Health Insurance
The Least and Most Economically Equal Places for Disabled Americans
ValuePenguin researchers found that the median pay gap between disabled and nondisabled Americans in the same county is $9,538 across 1,024 U.S. counties. Disabled Americans’ earnings being much lower than other residents' produces high poverty levels, which is the case in some of the most well-known and densely populated U.S. counties.
While wages are low, health care costs are high for people with disabilities. ValuePenguin estimated the cost of health care for disabled Americans using data from the Centers for Medicare and Medicaid Services, as many people with disabilities may qualify for Medicaid or Medicare. Per capita expenses for all beneficiaries can be as high as $14,611. But researchers found there are 11 states with counties where the median income among disabled earners is higher than the allowed limit for these services. Where care costs are high, unaffordability could create a problem of access for those who aren't exempted from earnings limits.
Key findings
- In nine counties, disabled workers' wages are in the lowest 25% while the countywide earnings are above the national median. The counties (or equivalents) with this type of inequality are San Francisco County, Calif.; New York County, N.Y.; Washington, D.C.; Fulton County, Ga.; Suffolk County, Mass.; Hudson County, N.J.; Kings County, N.Y.; Essex County, N.J.; and Baltimore.
- Disabled Americans earn more than nondisabled Americans in just seven of the 1,024 counties examined. People with disabilities earn the most relative to their counterparts in Tipton County, Tenn. — $2,294 more yearly. The earnings gap between disabled and nondisabled Americans is widest in San Francisco County, Calif., at $30,770.
- The most economically equal counties for people with disabilities are ones where poverty is low and the gap between disabled and nondisabled workers is minimal. Stafford County, Va., best combines low poverty with high employment and wages.
- Poverty levels tend to be lower where employment is relatively high for people with disabilities, though this isn’t the case in six counties. Despite low unemployment among people with disabilities, the poverty rate in Isabella County, Mich., is exceptionally high.
- In 26 counties across 11 states, the median personal income among disabled workers is greater than the disability benefits threshold allowed by local laws. In these counties, the average Medicare expenditure was $10,710 per capita from 2015 to 2019.
Disabled Americans tend to experience lower wages and higher rates of poverty in most counties across the country
The median personal income for disabled Americans is lower than for nondisabled residents in the same county. Disabled workers earn an average of $9,780 less than their counterparts. There are only seven counties of the 1,024 that ValuePenguin examined where disabled Americans make more money than nondisabled workers. However, the median personal income for all workers in these areas is only $29,244 a year.
In Tipton County, Tenn., on the outskirts of Memphis, Tenn., disabled workers make the most relative to nondisabled residents. In Tipton County, the median personal income of disabled workers is $2,294 greater.
More commonly, the income inequality between the two types of workers is much larger. In San Francisco County, the median personal earnings figure for disabled workers is $30,770 a year less than for nondisabled workers in the same county.
From an economic standpoint, San Francisco County is one of the worst places for people with disabilities. Since the income difference between disabled and nondisabled workers is so high, poverty is also very high. The poverty rate in the county is 38%, with one-quarter of the disabled population earning less than 100% of the federal poverty level ($12,880 a year for a single earner).
There are eight other counties where, like in San Francisco, the countywide earnings figure is greater than the national median but people with disabilities have significantly lower wages (in the bottom 25% compared to nondisabled workers' wages) and are more likely to live in poverty. These places are listed in the following table, along with earnings gaps and poverty rates.
County (or equivalent) | Major city | Wage gap | Poverty level |
|---|---|---|---|
| San Francisco County, Calif. | San Francisco | $30,770 | 38% |
| New York County, N.Y. | Manhattan, N.Y. | $29,518 | 43% |
| District of Columbia | Washington, D.C. | $21,984 | 42% |
| Fulton County, Ga. | Atlanta | $17,346 | 39% |
| Suffolk County, Mass. | Boston | $15,668 | 45% |
| Hudson County, N.J | Jersey City, N.J. | $14,339 | 39% |
| Kings County, N.Y. | Brooklyn, N.Y. | $10,219 | 46% |
| Essex County, N.J. | Newark, N.J. | $11,865 | 39% |
| Baltimore | Baltimore | $10,935 | 46% |
District of Columbia and Baltimore are county-level equivalents, according to the U.S. Census Bureau.
Where poverty is highest for people with disabilities
The county where the highest percentage of people with disabilities earn no more than $19,191 a year — 149% of the national poverty level for individuals — is Starr County, Texas. In Starr County, 62% of the disabled population earn within this range. At the same time, Starr County is a low-earning place for most — the median personal income is $17,828 a year, significantly less than the U.S. median income of $35,977.
