Functional disability, diabetes and hypertension among adults in the United States, August 2021–August 2023

Objective To describe diabetes and hypertension prevalence, diagnosis status and measured-threshold outcomes by functional disability. Methods We analyzed the National Health and Nutrition Examination Survey conducted in the United States during August 2021–August 2023. Adults aged 18 years or older were classified using six Washington Group functioning domains. Outcome-specific weights and direct age standardization were used. Disability-minus-no-disability differences and 95% confidence intervals accounted for the complex survey design. Results Among 8101 adults with complete functioning data, total diabetes and hypertension were classifiable in 5974 and 6172. Standardized total-disease differences were 9.3 percentage points (5.8, 12.7) for diabetes and 8.3 (3.1, 13.6) for hypertension. Undiagnosed-disease differences among eligible adults were 0.6 (−0.4, 1.7) and −3.4 (−7.2, 0.5), respectively. Among hypertension cases with known diagnosis status, the undiagnosed fraction was lower with disability: −14.1 (−19.9, −8.3). Conditional diabetes estimates were imprecise and sensitive to sparse younger-age cells. Conclusions Adults with functional disability had higher standardized total diabetes and hypertension prevalence. Diagnosis-status and measured-threshold findings depended on the condition and denominator; they do not establish equivalent care or explain the origins of prevalence differences.