The intersection of disability status and rurality in American Indian/Alaskan Native communities.
Genna M Mashinchi, Emily C Hicks, Arin J Leopold and 2 others
PMID 36189018WHAT IT FOUND
Disability prevalence was lower in counties with high American Indian/Alaskan Native populations compared to others.
This contradicts the hypothesis that rurality and minority status compound disability risk, suggesting potential community-level protective factors in these areas.
Key findings
01Counties with ≥5% American Indian/Alaskan Native populations had significantly lower disability prevalence among this group compared to counties with lower representation.
02A significant negative correlation existed between the concentration of American Indian/Alaskan Native residents in a county and the reported disability prevalence within that group.
03Disability prevalence for American Indian/Alaskan Natives was significantly higher in non-core rural counties compared to metropolitan counties when not stratified by ethnic concentration.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study used county-level data, so it cannot account for individual factors or specific types of disability (e.g., mobility vs. cognitive). Some counties had very small AI/AN populations, which increases the margin of error for estimates in those areas. The analysis is cross-sectional and descriptive, so it cannot determine why disability rates are lower in high-concentration counties, only that they are. The authors could not control for all potential confounders, such as specific state policies or tribal land status differences.
Declared interests
The study was supported by the Research and Training Center on Disability in Rural Communities under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research. The authors declared no commercial or financial conflicts of interest.
The easy way to misread this
Do not interpret the lower disability rates in high AI/AN counties as evidence that rural isolation protects health. The study suggests community-level factors may mitigate disability, but it does not prove causation or rule out reporting biases.