Physical and Mental Disabilities among the Gender-Diverse Population Using the Behavioral Risk Factor Surveillance System, BRFSS (2017–2019): A Propensity-Matched Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Data Source
2.2. Participants
2.3. Variables and Measures
2.4. Statistical Analysis
3. Results
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Gender Identities | Total | p Value | |
---|---|---|---|---|
TGNB | Cisgender | |||
n (weighted %) | n (weighted %) | n (weighted %) | ||
All | 2827 (0.5) | 661,276 (99.5) | 664,103 | - |
Sex assigned at birth | ||||
Male | 1456 (51.9) | 294,479 (47.7) | 295,935 (48.0) | <0.001 |
Female | 1324 (48.1) | 366,243 (51.7) | 36,7567 (52.0) | |
Education status | ||||
High school graduate or less | 1343 (55.1) | 223,742 (41.4) | 225,085 (41.4) | <0.001 |
Attended college | 723 (28.9) | 183,259 (31.3) | 183,982 (31.3) | |
College graduate | 742 (16.0) | 252,304 (27.4) | 253,052 (27.3) | |
Age (in years) | ||||
18–34 | 847 (47.4) | 99,009 (27.6) | 99,856 (27.7) | <0.001 |
35–54 | 700 (25.1) | 172,366 (32.3) | 173,066 (32.2) | |
55–74 | 936 (20.8) | 279,048 (31.0) | 279,984 (30.9) | |
75+ | 307 (6.7) | 101,102 (9.2) | 101,409 (9.2) | |
Race/ethnicity | ||||
White | 1784 (55.8) | 500,935 (63.7) | 502,719 (63.7) | <0.001 |
Non-white | 680 (23.2) | 109,607 (20.5) | 110,287 (20.5) | |
Hispanic | 337 (21.0) | 46,450 (15.8) | 46,787 (15.9) | |
Marital status | ||||
Married | 1032 (34.3) | 338,983 (51.1) | 340,015 (51.0) | <0.001 |
Divorced | 382 (9.8) | 92,057 (10.9) | 92,439 (10.9) | |
Widowed | 285 (6.2) | 82,717 (7.4) | 83,002 (7.3) | |
Separated | 80 (3.0) | 14,374 (2.6) | 14,454 (2.6) | |
Never married | 850 (38.8) | 107,597 (23.5) | 108,447 (23.6) | |
A member of unmarried couple | 181 (7.8) | 21,651 (4.6) | 21,832 (4.7) |
Means Treated (Trans) | Mean Control (Cis) | SMD | VR | Standard Pair Distance | |
---|---|---|---|---|---|
Age | 2.949 | 2.951 | −0.0015 | 1.001 | 0.0098 |
Biological sex | 1.569 | 1.533 | 0.0386 | 1.353 | 0.0507 |
Race | 1.843 | 1.849 | −0.0041 | 0.992 | 0.0102 |
Marital status | 2.988 | 3.004 | −0.0083 | 0.973 | 0.0146 |
Education level | 2.635 | 2.630 | 0.0047 | 0.998 | 0.0069 |
Unmatched | Matched | |||||
---|---|---|---|---|---|---|
Outcome | TGNB N (Weighted %) | Cisgender N (Weighted%) | p Value | TGNB N (%) | Cisgender N (%) | p Value |
Income in dollars | ||||||
Up to 25 K | 926 (43.7) | 138,849 (26.3) | <0.001 | 884 (39.5) | 655 (29.8) | <0.001 |
25–50 K | 573 (19.7) | 13,4271 (23.2) | 549 (24.6) | 533(24.2) | ||
50–75 K | 311 (12.5) | 89,208 (15.1) | 304 (13.6) | 338 (15.4) | ||
75+ K | 515 (24.1) | 192,787 (35.4) | 499 (22.3) | 675 (30.7) | ||
