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Trends in Veteran Disability Status and Service-Connected Disability: 2008–2022 American Community Survey Reports By Jonathan Vespa and Caitlin Carter ACS-58 November 2024 INTRODUCTION In 2022, over 13 percent of the U.S. population had a disability.1 People with disabilities are more likely to face challenges, such as limited access to health care services and experience poorer health outcomes.2 They are also more likely to face economic chal- lenges such as unemployment and are at a higher risk of living in poverty.3 Understanding the prevalence of disability and the communities it affects is piv- otal to addressing these economic and public health disparities. Within the population of people with disabilities, veter- ans represent an important group, especially in terms of public health and public policy. In 2022, of the 16.2 million American veterans in the United States, about 5.4 million received compensation benefits because of a service-connected disability.4 In total, more than $112 billion was spent in 2022 on veterans’ disability compensation benefits.5 1 U.S. Census Bureau, “Table S1810: Disability Characteristics,” 2022, <https://data.census.gov/table/ACSST1Y2022.S1810?q=disability>. 2 Centers for Disease Control and Prevention (CDC), “Health Equity for People With Disabilities,” National Center on Birth Defects and Developmental Disability, 2022, <www.cdc.gov/ncbddd/ humandevelopment/health-equity.html>. 3 Bureau of Labor Statistics, “Persons With a Disability: Labor Force Characteristics Summary, A01 Results,” USDL-23-0351, 2022, <www.bls.gov/news.release/pdf/disabl.pdf>; U.S. Census Bureau, “Table B18130: Age by Disability Status by Poverty Status,” 2022, <https://data.census.gov/table/ACSDT1Y2022.B18130?q=poverty+and +disability>. 4 U.S. Census Bureau, “Table S2101: Veteran Status,” 2022, <https:// data.census.gov/table/ACSST1Y2022.S2101?q=2022+veterans>. 5 U.S. Department of Veterans Affairs, “Veterans Benefits Administration Annual Benefits Report Fiscal Year 2022,” 2022, <www.benefits.va.gov/REPORTS/abr/docs/2022-abr.pdf#>. Compared with people who never served in the U.S. armed forces, veterans are more likely to have a disability.6 In large part, veterans have higher disability rates because they are older than the population in general (about one-half of veterans are aged 65 and over). Higher disability rates also stem from service- related injuries, as well as the physical and psycho- logical demands of military service. As the veteran population ages and faces further age-related health issues, examining the prevalence of disability is crucial to delivering the benefits and services that veterans need. This report investigates disability among veterans of the U.S. armed forces and how they compare to the broader nonveteran population.7 It focuses on dis- ability rates among post-9/11 veterans, i.e., those who have served since September 2001. Post-9/11 veter- ans are the youngest cohort of veterans and more recently have been at the forefront of veteran public health research. This report uses annual data from the American Community Survey (ACS), 2008 to 2019 and 2021 to 2022. The U.S. Census Bureau did not release its standard 2020 ACS 1-year estimates because of the impacts of the COVID-19 pandemic, so data from 6 J. A. Betancourt et al., “Exploring Health Outcomes for U.S. Veterans Compared to Non-Veterans From 2003 to 2019,” Healthcare, Basel, Switzerland, 9(5), May 18, 2021, p. 604, <https:// pubmed.ncbi.nlm.nih.gov/34070037/>. 7 The U.S. Census Bureau reviewed this report for unauthorized disclosure of confidential information and has approved the disclosure avoidance practices applied to this release (Data Management System [DMS] number: P-7533841, Disclosure Review Board [DRB] approval number: CBDRB-FY-24-POP001-0079). 2020 were not included in this analysis.8 Following an earlier report, it looks at the prevalence of service-connected disabilities (SCD) among veterans as well as ACS disabilities among both the veteran and nonveteran popu- lation.9 Lastly, the report uses statistical regression analysis to examine whether veterans have become increasingly likely to report an SCD or ACS disability over time, while accounting for differences in the demographic and socio economic composition of the veteran population.10 Highlights • Service-connected disabilities were more common in 2022 than in 2008. About 30 per- cent of veterans had a service- connected disability in 2022, up from 15 percent in 2008 (Figure 2a). • The share of veterans with neither a service-connected disability nor an ACS disability was around one-half in 2022 (52 percent), down from two-thirds in 2008 (65 percent) (Figure 3). • After accounting for the demo- graphic and socioeconomic characteristics of veterans, post-9/11 veterans were more likely to have a service- connected disability in 2022. They had a 31 percent chance of having a service-connected disability in 2022, up from an 18 percent chance in 2008 (Figure 5a). 8 2020 ACS 1-year estimates, <www. census.gov/programs-surveys/acs/technical- documentation/table-and-geography- changes/2020/1-year.html>. 9 K. Holder, “The Disability of Veterans,” U.S. Census Bureau, Washington, DC, 2015, <www.census.gov/library/working- papers/2016/demo/Holder-2016-01.html>. 10 For more information on how veteran periods of service are defined, refer to <https://www2.census.gov/topics/ population/veterans/guidance/acs-topic- information-veterans.pdf>. Figure 1. Disability Questions on the American Community Survey Source: American Community Survey questionnaire, <www.census.gov/programs-surveys/acs/about/forms-and-instructions.html>. • In 2022, post-9/11 veterans were more likely to have a cognitive disability (8.9 percent chance) than other veterans (4.8 percent chance) or nonveterans (3.8 percent chance), after account- ing for the demographic and socioeconomic characteristics of these groups (Figure 6a). • Post-9/11 veterans were more likely to report a high service- connected disability rating than in the past. In 2022, post-9/11 veterans with a service- connected disability had a 50 percent chance of report- ing a high service-connected disability rating (i.e., a rating of 70 percent or greater), up from 27 percent in 2008 (Figure 7). MEASURING DISABILITY Disability is a complex experience between individuals and their envi- ronment and can be measured in many ways. The medical model of disability views it in terms of medi- cal conditions that need treatment or therapy. Alternatively, the social model views disability more as a relationship between individual abilities and environmental and societal conditions.11 This report uses the ACS functional disability measure. A person reporting “yes” to one or more of the disability questions (refer to Figure 1) is clas- sified as having a disability. In addition, we examine SCDs among the veteran population. A service-connected disability is an injury, illness, or disease that was incurred during or aggravated by service in the military. ACS mea- sures service-connected disability through individuals’ responses to the SCD questions (Figure 1). A 11 M. Palmer and D. Harley, “Models and Measurement in Disability: An International Review,” Health Policy and Planning, (7), 2012, pp. 357–364, <https://academic.oup. com/heapol/article/27/5/357/749458>. 