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Why are rates of disability among Native American children going up?

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Story at a glance

  • Studies suggest that disability rates among the nation’s children have been rising since the early 1990s.
  • A new study finds that childhood disability rates are highest in the American Indian and Alaska Native communities.
  • Lack of access to healthcare as well as economic barriers all play a role in the prevalence of disability among various communities.

American Indian and Alaska Native children have the highest disability rates in the United States, according to a new brief published by the Census Bureau that found highest disability rates among native-born children, especially in the American South and Northeast. 

Disability is most prevalent among American Indian and Alaska Native children, followed by biracial children and then Black children, according to the study, which compared estimates from the 2019 American Community Survey (ACS) to the 2008 ACS. Asian, Native Hawaiian and other Pacific Islander children were least likely to have a disability, while both Hispanic and non-Hispanic white children fell in between. 


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The numbers, however, don’t tell the entire story, including why this is the case. While the study raises the “immigrant health paradox,” citing research that suggests immigrants to the United States and other western countries have better health (on average) than native-born residents, it also acknowledges that “differences across cultures in how disability is perceived and understood may lead to differences in disability reporting.”

What researchers do know is that once people arrive in the United States, access to health care is inequitable, which could account for the increase in disability prevalence among Asian and Hispanic children (not seen in other populations).


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“There are decades of evidence that these particular racial and ethnic groups, especially American Indian, Native American groups and Black Americans, have poor access to care, and also may not have access to the same quality of health care services,” Regan Bergmark, an otolaryngologist at Boston’s Brigham and Women’s Hospital, told ABC

The inequity is perpetuated by both the monetary and nonmonetary costs associated with caring for children with disabilities, which the brief says can be “substantial.” Children in poverty were more likely to have a disability than children above the poverty threshold in both 2008 and 2019, increasing “significantly” in the decade in between. This also means that the rate of disability could be even higher, the study notes, considering “the fact that diagnoses may be more readily available to or more sought out by certain groups in the United States, relative to others.”


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