Starr County's situation isn't uncommon. Among the 256 counties where poverty rates among disabled workers are in the top 25%, the only nine where the countywide median income is above $35,977 are those mentioned above where the earnings gaps drastically favor nondisabled workers.
Conversely, the counties where the spending power of disabled Americans is strongest are areas where relatively few people with disabilities live in poverty and where income inequality is low. ValuePenguin found 91 counties in the bottom quarter of poverty rates where the income gap is no greater than $9,538 — the median between disabled and nondisabled workers.
Stafford County, Va., on the northern edge of Fredericksburg, Va., best combines low poverty with high wages. Thirty-three percent of the disabled population are employed, and workers earn $44,232 a year — $8,255 more than the national median for all workers. Additionally, income inequality is relatively low (though disabled workers still make $5,297 less than their counterparts), and only 11% live in poverty.
County (or equivalent) | Income gap | Poverty level |
|---|---|---|
| Stafford County, Va. | $5,297 | 11% |
| Calvert County, Md. | $5,506 | 13% |
| James City County, Va. | $9,384 | 14% |
| Prince William County, Va. | $2,107 | 15% |
| Columbia County, Ga. | $8,584 | 17% |
| Charles County, Md. | $8,015 | 17% |
| Boone County, Ky. | $8,533 | 18% |
| Collier County, Fla. | $8,024 | 19% |
| Virginia Beach, Va. | $6,170 | 19% |
| Prince George's County, Md. | $4,620 | 19% |
| Sumter County, Fla. | $4,860 | 19% |
| Parker County, Texas | $4,657 | 20% |
Counties are ordered by lowest poverty rates; Virginia Beach, Va., is considered an independent city by the U.S. Census Bureau.
Where disabled Americans experience high rates of employment, poverty levels are low — for the most part
In most places, disabled Americans are more likely to be unemployed than employed. The average employment rate at the county level is just 24%. (Any value less than 27.3% falls into the lowest quarter of employment.) While Americans with disabilities can qualify for financial assistance, researchers found high poverty levels in areas where there's low employment. In the counties where employment levels are in the bottom quarter (less than 21%), there are 135 counties where poverty exceeds 37% — the number that marks the top 75% lowest-income counties.
Employment among people with disabilities is highest in Gallatin County, Mont. In Gallatin County, which encapsulates Boseman, Mont., 43% of the disabled population are employed, and the poverty rate is 26%.
While high employment rates generally correspond with low poverty levels among people with disabilities, this isn't always the case. There are six counties where both employment numbers and the share of the disabled population experiencing poverty are in the highest quarter. These counties are listed below.
County | Population employed | Population in poverty |
|---|---|---|
| Isabella County, Mich. | 30% | 42% |
| Ingham County, Mich. | 28% | 38% |
| Clarke County, Ga. | 28% | 42% |
| Tangipahoa Parish, La. | 28% | 42% |
| Taney County, Mo. | 27% | 39% |
| Nacogdoches County, Texas | 27% | 45% |
Counties with the most and least economic equality for disabled Americans
Researchers found 26 counties where disabled Americans have relatively high employment levels, high spending power and low poverty levels. Out of the 1,024 counties in this study, these 26 counties are in the top 25% for highest employment, lowest wage gap and lowest poverty levels.
In the most equal counties for people with disabilities, workers still earn $4,699 a year less on average than their nondisabled counterparts. Additionally, the average personal income of $31,539 a year is less than the national median. But low overall pay ($36,238 for everyone in these counties) means that local spending power for people with disabilities remains high.
County (or equivalent) | State | Percentage employed | Difference in earnings | Total in poverty |
|---|---|---|---|---|
| Cache County | Utah | 35% | -$5,634 | 27% |
| Calvert County | Maryland | 32% | -$5,506 | 13% |
| Canadian County | Oklahoma | 34% | -$4,418 | 20% |
| Chelan County | Washington | 30% | -$4,359 | 26% |
| Cleveland County | Oklahoma | 32% | -$2,881 | 24% |
| DeSoto County | Mississippi | 27% | -$6,222 | 26% |
| Douglas County | Washington | 39% | -$2,827 | 24% |
| Ellis County | Texas | 28% | -$6,541 | 20% |
| Garfield County | Oklahoma | 32% | -$4,860 | 27% |
| Gwinnett County | Georgia | 28% | -$5,676 | 22% |
| Hays County | Texas | 32% | -$6,249 | 24% |
| Leavenworth County | Kansas | 34% | -$5,935 | 22% |
Counties ordered alphabetically; Virginia Beach, Va., is considered an independent city by the U.S. Census Bureau.