2 U.S. Census Bureau Sample, Definitions, and Concepts Sample: This report includes civilian veterans and nonveterans aged 18 and over who are living in the United States. Veterans are individuals who have served on active duty in the past but are not currently serving. Nonveterans have never served on active duty in the U.S. armed forces. The report excludes active duty service members. ACS disability: Disability estimates in this report come from the American Community Survey (ACS). The ACS classifies individuals as having a disability if they reported difficulty with specific func- tional activities. The ACS considers someone to have a disability if the individual self-reports having a vision, hearing, cognitive, ambu- latory, self-care, or independent living difficulty. The ACS attempts to measure six aspects of disability, which can be used together to create an overall disability measure, or independently to examine populations with specific disability types. Hearing: Deafness or serious difficulty hearing. Vision: Blindness or serious difficulty seeing even when wearing glasses. Cognitive: Difficulty concentrating, remembering, or making deci- sions because of a physical, mental, or emotional condition. Ambulatory: Serious difficulty walking or climbing stairs. Self-care: Difficulty dressing or bathing. Independent living: Difficulty doing errands alone, such as visit- ing a doctor’s office or shopping, because of a physical, mental, or emotional condition. Service-connected disability (SCD): A disability, disease, or injury incurred or aggravated during military service. The U.S. Department of Veterans Affairs (VA) may assign veterans a disability rating based on the severity of a service-connected medical condition. The rating is graduated from 0 percent to 100 percent (in incre- ments of 10 percent). The VA calculates the total service-connected disability rating by combining evaluations of each disability rather than adding the individual ratings together. This report counts vet- erans as having an SCD if they answer “yes” to the ACS question- naire item about having a service-connected disability rating. Importantly, service-connected disabilities are reported indepen- dently of ACS disabilities, and a veteran may report one or both (or neither). Information about service-connected disabilities on the ACS come from self-reported survey responses, which differ from estimates published by the VA that are based on administrative records. High service-connected disability rating: A service-connected dis- ability rating of 70 percent or higher. This rating does not necessar- ily represent having a single serious disability, since the VA evalu- ates each service-connected disability rather than adding individual ratings. person who reports having an SCD is classified as having a service- connected disability. Only veterans may have a service-connected dis- ability, while any respondent may report an ACS disability. In some instances, the disabilities may overlap. A veteran may have hearing loss because of an injury while serving, so he or she reports a hearing difficulty from among the listed disabilities on the ACS. Other times the disabilities may be independent of military service (e.g., an older veteran who has dif- ficulty walking because of his age). One of the purposes of this report is to investigate the distribution of service-connected and ACS dis- abilities among veterans to better understand how these different definitions of disability relate to one another. Another dimension of disabil- ity that the report examines is service -connected disability rat- ings. The VA assigns these ratings to veterans based on the severity of their injuries, which veterans may then self-report on the ACS.12 The rating is used to determine eligibility for compensation as well as other benefits and programs. Service-connected disability rat- ings are provided in the form of a graduated percentage, between zero and 100 percent, which represents how much a disability affects a veteran’s overall health and ability to function. This report uses the service-connected dis- ability ratings that are reported in the ACS. In addition, it classi- fies veterans with a rating of 70 percent or higher as having a high SCD rating. 12 For more information on how the VA assigns disability ratings, refer to <www. va.gov/disability/about-disability-ratings/>. U.S. Census Bureau 3 Figure 2a. Veteran Service-Connected and American Community Survey (ACS) Disability Rates: 2008–2022 (In percent, civilian veterans aged 18 and over) ACS disability Service-connected disability 29.5 29.6 30.0 30.2 30.0 29.1 30.6 30.6 30.6 31.3 29.5 27.8 26.7 25.6 24.2 23.0 21.7 20.6 19.5 18.3 26.0 26.4 26.3 26.9 27.4 15.1 14.9 15.6 16.9 16.1 2008 2010 2012 2014 2016 2018 2020 2022 Note: Estimates for 2020 were interpolated and may not match estimates from the 2020 ACS Experimental Data. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2008 through 2019 and 2021 through 2022 American Community Survey 1-year estimates. DISABILITY PREVALENCE AMONG VETERANS The Percentage of Veterans With a Service-Connected Disability Has Nearly Doubled Since 2008. Over the past decade, the percent- age of veterans with a service- connected disability has nearly doubled, from 15.1 percent in 2008 to 29.5 percent in 2022—corre- sponding to 4.8 million veterans in 2022. ACS disability rates have remained more stable, rising from 26.0 percent to 31.3 percent across the same period (Figure 2a). Rates of ACS disability tend to be higher among older age groups, although this report found that rates of SCD increased across multiple age groups.13 Among veterans under the age of 65, the rate of service-connected disabil- ity increased from 16.9 percent in 2008 to 34.5 percent in 2022 (Figure 2b). Among veterans aged 65 and over, the rate of service- connected disability increased from 12.4 percent in 2008 to 24.4 percent in 2022 (Figure 2b). ACS disability rates increased slightly between 2008 and 2022, though those aged 65 and over 13 U.S. Census Bureau, “Table S1810: Disability Characteristics,” 2022, <https:// data.census.gov/table/ACSST1Y2022. S1810?q=disability>; K. Holder, “The Disability of Veterans,” U.S. Census Bureau, Washington, DC, 2015. consistently had higher rates than their 65 and under peers through- out this period. Among veterans under the age of 65, ACS disability rates increased from 16.7 percent in 2008 to 20.3 percent in 2022 (Figure 2c). Among veterans aged 65 and over, the rate increased from 39.9 percent in 2008 to 42.7 percent in 2022 (Figure 2c). Among veterans under the age of 45, service-connected disabilities appear to be rising at a faster rate than ACS disabilities. For younger veterans, rates of SCD more than doubled (from 16.1 percent to 39.4 percent) between 2008 and 2022 (Figure 2d). The percentage of veterans under the age of 45 4 U.S. Census Bureau Figure 2b. Veteran Service-Connected Disability Rates by Age: 2008–2022 (In percent, civilian veterans aged 18 and over) 45 40 35 30 25 20 15 10 5 0 Aged 65 and over Under the age of 65 2008 2010 2012 2014 2016 2018 2020 2022 Note: Estimates for 2020 were interpolated and may not match estimates from the 2020 American Community Survey Experimental Data. