Utilization of Routine and Recommended Preventive Care among Individuals with Disabilities in Nebraska

Background: Healthcare access disparities exist among individuals with and without disabilities (IWD, IWoD). There is a scarcity of studies focused on Nebraskans living with disabilities. Methods: Access to Care Nebraska surveyed adults (age 19+) in Oct 2020-Mar 2021. We used Andersen’s model of healthcare utilization to group risk factors for non-compliance with routine care and recommended cancer screening. A multivariate log-binomial regression compared the non-compliance between IWD and IWoD to compute adjusted prevalence ratios (aPR) for risk factors. Results: Of the 1101 participants,96(8.7%) were IWD. IWD had a higher proportion of non-compliance to routine preventive care (61.7% vs 54.1%) and recommended cancer screenings (68.4% vs 57.6%). Non-compliance to routine care was higher in younger adults (aPR=2.74, 1.51-4.97; P\u3c.001) and among those with transport barriers (aPR=13.48, 3.31-54.8; P\u3c.001). Recommended cancer screening results showed age and chronic conditions had significant interaction (P=0.01). Younger adults were 0.06 times less likely to be non-compliant (95% CI 0.01-0.68; P=0.02), whereas non-Whites (aPR=1.76, 1.04-3.00; P=0.04) and those with transport barriers (aPR=3.13, 1.13-7.34; P=0.02) had higher non-compliance. Conclusion: Despite continued efforts to improve health accessibility for IWD, this study finds there still a significant gap in screening uptake for this population in Nebraska based on age, transport barrier, and race/ethnicity. The study underscores the need to increase health promotion activities to change screening behaviors and programs to close the healthcare gaps among IWD