Employment status | ||||||
In labor force or working | 1350 (49.2) | 326,136 (56.8) | <0.001 | 1301 (48.4) | 1385 (51.5) | <0.001 |
Out of labor force or unemployed | 1091 (36.9) | 280,908 (36.0) | 1049 (39.1) | 1072 (39.9) | ||
Unable to work | 353 (13.9) | 48,893 (7.2) | 337 (12.5) | 230 (8.6) | ||
Healthcare insurance | ||||||
Yes | 2434 (82.2) | 605,968 (87.2) | <0.001 | 2317 (86.7) | 2332 (87.4) | 0.5 |
No | 389 (17.8) | 54,374 (12.8) | 354 (13.3) | 337 (12.6) | ||
Personal doctor | ||||||
Yes, only one | 1967 (67.3) | 500,447 (70.6) | <0.001 | 1876 (69.9) | 1638 (61.1) | <0.001 |
Yes, more than one | 237 (7.4) | 54,825 (7.6) | 224 (8.3) | 240 (8.9) | ||
No | 619 (25.3) | 10,469 (21.8) | 584 (21.8) | 805 (30.0) | ||
Delayed care due to cost | ||||||
Yes | 547 (21.9) | 67,990 (13.3) | <0.001 | 511 (19.0) | 334 (12.4) | <0.001 |
No | 2277 (78.1) | 592,187 (86.7) | 2173 (81.0) | 2352 (87.6) | ||
Medical check up | ||||||
Yes, within past year | 2161 (72.6) | 521,770 (74.6) | <0.001 | 2057 (76.6) | 1889 (70.3) | <0.001 |
Yes, within past 2 years | 259 (11.6) | 62,672 (11.0) | 244 (9.1) | 319 (11.9) | ||
Within past 5 years | 171 (6.1) | 33,406 (6.5) | 163 (6.1) | 204 (7.6) | ||
5 or more years | 176 (7.9) | 31,738 (5.8) | 168 (6.3) | 208 (7.7) | ||
No | 57 (1.8) | 10,423 (2.0) | 52 (1.9) | 67 (2.5) |
Unmatched | Matched | |||||
---|---|---|---|---|---|---|
Outcome | TGNB N (%) | Cisgender N (%) | p Value | TGNB N (%) | Cisgender N (%) | p Value |
Difficulty hearing | ||||||
Yes | 302 (9.8) | 58,784 (6.6) | <0.001 | 286 (10.7) | 247 (9.3) | 0.07 |
No | 2493 (90.2) | 596,657 (93.4) | 2375 (89.3) | 2411 (90.7) | ||
Difficulty seeing | ||||||
Yes | 219 (7.8) | 34,750 (5.1) | <0.001 | 211 (7.9) | 161 (6.1) | 0.008 |
No | 2572 (92.2) | 620,253 (94.9) | 2448 (92.1) | 2492 (93.9) | ||
Difficulty making decisions | ||||||
Yes | 629 (27.3) | 69,714 (11.4) | <0.001 | 598 (22.5) | 323 (12.2) | <0.001 |
No | 2158 (72.7) | 584,543 (88.6) | 2058 (77.5) | 2328 (87.8) | ||
Difficulty walking | ||||||
Yes | 576 (17.4) | 115,267 (14.5) | <0.001 | 546 (20.6) | 379 (14.3) | <0.001 |
No | 2207 (82.6) | 538,729 (85.5) | 2108 (79.4) | 2270 (85.7) | ||
Difficulty dressing | ||||||
Yes | 217 (9.6) | 29,252 (4.1) | <0.001 | 202 (7.6) | 114 (4.3) | <0.001 |
No | 2567 (90.4) | 624,558 (95.6) | 2452 (92.4) | 2531 (95.7) | ||
Difficulty doing things alone | ||||||
Yes | 427 (20.0) | 50,627 (7.2) | <0.001 | 409 (15.4) | 218 (8.3) | <0.001 |
No | 2352 (80.0) | 602,566 (92.8) | 2240 (84.6) | 2423 (91.7) | ||
General health | ||||||
Excellent | 106,025 (17.2) | 399 (16.9) | <0.001 | 380 (14.2) | 388 (14.5) | <0.001 |
Very Good | 216,242 (31.4) | 787 (25.7) | 754 (28.1) | 825 (30.8) | ||
