Geography and Rural Disability

Rural landscapes dominate American geography. Depending on the definitions used, rural areas account for 72% to 97% of the total landmass of the United States. However, only a minority of Americans live in rural areas (approximately 15-19% again depending on the definition). Yet, people living in rural areas represent a higher percentage of people who are unemployed, living in poverty, are elderly, and experience a disability. Further, it has been well documented that individuals with disabilities living in rural areas face unique challenges in acquiring services and supports. For example, rural residents typically rely on services that are more informal and less specialized; must travel farther and pay more for those services; and tend to receive lower quality services than their urban counterparts (Whitener, Weber, & Duncan, 2001; Dabson & Weber, 2008).

Map of disability rates by county

Click on the map for a larger, downloadable and shareable version.

While Census data about more urbanized areas have been available in contiguous years, data about rural America have been limited.  In particular, disability data for rural areas was not available for 13 years, 2000 to 2013. This knowledge gap impacted our ability to understand or track changes in the needs of people with disabilities living in rural communities. As a result, policy makers and program planners were left in the dark and advocacy effort to highlight the needs of people with disabilities in rural America were been hampered. People with disabilities living in rural areas face unique problems, and resources are very limited to address them. Consequently, there is an urgent need to update analyses of the geographic distribution of people with disabilities living in rural America to provide data necessary for timely and cost-effective policy and program development.

The objective of this study is to depict the distribution and demographics of people with disabilities living in rural areas and the services available to them. This project serves the overarching goal of providing information that will allow improved services for people with disabilities in rural communities by addressing major questions of resource allocation and provide recommendations on policy and program practices.

Policy makers need to consider spatial variations of access to services for people with disabilities, especially in rural areas where resources are limited. For example, how disability services are distributed may matter for rural employment, especially employment of people with a disability. Outcomes of the analysis of location of service providers such as will provide opportunity to strategically coordinate the locations of service facilities and improve service delivery in isolated rural communities. In addition, the analysis will reveal areas of overlapping services and can provide insight into how to more efficiently manage these services.

Understanding migration trends in people with disabilities – who moves, where they come from, and where they go – is important for planning the location of public and private services and programs.  Without accurate information, decision makers rely on urban solutions that may not be applicable or cost effective for rural areas. Looking at where movement of the population is occurring, and the direction that it’s moving (rural to urban or otherwise) provides clues to why people might move to or from rural environments.  This project will provide an understanding of migration behavior, and will also shed light on potential causes of rural- urban differences in disability levels such as less access to health care services and poorer health outcomes, reduced economic opportunity, and an increasing aging population.

  • Project dates: 2013-2018
  • Funded by: National Institute on Disability, Independent Living and Rehabilitation Research Grant No. H133B130028
  • Principal staff: Tom Seekins, Ph.D., Christiane von Reichert, Ph.D., Lillie Greiman, M.A., Andrew Myers, M.A.
  • Related Projects:

What the Research Says…

Links to Publications:

Map Facts: Disability in Rural America – 2014 (research brief)

The Geography of Disability in America: On Rural-Urban Differences in Impairment Rates – 2014 (research brief)

Disability Patterns in Rural Areas   (poster)

Map Series: Disability across America – updated July 2017 (maps)

Prevalence of Disability: Individual and Household Context – June 2017 (research brief)

Data Limitations in the American Community Survey: The Impact on Rural Disability Research – September 2017 (research brief)