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2008 through 2019 and 2021 through 2022 American Community Survey 1-year estimates. Figure 2c. Veteran American Community Survey (ACS) Disability Rates by Age: 2008–2022 (In percent, civilian veterans aged 18 and over) Aged 65 and over Under the age of 65 2008 2010 2012 2014 2016 2018 2020 2022 45 40 35 30 25 20 15 10 5 0 Note: Estimates for 2020 were interpolated and may not match estimates from the 2020 ACS Experimental Data. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2008 through 2019 and 2021 through 2022 American Community Survey 1-year estimates. who reported an ACS disability increased from 9.0 percent to 17.2 percent across the same period (Figure 2d). About One-Half of Veterans Reported Having No Disability in 2022. Veterans with service-connected disabilities may not necessarily have ACS disabilities such as hearing, ambulatory, or self-care difficulties (refer to “Measuring Disability”). Overall, most veterans did not report either type of disability. In 2008, 65.1 percent of veterans did not report either kind of disability (i.e., a service- connected or ACS-defined disability). Over time, however, this percentage has declined. By 2022, just over one-half of veterans (51.8 percent) reported having no disability at all (Figure 3). Interestingly, service-connected disabilities appear to be causing the decline in the percentage of veterans with no disability. The prevalence of ACS-only disabilities decreased slightly between 2008 and 2022, while the prevalence of SCDs increased markedly (Figure 3). In 2008, 8.8 percent of veterans had only a SCD. By 2022, this fig- ure had increased to about 17 per- cent, while the share of veterans with both ACS and SCD doubled (from 6.2 percent to 12.6 percent across the same period). Veterans Have Been Reporting Higher Service-Connected Disability Ratings Over Time. About one-half of veterans had some kind of disability in 2022, whether an ACS or service- connected disability (Figure 3). Trends in Figure 3 suggest that the increase in disability rates overall among veterans is driven by the increase in SCD rates specifically. Another way to look U.S. Census Bureau 5 Figure 2d. Service-Connected and American Community Survey (ACS) Disability Rates For Veterans Under the Age of 45: 2008–2022 (In percent, civilian veterans aged 18 and over) 37.8 39.4 Service-connected disability, under the age of 45 ACS disability, under the age of 45 36.1 34.4 31.6 29.7 27.8 25.3 23.6 21.8 19.5 16.8 17.4 17.9 16.1 9.0 9.2 8.4 9.0 9.7 11.0 11.2 12.5 11.9 13.1 13.1 14.4 17.2 16.1 15.2 2008 2010 2012 2014 2016 2018 2020 2022 Note: Estimates for 2020 were interpolated and may not match estimates from the 2020 ACS Experimental Data. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2008 through 2019 and 2021 through 2022 American Community Survey 1-year estimates. at this increase is to examine whether more veterans are report- ing high SCD ratings than in the past. We classified veterans with a self-reported rating of 70 per- cent or above as having a high SCD rating (for more informa- tion on veteran disability ratings, refer to “Measuring Disability” and “Sample, Definitions, and Concepts”). For comparison, we also examined whether veterans reported multiple ACS disabilities. The percentage of veterans with a high service-connected disability rating increased nearly fivefold (from 2.6 percent to 12.8 percent) between 2008 and 2022 (Figure 4). Although more veterans reported multiple ACS disabilities than a high service-connected disability rating, the change over time for multiple ACS disabilities was far less pronounced. Between 2008 and 2022, the percentage of veterans with two or more ACS disabilities increased from 12.5 to 15.3 percent. The prevalence of high service- connected disability ratings depends on when a veteran served. Previous research has indi- cated that high disability ratings are most common among post- 9/11 veterans. In 2018, post-9/11 veterans reported the largest percentage with a high SCD rating (nearly 16 percent), followed by Gulf War veterans (13.1 percent), and Vietnam veterans (9.8 percent).14 The prevalence of high SCD ratings among Korean War and World War II veterans was much lower, at 3.4 percent and 3.7 percent, respectively (the two estimates are not significantly different from one another). There are several reasons why we observe higher SCD ratings among more recent service periods, including selection bias and policy changes. First, only the healthi- est older veterans are still alive, as those with severe disabilities would have higher mortality rates, 14 J. Vespa, “Those Who Served: America’s Veterans From World War II to the War on Terror,” American Community Survey Reports, ACS-43, U.S. Census Bureau, Washington, DC, 2020, <www.census. gov/content/dam/Census/library/publica- tions/2020/demo/acs-43.pdf>. 6 U.S. Census Bureau Figure 3. Veteran Disability Status: 2008 and 2022 (In percent) 2008 2022 65.1 51.8 19.8 18.7 16.9 8.8 12.6 6.2 No disability American Community Survey disability only Service-Connected Disability only Both ACS and SCD disability Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2008 and 2022 American Community Survey 1-year estimates. Most Common Service-Connected Disabilities According to the U.S. Department of Veterans Affairs, the ten most prevalent service-connected disabilities in 2022 were: Tinnitus. 1. 1. Tinnitus. Limitation of flexion, knee. 2. 2. Limitation of flexion, knee. Hearing loss. 3. 3. Hearing loss. Post-traumatic stress disorder (PTSD). 4. 4. Post-traumatic stress disorder (PTSD). Lumbosacral or cervical strain. 5. 5. Lumbosacral or cervical strain. Paralysis of the sciatic nerve. 6. 6. Paralysis of the sciatic nerve. Scars, general. 7. 7. Scars, general. Limitation of motion of the ankle. 8. 8. Limitation of motion of the ankle. Limitation of motion of the arm. 9. 9. Limitation of motion of the arm. Migraine. 10. Migraine. 10. and the healthiest post-9/11 service members may still be serving (and thus not yet counted among the population of veterans).15 Both instances would represent selec- tivity in the veteran population. Second, high ratings could reflect a greater likelihood of injury or illness while serving for post-9/11 veterans. And third, high ratings may reflect changes in the VA’s schedule of service-connected dis- abilities and how their ratings are assessed (e.g., changes in eligibil- ity rules for post-traumatic stress Source: U.S. Department of Veterans Affairs, “Annual Benefits Report: Fiscal Year 2022,” Veterans Benefits Administration, Washington, DC, 2022, <www.benefits.va.gov/REPORTS/abr/ docs/2022-abr.pdf>. 