Why Are Some Areas “Hot Spots” of Disabling Condition Prevalence?

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Anna Hill and Jody Schimmel Hyde, Mathematica Policy Research and Jonathan Schwabish and Aaron R. Williams, Urban Institute

This paper examines local-level variation in the primary disabling conditions of new awardees for Social Security Disability Insurance (SSDI) from 2005 through 2018. It uses data from the Social Security Administration’s Disability Analysis File data linked to other publicly available information from the American Community Survey and Area Health Resource File. The analysis is at the level of U.S. Census Bureau Public Use Microdata Areas (PUMAs). The paper documents the share of awards in each PUMA and year in one of five impairment group categories, selected to align with areas of strong policy interest. In each impairment group, the paper identifies “hot spots” as PUMAs in which the share of awards for that condition is in the top 10 percent relative to other PUMAs in the same year. The paper documents the geographic variation in award shares and hot spots using maps and uses regression analysis to explore relationships between SSDI award shares by impairment group and a range of PUMA-level factors. The findings are descriptive and should not be interpreted causally.