Quick Links: Community Participation & Independent Living

Current Projects

  • Effort Capacity and Choice
    Participating in the community requires effort, and people vary in how much they spend before needing rest. As a result, everyone must make choices about what activities they spend their effort on. This project will study two interventions that look at the relationship between personal effort and community participation.
  • Improving Home Usability
    In order to live independently and participate in the community, a person needs a usable home. Previous research has shown that those with more usable homes participate more in their communities. This project will partner with two local CILs to build a Home Usability Network to support consumers to make home improvements.
  • Ecology of Rural Disability
    Little is known about how disability emerges and unfolds for people living in rural areas. For example, how does losing employment affect a person’s physical and social wellbeing? Are people who live in relatively more accessible places more apt to engage in community activities once disabled? The ecology project will follow along a group of people over five years to examine how their physical, social and emotional wellbeing interact with the accessibility of their environment over time.
  • Geography and Rural Disability
    In order for policy makers to make decisions about resources and program development for people with disabilities, they must have accurate information. For example, many people think that when a person acquires a disability, they move to cities where more services are located. But, until recently, there has been no data to see if this is true. This project will use this data to see where people with disabilities live in order to improve services in rural communities.
  • Monitoring and Managing Community Accessibility
    The goal of this study is to create more opportunities for people with disabilities to take part in community life. Events will be studied to see if they are accessible. This information will be provided to planners and policy makers to help set community accessibility goals. Communities and events will receive an accessibility report card to build awareness of the need to make events accessible.
  • Participation in Rural Events Among Young Adults with Disabilities
    In order for people with disabilities to take part in all areas of community life, events and event programs must be accessible. For example, many communities host county fairs but not all county fair sites and programs are accessible to people with disabilities. This project will take a look at communities in rural America to see if people with disabilities are able to participate in community events. This information will help policy makers improve accessibility to community life for everyone.
  • Person-Environment Fit
    People feel like they fit into an environment when they share similar goals and values to those around them. This project will use electronic diaries collected in real time to examine how a person’s sense of fit affects their participation in community life. Participants in this study will use a smart phone like device to record their feelings about fit as they participate in different activities.

Completed Projects


  • Assess and Monitor the Distribution and Use of 5310 Funds between Rural and Urban Areas
    The lack of accessible transportation for people with disabilities in rural communities is a common problem. Without transportation, it is difficult to get medical care, maintain a job and participate in community life. This project studied the use of federal funding for accessible transportation and found that fewer dollars were spent in rural communities. Recommendations were made to policy-makers to address these problems.
  • Home Usability Networks
    While there is a great deal of research on the relationship between the environment and disability, there is less research on housing and how it affects the health and participation of people with disabilities. The goal of this project was to develop tools to assess whether or not housing is usable and to facilitate development of a local Home Usability Network to help people solve home usability problems.
  • Community Access from the American Housing Survey
    In 2009, the American Housing Survey included questions about disability to see if people with disabilities live in housing that is accessible. The data showed that many people live in housing with poor access and cannot easily enter or leave their homes. This lack of access can prevent people with disabilities from participating in their communities, accessing medical care or working outside the home.
  • Transportation and the American Time Use Survey
    The American Community Survey collects time-use data to study the ways in which people spend their time. People with disabilities have higher rates of unemployment than people without disabilities. This study looked at the ways in which people used their time and whether or not accessible transportation accounted for differences in employment. The goal of this project is to inform both policy makers and further research projects.

COMPLETED PROJECTS | prior to 2008

  • Assess the Potential Involvement of Rural Faith-Based Organizations in Providing Community Transportation for People with Disabilities
    Some people believe that safe, accessible transportation for people with disabilities can be provided by faith-based organizations. This study found that these groups often didn't own vehicles or, if they did, the vehicles were not accessible or in good repair.
  • Develop and Evaluate a Voucher System for Increasing Access to Transportation for People with Disabilities Living in Rural Areas
    This project looked at transportation in rural communities and developed a voucher system to help people with disabilities find their own transportation. This system supported the independence of people with disabilities by allowing them to make their own decisions.
  • Evaluating Community Accessibility
    Accessibility to public spaces and buildings is so important to people with disabilities that it is a central feature of federal legislation, state regulations, and municipal ordinances. Despite its importance, however, there are no standard measures of infrastructural accessibility for making systematic comparisons across communities that could help guide efforts to increase accessibility.
  • Independent Living Services and Participation
    Centers for Independent Living (CILs) were established to provide services and advocacy for people with disabilities who want to live independently in the community. These centers provide a means to increase participation in life activities and many of them serve people in rural communities. This project focused on the services CILs provide that potentially increase consumer participation.
  • Leadership by People with Disabilities
    People with disabilities are leaders in disability rights and in their rural communities. Researchers found that, at the time of this study, over 85,000 people with disabilities served as elected or appointed officials and, as a result, developed information and strategies for becoming involved in advocacy work.
  • Rural Policy Foundations
    The New Paradigm on Disability specifically recognizes that social and public policy affect the opportunity and ability of individuals with disabilities to participate in their communities (NIDDR,1999). This research project conducted analyses of important disability and mainstream rural policy and developed a framework for analysis of existing and emerging policy.
  • Using Ecological Momentary Assessment to Measure Participation
    Ecological momentary assessment (EMA) methods can be used to evaluate participation as it occurs, across time and situations. Typically, EMA involves recording events and behaviors as they occur using a handheld device such as a personal data assistant, smart phone, or iPod. Real-time measurements allows for the collection of data on participation as it occurs rather than relying on participant recall.

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