15 C. Maynard, K. Nelson, and S. Fihn, “Disability Rating and 1-Year Mortality Among Veterans With Service-Connected Disability Conditions,” Public Health Report, Volume 133, Issue 6, November 2018, pp. 692–699, <https://pubmed.ncbi.nlm.nih. gov/30223760/>. U.S. Census Bureau 7 Figure 4. Veterans With Two or More American Community Survey (ACS) Disabilities or High Service-Connected Disability (SCD) Rating: 2008–2022 (In percent, civilian veterans aged 18 and over) 14.2 14.4 14.6 14.8 14.8 14.7 15.1 15.0 15.0 15.3 12.8 12.9 12.5 13.6 13.2 12.8 11.5 10.5 9.6 Two or more ACS disabilities High SCD rating 8.5 7.7 6.9 6.2 5.5 4.9 4.2 3.8 3.0 3.2 2.6 2008 2010 2012 2014 2016 2018 2020 2022 Note: High SCD rating refers to a service-connected disability rating of 70 percent or higher. Estimates for 2020 were interpolated and may not match estimates from the 2020 ACS Experimental Data. Data based on sample. For information on confidentiality protection, sampling error, nonsampling error, and definitions refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2008 through 2019 and 2021 through 2022 American Community Survey 1-year estimates. disorder, or PTSD).16 We will return to this trend of higher service- connected disability ratings in the last section of this report and investigate whether post-9/11 vet- erans are more likely to have high ratings, net of other important demographic and socioeconomic characteristics. TYPES OF DISABILITY AMONG VETERANS AND NONVETERANS Although the number of non- veterans with an ACS disability far 16 K. Contreary, J. Tennant, and Y. Ben-Shalom, “Impacts of the 2010 VA PTSD Rule Change on Veterans’ Disability Compensation and Reported Cognitive Disability,” Journal of Disability Policy Studies, Volume 28, Issue 3, 2017, pp. 141–149, <https://doi. org/10.1177/1044207317714747>. exceeds that of veterans with an ACS disability (37.7 million versus 5.1 million, respectively), disability rates are about twice as prevalent among the veteran population (Table 1). The most common type of ACS disability among veterans was ambulatory difficulty, followed by hearing difficulty. About 16 percent of veterans reported either one. Among nonveterans, the most common ACS disability was also ambulatory, but the second most common was independent living. About 8 percent of nonveterans reported an ambulatory difficulty and 6 percent reported an inde- pendent living difficulty. The types of ACS disability among veterans varied widely by their period of military service, which is a proxy for age.17 For example, over two-thirds (69 percent) of veter- ans who served during the Korean War reported an ACS disability. In contrast, less than one-quarter of Gulf War and post-9/11 veterans (21 and 19 percent, respectively) reported an ACS disability (Table 2). Looking at disability type, the pro- portion of post-9/11 veterans with a cognitive disability was higher than either Gulf War or Vietnam veterans (Table 2). This suggests that post-9/11 veterans may be more likely to have cognitive dis- abilities than some groups of vet- erans. However, cognitive disability is closely tied with a veteran’s age 17 Veterans may serve in multiple periods. This report categorizes veterans in their most recent period of service. 8 U.S. Census Bureau Table 1. Prevalence of American Community Survey (ACS) Disabilities by Veteran Status: 2022 (Numbers in thousands, civilian population aged 18 and over) Veteran Nonveteran Characteristic    Total. . . . . . . . . . . . Has an ACS disability . . . . . .  Hearing . . . . . . . . . . . . . . . . .  Vision. . . . . . . . . . . . . . . . . . .  Ambulatory . . . . . . . . . . . . .  Cognitive . . . . . . . . . . . . . . .  Self-care . . . . . . . . . . . . . . . .  Independent living . . . . . . . Number 16,200 5,072 2,541 768 2,615 1,528 934 1,601 Standard error 43.1 20.3 16.2 9.5 14.6 12.3 9.0 12.9 Percent 100.0 31.3 15.7 4.7 16.1 9.4 5.8 9.9 Standard error X 0.1 0.1 0.1 0.1 0.1 0.1 0.1 Number 243,400 37,680 9,553 7,191 19,470 14,680 7,732 15,340 Standard error 40.3 74.1 34.8 36.3 59.2 46.2 33.9 45.7 Percent 100.0 15.5 3.9 3.0 8.0 6.0 3.2 6.3 Standard error X Z Z Z Z Z Z Z X Not applicable. Z Indicates a value of less than 0.0. Note: People can have more than one disability. As a result, estimates will not sum to the total. Data based on sample. For information on confidentiality protection, sampling error, nonsampling error, and definitions refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2022 American Community Survey 1-year estimates. (as the trends in Table 2 suggest). Age differences in veteran cohorts must be accounted for to better understand the likelihood of hav- ing a cognitive disability, an analy- sis that we will return to in the last section of the report. Veterans With a Service- Connected Disability (SCD) Are Twice as Likely to Have Cognitive Difficulty Than Veterans Without an SCD. Although the ACS does not collect information on the specific disabil- ity diagnoses, this report esti- mated general disability categories among veterans with SCDs by examining which ACS difficulties they reported. In 2022, 42.7 per- cent of veterans with an SCD also reported having at least one ACS disability (Table 3). Among these veterans, the most prevalent ACS disability was hearing, followed by ambulatory. Across each of the six types of ACS disabilities, veterans with an SCD were more likely to report a difficulty than veterans without an SCD. In other words, all types of disability measured by the ACS were overrepresented among veterans with an SCD (Table 3). Interestingly, veterans with an SCD were twice as likely to report cog- nitive difficulty as their peers who did not have an SCD. REGRESSION ANALYSIS: PREDICTING THE LIKELIHOOD OF HAVING A SERVICE- CONNECTED DISABILITY OVER TIME Veterans have higher ACS dis- ability rates than nonveterans, and post-9/11 veterans have higher rates of SCDs than other veteran groups. Several different factors likely underlie these trends. The most obvious is age. The veteran population is substantially older than the American population in general (median age of 65 versus 39).18 As a result, ACS disability rates such as hearing or vision difficulties may be higher among veterans because they are much older, on average, than the general population. Even among veterans, certain service cohorts may have selective characteristics, such as sex, education, or distinctive tours 18 For the median age of veterans, refer to J. Vespa, “Those Who Served: America’s Veterans From World War II to the War on Terror,” American Community Survey Reports, ACS-43, U.S. Census Bureau, Washington, DC, 2020. For the median age of the U.S. population, refer to “Table S0101: Age and Sex,” U.S. Census Bureau, Washington, DC, <https://data.census.gov/ table/ACSST1Y2022.S0101>. of duty and service experiences, that are linked to either ACS or service-connected disabilities. Another reason that veterans may have higher disability rates is because they were injured while serving or that the physical and mental stresses of training or com- bat took a toll on their health. To try to account for these numer- ous factors, we used a type of statistical analysis, logistic regres- sion, to test whether ACS and service-connected disability rates have significantly increased over time while taking into account the effect of other characteristics, such as age. This ability is the chief ben- efit of regression analysis—that it helps separate the effects of time and period of service from other factors that also affect disability. In a sense, regression analysis lets us compare veterans and nonveter- ans of the same age, sex, race, and income (among other character- istics) so that veteran status is the only measured difference between them, thereby isolating the effect that being a veteran has on disabil- ity prevalence. To aid in interpreting the regres- sion analyses, this report presents a series of predicted probabilities in Figures 5 through 7. Predicted U.S. Census Bureau 9 Table 2. Prevalence of Service-Connected and American Community Survey (ACS) Disabilities by Type and Service Cohorts: 2022 (In percent, civilian veterans aged 18 and over) Characteristic All veterans Post-9/11 Gulf War Peacetime (1975 or later) Vietnam War Korean War World War II Peacetime (before 1975) Has service-connected disability . . . . . . . . . . . . . . . . . Has ACS disability . . . . . . . . . .  