On the other hand, there are 15 counties where researchers discovered that people with disabilities earn the lowest wages relative to the entire population while also experiencing low employment levels and high poverty rates.
Of these counties, New York County, N.Y., (which overlays Manhattan) is the most unequal. Wages for disabled workers are not only $29,518 less than their counterparts' wages, but this county is also the only one of this group where the median income for all people is greater than the national median — reducing the group’s buying power even more.
County (or equivalent) | State | Percentage employed | Difference | Total in poverty |
|---|---|---|---|---|
| Alcorn County | Mississippi | 16% | -$12,610 | 46% |
| Beaufort County | North Carolina | 15% | -$13,315 | 41% |
| Calhoun County | Michigan | 20% | -$12,744 | 39% |
| Clinton County | New York | 18% | -$14,055 | 39% |
| Fulton County | New York | 20% | -$13,974 | 38% |
| Hampden County | Massachusetts | 20% | -$13,477 | 43% |
| Hopkins County | Kentucky | 20% | -$12,567 | 43% |
| New York County | New York | 20% | -$29,518 | 43% |
| Newaygo County | Michigan | 18% | -$13,799 | 39% |
| Peoria County | Illinois | 19% | -$13,418 | 38% |
| Roanoke | Virginia | 19% | -$12,853 | 42% |
| Scioto County | Ohio | 17% | -$13,721 | 51% |
Counties ordered alphabetically; Roanoke, Va., is considered an independent city by the U.S. Census Bureau.
People with disabilities can receive access to Medicaid, but costs can still be high and access to care affected by pay
The cost of health care is high for disabled Americans. Those who qualify for Social Security Disability Insurance or Supplemental Security Income (SSI) benefits gain access to Medicare, even if they aren't yet 65 years old. Under certain circumstances, disabled Americans who work may still be eligible for Medicare benefits even if they earn more than their state's income threshold.
However, ValuePenguin found 26 counties across 11 states where the median wages (which already don't include payments from SSI) for people with disabilities are higher than the statewide Supplemental Security Income limit's threshold. On average, disabled earners in these counties make $38,238 per year. In only one of these counties (Chilton County, Ala.) are rates of poverty in the highest quarter relative to the data set.
County (or equivalent) | Median earnings of people with disabilities | Total in poverty | Medicare costs per capita |
|---|---|---|---|
| Alexandria city, Va. | $46,886 | 22% | $8,687 |
| Arlington County, Va. | $64,538 | 21% | $8,126 |
| Autauga County, Ala. | $35,366 | 36% | $10,122 |
| Bergen County, N.J. | $35,566 | 20% | $10,372 |
| Boone County, Ky. | $31,696 | 18% | $10,525 |
| Calvert County, Md. | $47,944 | 13% | $9,354 |
| Canadian County, Okla. | $31,568 | 20% | $10,338 |
| Charles County, Md. | $44,760 | 17% | $10,097 |
| Chilton County, Ala. | $29,115 | 38% | $10,795 |
| Douglas County, Colo. | $41,578 | 10% | $9,475 |
| Elmore County, Ala. | $30,627 | 27% | $9,874 |
| Fairfax County, Va. | $39,839 | 17% | $7,789 |
Alexandria, Va., is considered a county-equivalent city by the U.S. Census Bureau.
While per capita Medicare expenses are low in most of the counties where disabled median personal earnings exceed income limits, there are three exceptions where per capita health care costs are at their highest:
- Chilton County, Ala.
- Grady County, Okla.
- Boone County, Ky.
The average amount per capita spent on Medicare in these three counties from 2015 to 2019 was $10,710. With an average income of just $31,081 across these three counties — which exceeds the earnings thresholds in each of these states — the combination of high costs for medical care and low wages could cause a lack of health care access among working disabled Americans who don't meet their states' earnings-related exemptions for public assistance.
Methodology
ValuePenguin analyzed data from the U.S. Census Bureau on population, employment and individual earnings of people with disabilities in American counties. This study focused on 1,024 counties — ones large enough to contain five-year estimates on the disabled population. Five-year estimates focus on 2015 to 2019, the time period with the most recent available data.
In addition to gathering data from the U.S. Census Bureau, ValuePenguin derived the per capita Medicare expenditures from the Centers for Medicare and Medicaid Services.