title: Socioeconomic Factors at the Intersection of Race and Ethnicity Influencing Health Risks for People with Disabilities.
abstract: People with disabilities are known to experience disparities in behavioral health risk factors including smoking and obesity. What is unknown is how disability, race/ethnicity, and socioeconomic status combine to affect prevalence of these health behaviors. We assessed the association between race/ethnicity, socioeconomic factors (income and education), and disability on two behavioral health risk factors.
  
  
  
  Data from the 2007-2010 Behavioral Risk Factor Surveillance System were used to determine prevalence of cigarette smoking and obesity by disability status, further stratified by race and ethnicity as well as income and education. Logistic regression was used to determine associations of income and education with the two behavioral health risk factors, stratified by race and ethnicity.
  
  
  
  Prevalence of disability by race and ethnicity ranged from 10.1 % of Asian adults to 31.0 % of American Indian/Alaska Native (AIAN) adults. Smoking prevalence increased with decreasing levels of income and education for most racial and ethnic groups, with over half of white (52.4 %) and AIAN adults (59.3 %) with less than a high school education reporting current smoking. Education was inversely associated with obesity among white, black, and Hispanic adults with a disability.
  
  
  
  Smoking and obesity varied by race and ethnicity and socioeconomic factors (income and education) among people with disabilities. Our findings suggest that disparities experienced by adults with disabilities may be compounded by disparities associated with race, ethnicity, and socioeconomic factors. This knowledge may help programs in formulating health promotion strategies targeting people at increased risk for smoking and obesity, inclusive of those with disabilities.
authors.affiliation: Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop E-88, Atlanta, GA, 30341-3717, USA. gmr9@cdc.gov.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Courtney-Long
authors.affiliation: Oak Ridge Institute for Science and Education Fellowship with the National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA.|Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE MS E-97, Atlanta, GA, 30333, USA.
authors.forename: Sebastian D
authors.initials: SD
authors.lastname: Romano
authors.affiliation: Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop E-88, Atlanta, GA, 30341-3717, USA.|Commissioned Corps, U.S. Public Health Service, Atlanta, GA, USA.
authors.forename: Dianna D
authors.initials: DD
authors.lastname: Carroll
authors.affiliation: Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop E-88, Atlanta, GA, 30341-3717, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Fox
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000072957:Alaska Natives; D001213:Asian; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004522:Educational Status; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D000073599:Health Risk Behaviors; D006630:Hispanic or Latino; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007198:Indians, North American; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology*; D012307:Risk Factors; D012907:Smoking / Q000208:ethnology*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult
keywords: Cigarette smoking; Disability; Disparities; Obesity; Race and ethnicity