Hearing . . . . . . . . . . . . . . . . . .  Vision. . . . . . . . . . . . . . . . . . . .  Ambulatory . . . . . . . . . . . . . .  Cognitive . . . . . . . . . . . . . . . .  Self-care . . . . . . . . . . . . . . . . .  Independent living . . . . . . . . 29.5 31.3 15.7 4.7 16.1 9.4 5.8 9.9 45.4 19.1 7.2 2.1 6.1 9.7 2.2 5.3 32.4 21.0 8.4 3.0 10.4 7.4 3.2 5.6 17.9 26.2 9.8 4.5 15.1 7.8 5.0 7.6 27.1 39.1 22.3 6.0 20.7 8.8 7.0 10.9 12.5 68.6 41.3 12.9 44.0 20.0 20.1 35.4 11.9 83.1 52.5 19.1 61.7 27.9 35.1 56.3 9.1 52.7 30.8 8.3 30.0 12.6 11.0 19.6 Note: Veterans can have more than one type of disability. As a result, estimates will not sum to the total. In addition, periods of service are not mutually exclusive. Data based on sample. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2022 American Community Survey 1-year estimates. Table 3. American Community Survey (ACS) Disability Type by Service-Connected Disability Status: 2022 (Numbers in thousands, civilian veterans aged 18 and over) Characteristic    Total veterans . . Has ACS disability . . . . . .  Hearing . . . . . . . . . . . . . .  Vision. . . . . . . . . . . . . . . .  Ambulatory . . . . . . . . . .  Cognitive . . . . . . . . . . . .  Self-care . . . . . . . . . . . . .  Independent living . . . . Veterans, no service-connected disability Veterans, with service-connected disability Number 11,420 Standard error 36.8 Percent 100.0 Standard error X Number 4,781 Standard error 25.6 Percent 100.0 Standard error X 3,029 1,458 503 1,623 803 589 1,018 16.7 10.8 7.9 12.7 9.4 7.0 10.0 26.5 12.8 4.4 14.2 7.0 5.2 8.9 0.1 0.1 0.1 0.1 0.1 0.1 0.1 2,043 1,083 265 992 725 345 583 14.7 11.6 5.4 8.3 9.0 5.3 8.0 42.7 22.6 5.5 20.7 15.2 7.2 12.2 0.2 0.2 0.1 0.2 0.2 0.1 0.2 X Not applicable. Note: People can have more than one disability. As a result, estimates will not sum to the total. Data based on sample. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Cenusu Bureau, 2022 American Community Survey 1-year estimates. probabilities are the likelihood or chance that a veteran has a type of disability (the full regression results are presented in Appendix B). They were calculated holding a veteran’s demographic and socio- economic characteristics at their mean level (i.e., the probabilities reflect the chances of having an ACS or service-connected disabil- ity for the average veteran). Regression Analysis Shows That Service-Connected Disability Rates Have Increased Significantly Among Post-9/11 Veterans Since 2008. trend is that the rate of increase was about one-and-one-half times greater for post-9/11 veterans than for veterans of other service periods. On average, post-9/11 veterans had a 31.3 percent chance of having a service-connected disability in 2022, up from 17.7 percent in 2008. In comparison, the probability for other veterans increased more slowly, from 11.1 to 21.0 percent, across the same period (Figure 5a). Another way of looking at this In contrast to the increasing likelihood of having a service- connected disability, the prob- ability of having a general ACS disability did not change for post-9/11 veterans between 2008 and 2022 (Figure 5b). Their overall probability is significantly higher than that of other veterans, which 10 U.S. Census Bureau is surprising. Other veterans are much older than post-9/11 veter- ans, and a person’s age is a key factor in developing disabilities such as difficulty seeing, hearing, or walking. Even when compared with nonveterans, post-9/11 veter- ans were twice as likely to have an ACS disability in 2022 (10.5 per- cent chance for nonveterans com- pared with 22.0 percent chance for post-9/11 veterans). Looking at the intersection of SCDs and ACS disabilities, the probability of veterans reporting both types increased significantly since 2008. A post-9/11 veteran had about a 9 percent chance of reporting both kinds of disability, compared with about a 7 percent chance for other veterans in 2022 (Figure 5c). Taken together, the results in these three figures (Figures 5a through 5c) show that post-9/11 veterans were more likely to report an SCD than other veterans and were more likely to report an ACS disabil- ity than either other veterans or no nveterans. Furthermore, post- 9/11 veterans’ chances of reporting a service-connected disability have increased significantly over time. Regression Analysis Shows That Post-9/11 Veterans Were More Likely to Have a Cognitive Disability Than the Broader Population. Cognitive impairments are one type of disability that respondents can report on the ACS. Cognitive disability includes difficulty con- centrating, remembering, or mak- ing decisions because of a physi- cal, mental, or emotional condition. Do post-9/11 veterans have distinc- tive trends in reporting cognitive disabilities? They do. Post-9/11 veterans were more likely to have a cognitive disability than other veterans, even after accounting for differences in their demographic and socio- economic characteristics: an 8.9 percent chance compared with a 4.8 percent chance, respectively (Figure 6a). Post-9/11 veterans may be more likely to report a cognitive disabil- ity because this type of condition has become more common among younger groups of people over- all, regardless of military service. Among the nonveteran population, the chances of having a cognitive disability have risen since 2008, but those chances are significantly lower than those for post-9/11 veterans—even after accounting for age differences between these groups. A nonveteran had a 3.8 percent chance of having a cogni- tive disability in 2022, compared with an 8.9 percent chance for post-9/11 veterans (Figure 6a). Looking at the intersection of service-connected and cogni- tive disabilities, regression results show that the probability of having a cognitive disability is highest among veterans with an SCD. For veterans who do not have an SCD, the chances of having a cognitive disability are significantly smaller (Figure 6b). More importantly, the regression results show that these probabilities in 2022 were not sig- nificantly different than they were in 2008. The Census Bureau does not col- lect information on specific types of service-connected disability. It is possible that cognitive impair- ment is a proxy for reporting post- traumatic stress disorder (PTSD) and other major symptoms of depression. Other researchers have reported that rates of PTSD have been rising over time, although it is unclear whether post-9/11 veterans are more likely to report it than other veterans.19, 20 Regression Results Show That Having High Service-Connected Disability Ratings Was More Likely in 2022 Than 2008. As