Of the 33,166 adults included in the sample, 6.3% of adults endorsed voice disabilities, 2.2% endorsed SL disabilities, and 1.3% endorsed SLV disabilities (Table 1). People without CD and those with voice disabilities were more frequently married, employed, and female than their counterparts with SL disabilities. Adults with SL and SLV disabilities more frequently reported public only health insurance and other co-occurring disabilities than did their peers without CD. Of note, 14.8% of persons without CD endorsed a non-communication disability vs. 23.8%, 53.5%, and 64.7% of persons with Voice, SL, and SLV disabilities, respectively.
Adults with CD reported higher prevalence of any chronic conditions compared to persons without CD (Voice 67.9%, SL 68.6%, SLV 79.9%, no CD 49.9%, p < 0.001; Table 2, eTable 1). Only 25% of adults without CD reported ≥ 2 chronic conditions compared to 40% of people with Voice, 44% adults with SL, and 63% of adults with SLV disabilities (p < 0.001). Persons with CD were more likely to report additional chronic conditions compared to those without a CD, controlling for the measures in Table 1 (AOR (95% CI): Voice 1.9 (1.7–2.2), SL 1.7 (1.3–2.2), SLV 2.7 (1.9–3.8)).
Adults with CD were more likely to report fair/poor health compared to those without CD (Voice 19.5%, SL 32.5%, SLV 48.3%; no CD 11.2%; p < 0.001; Table 2). After controlling for the characteristics in Table 1, adults with CD were less likely to rate their health highly compared to adults without CD (AOR (95% CI): Voice 0.7 (0.6–0.8), SLV 0.5 (0.4–0.7)).
People across all CD types reported stroke, emphysema, and asthma more frequently than their peers without CD (eTable 1). Cardiovascular disease and diabetes were also more frequently reported by people with rather than without CD. Persons with Voice and SLV were 1.2–4.1 times more likely to report each of the specific chronic conditions compared to persons without CD, controlling for the measures in Table 1 (Fig. 1). Similarly, persons with SL CD were 1.3–2.4 times more likely to report the same chronic conditions as those without CD.
Adults with CD more frequently had ≥ 1 hospital stays and ≥ 1 emergency department visits than their peers without CD (≥ 1 hospital stay: Voice 14.0%, SL 17.1%, SLV 22.6%, no CD 8.5%. p < 0.001; ≥ 1 emergency department visits: Voice 27.5%, SL 38.1%, SLV 43.3%, no CD 18.1%, p < 0.001) (Table 3). Similarly, persons with CD more frequently had ≥ 1 office-based visits compared to people without CD (Voice 91.0%, SL 83.5%, SLV 86.3%, no CD 79.5%, p < 0.001) (Table 3). In analyses adjusted for the demographics and presence of non-communication disabilities described in Table 1, adults with CD had higher odds of more hospital stays (AOR (95% CI): Voice 1.3 (1.0–1.5)) and emergency department visits (AORs (95% CI): Voice 1.4 (1.2–1.6), SL 1.5 (1.1–1.9), SLV 1.5 (1.1–2.0)) compared to people without CD. Adults with Voice CD were 1.6 (95% CI 1.4–1.8) times more likely to have additional office-based visits than their peers without CD, accounting for the measures in Table 1. Persons with SL and SLV disabilities more frequently reported ≥ 4 visits (SL 48.3%; SLV 61.3%) compared to people without CD (34.8%, p < 0.001). However, these findings were not significant in multivariate results.
All persons with CD in this cohort endorsed higher rates of “trouble finding a provider” for healthcare (Fig. 2; e Table 2), although the confidence intervals for the adjusted odds ratios were only significant for persons with Voice and SLV disabilities (AOR (95% CI): Voice 1.9 (1.5–2.5), SL 1.4 (0.9–2.2), SLV 2.3 (1.5–3.6)). Persons with CD had different experiences in identifying usual sources of care for ill or routine care. For those measures, persons with Voice and SL disabilities endorsed similar experiences to persons without CD while persons with SLV disabilities had significantly greater difficulties identifying a usual source of care when ill (usual source of care when ill: AOR (95% CI): Voice 1.1 (0.9–1.3)), SL 0.9 (0.6–1.2), SLV 0.5 (0.3–0.9)).
Persons with CD more frequently reported unmet needs for care than persons without CD (for example, delayed healthcare due to cost: Voice 16.4%; SL: 17.0%; SLV: 23.9%; no CD: 10.4%, p < 0.001 for pairwise comparisons; delayed due to availability: Voice: 18.9%; SL: 25.2%; SLV: 30.8%; no CD: 9.4%, p < 0.001 for pairwise comparisons). All CD groups reported greater unmet needs for care, with adjusted odds ranging from 1.6 (95% CI 1.3–1.9, foregone medical care due to cost) to 2.3 (95% CI 1.7–3.1, delayed care due to availability).