Good | 209,887 (32.4) | 891 (30.3) | 844 (31.5) | 896 (33.4) | ||
Fair | 509 (17.6) | 91,996 (14.1) | 490 (18.3) | 426 (15.9) | ||
Poor | 232 (9.4) | 35,467 (4.9) | 213 (7.9) | 146 (5.4) | ||
Poor physical health | ||||||
0 days | 1411 (50.2) | 402,618 (63.6) | <0.001 | 1345 (51.8) | 1523 (58.0) | <0.001 |
1–13 days | 812 (32.4) | 152,847 (23.8) | 772 (29.7) | 738 (28.1) | ||
≤14 days | 505 (17.4) | 91,189 (12.6) | 478 (18.4) | 365 (13.9) | ||
Poor mental health | ||||||
0 days | 1408 (44.9) | 433,007 (64.0) | <0.001 | 1351 (51.5) | 1577 (59.8) | <0.001 |
1–13 days | 651 (25.0) | 141,039 (23.3) | 617 (23.5) | 687 (26.1) | ||
≤14 days | 694 (30.1) | 75,359 (12.7) | 654 (24.9) | 373 (14.1) |
Variable | Unadjusted Odds Ratio | 95% CI | p Value | AOR | 95% CI | p Value | ||
---|---|---|---|---|---|---|---|---|
LCL | UCL | LCL | UCL | |||||
Difficulty hearing | ||||||||
TGNB | 1.175 | 0.982 | 1.406 | 0.07 | 1.066 | 0.888 | 1.280 | 0.5 |
Cisgender | REF | - | - | - | - | - | - | - |
Difficulty seeing | ||||||||
TGNB | 1.334 | 1.079 | 1.650 | 0.008 | 1.236 | 0.995 | 1.534 | 0.05 * |
Cisgender | REF | - | - | - | - | - | - | - |
Difficulty making decisions | ||||||||
TGNB | 2.094 | 1.807 | 2.428 | <0.001 | 1.948 | 1.673 | 2.269 | <0.001 |
Cisgender | REF | - | - | - | - | - | - | - |
Difficulty walking | ||||||||
TGNB | 1.551 | 1.344 | 1.791 | <0.001 | 1.381 | 1.192 | 1.599 | <0.001 |
Cisgender | REF | - | - | - | - | - | - | - |
Difficulty dressing | ||||||||
TGNB | 1.829 | 1.444 | 2.316 | <0.001 | 1.598 | 1.256 | 2.034 | <0.001 |
Cisgender | REF | - | - | - | - | - | - | - |
Difficulty doing things alone | ||||||||
TGNB | 2.029 | 1.705 | 2.415 | <0.001 | 1.833 | 1.533 | 2.191 | <0.001 |
Cisgender | REF | - | - | - | - | - | - | - |
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Pharr, J.R.; Batra, K. Physical and Mental Disabilities among the Gender-Diverse Population Using the Behavioral Risk Factor Surveillance System, BRFSS (2017–2019): A Propensity-Matched Analysis. Healthcare 2021, 9, 1285. https://doi.org/10.3390/healthcare9101285
Pharr JR, Batra K. Physical and Mental Disabilities among the Gender-Diverse Population Using the Behavioral Risk Factor Surveillance System, BRFSS (2017–2019): A Propensity-Matched Analysis. Healthcare. 2021; 9(10):1285. https://doi.org/10.3390/healthcare9101285
Chicago/Turabian StylePharr, Jennifer R., and Kavita Batra. 2021. "Physical and Mental Disabilities among the Gender-Diverse Population Using the Behavioral Risk Factor Surveillance System, BRFSS (2017–2019): A Propensity-Matched Analysis" Healthcare 9, no. 10: 1285. https://doi.org/10.3390/healthcare9101285