discussed earlier in the report, more veterans are reporting high SCD ratings than in the past. This kind of rating represents one or more injuries or conditions that severely impair a veteran’s daily life and activities. Since 2008, the proportion of veterans with a high service-connected disability rating has increased from 2.6 percent to 12.8 percent in 2022 (Figure 4). Regression results support this conclusion. Among post-9/11 veterans with a service-connected disability, the probability of having a high disability rating increased from 27.4 to 50.4 percent between 2008 and 2022 (Figure 7). In other words, if post-9/11 veterans have a service-connected disability, there is a 1-in-2 chance that it will be rated at 70 percent or higher. These chances were higher than those for other veterans, although the probability for other veterans increased significantly as well (from 18.7 to 38.2 percent across the same period). Possible Causes and Data Limitations There are many reasons why post- 9/11 veterans were more likely to have an ACS disability and SCD 19 R. J. Glasser, Broken Bodies, Shattered Minds: A Medical Odyssey from Vietnam to Afghanistan, History Publishing Company, Palisades, NY, 2011. 20 T. L. Tanielian and L. H. Jaycox (eds), Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery, RAND Corporation, Santa Monica, CA, 2008; P. P. Schnurr, C. A. Lunney, M. J. Bovin, and B. P. Marx, “Posttraumatic Stress Disorder and Quality of Life: Extension of Findings to Veterans of the Wars in Iraq and Afghanistan,” Clinical Psychology Review, 29, 2009, pp. 727–735. U.S. Census Bureau 11 Figure 5a. Predicted Probability of Having a Service-Connected Disability: 2008 and 2022 (In percent) Post-9/11 veterans All other veterans 31.3 21.0 17.7 11.1 Figure 5b. Predicted Probability of Having an American Community Survey Disability: 2008 and 2022 (In percent) Figure 5c. Predicted Probability of Having Both an American Community Survey Disability and Service-Connected Disability: 2008 and 2022 (In percent) Post-9/11 veterans All other veterans Nonveterans Post-9/11 veterans All other veterans 22.1 14.4 10.5 22.0 14.4 10.5 5.5 4.2 8.5 6.6 2022 2008 2022 2008 2022 2008 Note: Data based on sample. For information on confidentiality protection, sampling error, nonsampling error, and definitions refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2008 and 2022 American Community Survey 1-year estimates. than other veterans, and why these chances have increased over time. As prior research has noted, post-9/11 veterans may be more likely to experience an injury during their service because of distinctive tours of duty or ser- vice conditions that other veteran cohorts did not experience.21 What is more, medical advances have made it more likely for veterans to survive injuries that would have 21 Coinciding with the wars in Iraq and Afghanistan, the number of veterans with service-connected disabilities has increased since 2001, after decades of remaining relatively stable. Refer to M. Duggan, “The Labor Market Effects of the VA’s Disability Compensation Program,” Stanford University Economic Policy Research, Stanford, California, 2014. been fatal in prior decades.22 Both reasons could explain why post-9/11 veterans were more likely to have a service connected or ACS disability than other veterans. These are not the only reasons, however. One alternative may be 22 M. S. Goldberg, “Death and Injury Rates of U.S. Military Personnel in Iraq,” Military Medicine, 175(4), 2010, pp. 220–226. Also refer to T. Regan, “Report: High Survival Rate for U.S. Troops Wounded in Iraq,” Christian Science Monitor, November 29, 2004; D. Warden, “Military TBI During the Iraq and Afghanistan Wars,” Journal of Head Trauma Rehabilitation, 21(5), 2006, pp. 398–402; R. J. Glasser, Broken Bodies, Shattered Minds: A Medical Odyssey From Vietnam to Afghanistan, History Publishing Company, Palisades, NY, 2011; and Harvard University, “Ninety Percent of U.S. Wounded Survive: In Iraq, Firepower Increases, Deaths Decrease,” Science Daily, 2005, <www.sciencedaily.com/ releases/2005/01/050127234012.htm>. selection bias. Only the healthiest and youngest veterans of older service periods (such as World War II, the Korean War, and the Vietnam War) are still alive today. The oldest individuals, and those in the worst health, have already passed away, which has left a selective group of older veterans who look healthier compared with post-9/11 veterans. Similarly, the youngest post-9/11 service mem- bers may still be serving on active duty and therefore are not yet counted among the veteran popu- lation (ACS classifies individuals as veterans if they served in the past but are not currently serving on active duty). 12 U.S. Census Bureau Figure 6a. Predicted Probability of Having a Cognitive Disability: 2008 and 2022 (In percent) Post-9/11 veterans All other veterans Nonveterans 8.1 4.4 3.5 8.9 4.8 3.8 2008 2022 Note: Data based on sample. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2008 and 2022 American Community Survey 1-year estimates. Figure 6b. Predicted Probability of Having a Cognitive Disability by Service-Connected Disability (SCD): 2008 and 2022 (In percent) With SCD, post-9/11 veterans With SCD, all other veterans No SCD, post-9/11 veterans No SCD, all other veterans 15.9 10.4 7.0 4.4 15.9 10.4 7.1 4.5 2008 2022 Note: Data based on sample. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2008 and 2022 American Community Survey 1-year estimates. More importantly, changes in service-connected disabilities and ratings are directly tied to how the VA classifies and assigns ratings. Such policy changes would sub- stantially alter service-connected disability rates and ratings among veterans. For example, classifi- cations for PTSD have changed significantly over time.23 The impor- tance of these kinds of adjustments and schedule changes cannot be overstated because they directly affect the number of veterans with a service-connected disability and which disability rating has been assigned to those injuries and ill- nesses. The regression analyses presented in this report do not control for these kinds of policy and schedule changes. SUMMARY This report examined two types of disability rates among veter- ans, ACS-defined disabilities and service-connected disabilities, and explored whether their probability of having either kind of disability has increased over time. Compared with 2008, veterans in 2022 were more likely to have a service- connected disability and to have a high SCD rating (i.e., an SCD rating of 70 percent or higher). In contrast, although the likelihood of having an ACS disability has not increased since 2008, veterans remained significantly more likely to have an ACS disability than nonveterans. Regression analysis, which con- trolled for demographic and socioeconomic differences among the veteran population, supported the conclusion that recent veterans have become increasingly likely to report a service-connected disabil- ity. This report found that post-9/11 23 F. D. Nidiffer and S. Leach, “To Hell and Back: Evolution of Combat-Related Post Traumatic Stress Disorder,” Developments in Mental Health Law, 29, 2010, pp. 1–22. U.S. Census Bureau 13 Figure 7. Predicted Probability of Having a High Service-Connected Disability (SCD) Rating Among Veterans With an SCD: 2008 and 2022 (In percent) Post-9/11 veterans All other veterans 50.4 38.2 27.4 18.7 2008 2022 Note: High SCD refers to service-connected disability rating of 70 percent or higher. Data based on sample. