Disability in America (2017)

Map Description

Reported rates of disability vary across the country with a notable difference between rates in urban and rural counties. In aggregate, we see higher rates in rural counties across a variety of indicators (see table 14.1). However, rural disability rates are not consistent and clear geographic and regional patterns emerge when exploring these data on a map. The map above on the previous page shows disability rates at the county level for every county in the United States (including Puerto Rico). Rates are classified by quartile with lower rates shown in lighter purple and higher rates in darker purple. There are clear geographic clusters of both high and low rates of disability throughout the U.S.

There are higher rates of reported disability throughout the rural Southern United States in Appalachia, Southern Missouri and Arkansas, along the border of Mississippi and Alabama and across New Mexico into Southern Colorado. Clusters of high rates of reported disability can also be found in rural areas of Maine, Michigan, Idaho, California and Oregon. Finally, there are high rates of reported disability throughout Puerto Rico.

There is also a noticeable regional pattern where reported rates of disability are lowest. States in the North and Middle Atlantic region as well as across the Midwest, Great Plains and Rocky Mountain West (with the exception of Northern Idaho) all have lower rates of reported disability.

The forces underlying these geographic clusters are complex. Local level social, economic and environmental factors all contribute to people’s experience of disability. Communities and regions experiencing persistent and historical poverty, extractive industry dependence and other forms of social, spatial, and economic marginalization tend to report higher levels of disability. Improving our understanding of how and why rates of disability vary across rural America is valuable for developing effective policies and programs to serve rural people with disabilities.

For more information check out the RTC:Rural’s Disability Counts webpage where you can view and download additional maps for both the nation and states and access disability data by county using our data lookup tool.  http://rtc.ruralinstitute.umt.edu/resources/disability-counts-data-finder