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Census Bureau, 2008 and 2022 American Community Survey 1-year estimates. veterans were more likely to have a disability than both other veterans and nonveterans on several dif- ferent levels: (1) to have a service- connected disability; (2) to have a high service-connected disability rating; (3) to have an ACS-defined disability; and (4) to have a cogni- tive disability. For each of these dimensions of disability, post-9/11 veterans were more likely to have that kind of disability than other groups of veterans. Additionally, post-9/11 veterans’ chances of hav- ing these dimensions of disability have all increased since 2008 (except for ACS disabilities, which did not significantly change over time). These findings come with impor- tant caveats. The regression analy- ses were limited by what could be measured with ACS data. Other characteristics may underlie the link between post-9/11 veterans and disability, such as length of military service and repeated tours of duty to war zones. Regression analysis cannot show that military service causes more injuries and illnesses today. Medical technol- ogy allows veterans to survive injuries that might have been fatal in the past. And more importantly, changes in service-connected disabilities are directly tied to adjustments in the VA’s ratings and schedules. We conclude that post-9/11 vet- erans were more likely to have a service-connected disability than other groups of veterans and that the likelihood has significantly increased since 2008. Post-9/11 veterans were more likely to have a high SCD rating than they were in 2008. This report highlights the need to better understand how the physical and psychological demands of military service affect the long-term health and well- being of veterans, as well as the importance of examining multiple dimensions of disability. DATA, SOURCE, AND ACCURACY This report uses data from the American Community Survey, which is a nationwide survey designed to provide timely and reliable data every year on the demographic, social, economic, and housing characteristics of the nation, states, counties, and other localities. The survey has an annual sample size of about 3.5 million addresses across the United States and Puerto Rico and includes both housing units and group quarters. The ACS is conducted in every county throughout the nation. The ACS 1-year data are released for geographic areas with populations of 65,000 or greater. The ACS 5-year data are released for all geographic areas. For information on the ACS sample design and other topics, visit <www.census. gov/programs-surveys/acs/>. Data in this report come from the 2008 through 2022 American Community Survey (excluding the 2020 ACS) and are subject to sampling and nonsampling error. Comparisons of estimates in the report have taken sampling error into account and are significant at the 90 percent confidence level or higher, unless otherwise noted. Because of rounding, some details may not sum to totals. For information on sampling and estimation methods, confidentiality protection, and sampling and non sampling errors, refer to the “Accuracy of the Data” documents for 2022 located at <www.census. gov/programs-surveys/acs/ technical-documentation/code- lists.html>. 14 U.S. Census Bureau APPENDIX A. METHODS AND DATA LIMITATIONS This report used the American Community Survey (ACS) 1-year estimates from 2008 through 2019 and 2021 to 2022. The target population included U.S. veteran and nonveteran civilians, aged 18 and over, living in the United States. The civilian population refers to people living in households and group quarters (except military barracks) who are not on active duty in the U.S. armed forces. Therefore, the report excluded active-duty service members. For technical information on the ACS, refer to <www.census.gov/ programs-surveys/acs/technical- documentation.html>. To examine whether veterans have become more likely to report an ACS disability or service- connected disability over time, we used logistic regression analy- sis, which is a statistical tool that helps calculate the effect that one variable has on another. Because numerous factors affect the likeli- hood of having a disability, regres- sion allows us to separate these competing influences. For exam- ple, veterans of different service periods vary in their demographic and social characteristics—whether age, sex, or income. Since these characteristics are also associ- ated with a veteran’s likelihood of reporting a disability, we want to use regression analysis to calculate the effects of time or post-9/11 military service net of a veteran’s age, sex, or income. The regression results presented in Appendix B show odds ratios, which are the odds of having a dis- ability relative to a particular com- parison group (e.g., men versus women). Odds ratios of “1” indicate that the odds are the same for the comparison groups. Odds ratios “greater than 1” indicate higher odds of reporting a disability, while those “less than 1” indicate smaller odds. Because of the statistical power of the ACS sample, we only report significance for estimates that are at least “p < .001.” A sig- nificance level of “p < .001” means a less than 1 in 1,000 chance that an estimate is a random result. The regression models included the following variables as controls: • Year: Linear or dichotomous variable measuring the survey year. • Veteran status: Categorical vari- able indicating whether respon- dents were (0) not a veteran, (1) a veteran who served prior to September 2001, or (2) a vet- eran who served in 2001 or later. Veterans are classified by their most recent period of service. • VA health care: Dichotomous variable indicating whether the veteran was enrolled for health care through the Department of Veterans Affairs. • Sex: Dichotomous variable for whether the respondent was (0) female or (1) male. • Age: Linear variable measuring the respondent’s age in years. • Race and Hispanic origin: Categorical variable indicating whether respondents were (0) non-Hispanic White, (1) non-Hispanic Black, (2) Hispanic, or (3) non-Hispanic Some Other Race. • Group quarters: Dichotomous variable measuring whether respondents lived in (1) group quarters, excluding military bar- racks, or (0) a household. • Marital status: Dichotomous variable measuring whether respondents were (1) married or (0) not married, including divorced, separated, widowed, and never married. • Educational attainment: Categorical variable measured by the respondent’s highest level of education: (0) high school diploma or less, (1) some college but no degree, (2) bach- elor’s degree or higher. • Income-to-poverty ratio: A cat- egorical measure of respondents’ income relative to the poverty threshold, coded: (0) less than 150 percent, (1) 150 percent to 299 percent, (2) 300 percent to 499 percent, and (3) 500 per- cent or higher. • Public assistance: A dichoto- mous measure of whether a respondent received certain government assistance pro- grams, coded as: (1) received food stamps, public assistance income, or Supplemental Security Income, and (0) did not receive any of these programs. To help interpret the regression analyses, we reported predicted probabilities in Figures 5 through 7, which are the chances, in terms of a percentage, that a veteran has an ACS or service-connected disability (with 0 percent meaning no chance and 100 percent mean- ing complete certainty). Predicted probabilities were calculated using the results of the logistic regressions in Appendix B. They were calculated while holding a veteran’s demographic and socio- economic characteristics at their mean level. In other words, the predicted probabilities represent the chance that the average vet- eran would report a disability. U.S. Census Bureau 15 There are several limitations to the data presented in this report. ACS estimates are based on self- reported survey responses and are susceptible to response and nonresponse bias. Furthermore, because the data are self-reported, estimates of service-connected disability will not match those published by the VA, which are based on administrative records. The ACS measurement of disabil- ity is not comprehensive. There may be other types of disability or a range of severity that are not represented by the results in this report. Another limitation is the sampling structure of the ACS. Ideally, we would like to measure the dis- abilities of the same veterans every year to observe how their health changes over time. Even though the ACS is collected annually, it does not sample the same house- holds every year. Thus, the data represent repeated cross-sections of the veteran population, which we use as a proxy for measuring veteran health over time. Last, regression analysis cannot definitively identify cause and effect. As discussed in the final section of the report, there are other possible explanations why disability rates, especially service- connected ones, may be rising for post-9/11 veterans. These include unmeasured characteristics such as length of service and tours of duty, as well as various kinds of reporting and sampling bias. They also include changes in how the VA classifies and scores SCDs, which, as a result, directly affect the prevalence of SCDs. The analy- sis does not account for this kind of change. 16 U.S. Census Bureau APPENDIX B. REGRESSION RESULTS Appendix Table B-1. Logistic Regression Predicting Likelihood of Service-Connected Disability: 2008–2019 and 2021–2022 (Civilian veterans aged 18 or over) Characteristic Year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Period of service  Before September 2001 (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  September 2001 or later. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enrolled in Veterans Affairs health care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Age (in years) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Race and Hispanic origin  White, non-Hispanic (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Black, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Some Other Race, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lived in group quarters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Education  Less than some college (reference). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Some college. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Bachelor’s degree or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Income-to-poverty ratio  Less than 150 percent (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  150 percent to 299 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  300 percent to 499 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  500 percent or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Received public assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Model 1 Model 2 Odds ratio *1.06 X *2.39 X X X X X X X X X X X X X X X X X Standard error Odds ratio Standard error Z *1.04 Z X 0.008 X X X X X X X X X X X X X X X X X X *2.09 *8.24 0.99 *0.99 X *1.58 *1.24 *1.19 1.07 *1.33 X *1.40 *1.35 X *1.07 *1.41 *1.63 1.01 X 0.011 0.027 0.007 Z X 0.008 0.010 0.009 0.030 0.005 X 0.006 0.005 X 0.007 0.009 0.011 0.007 * p < .001. X Not applicable. Z Indicates a value of less than 0.000. Source: U.S. Census Bureau, 2008 through 2019 and 2021 through 2022 American Community Survey 1-year estimates. U.S. Census Bureau 17 Appendix Table B-2. Logistic Regression Predicting Likelihood of American Community Survey Disability: 2008 and 2022 (Civilian adults aged 18 or over) Model 1 Model 2 Characteristic Year, 2022 (reference, 2008) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Odds ratio *1.13 Standard error 0.003 Odds ratio 1.00 Veteran status Not a veteran (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Veteran, served before September 2001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Veteran, served September 2001 or later. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Age (in years) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X *2.54 *1.08 X X 0.010 0.013 X X Race and Hispanic origin White, non-Hispanic (reference). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Black, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Some Other Race, non-Hispanic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lived in group quarters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Education Less than some college (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Some college . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bachelor’s degree or more. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Income-to-poverty ratio Less than 150 percent (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 percent to 299 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300 percent to 499 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 500 percent or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Received public assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * p < .001. X Not applicable. Z Indicates a value of less than 0.000. Source: U.S. Census Bureau, 2008 and 2022 American Community Surveys 1-year estimates. X X X X X X X X X X X X X X X X X X X X X X X X X X X X X *1.43 *2.41 *1.06 *1.05 X *0.87 *0.89 *0.72 *4.14 *0.65 X *0.81 *0.54 X *0.77 *0.62 *0.48 *3.20 Standard error 0.003 X 0.007 0.034 0.003 Z X 0.005 0.006 0.004 0.088 0.002 X 0.003 0.002 X 0.004 0.003 0.003 0.014 18 U.S. Census Bureau Appendix Table B-3. Logistic Regression Predicting Likelihood of Both Service-Connected and American Community Survey Disability: 2008–2019 and 2021–2022 (Civilian veterans aged 18 or over) Model 1 Model 2 Characteristic Odds ratio Standard error Year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *1.06 0.001 Period of service  Before September 2001 (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  September 2001 or later. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enrolled for Veterans Affairs health care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Age (in years) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 1.01 X X X X 0.007 X X X Race and Hispanic origin  White, non-Hispanic (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Black, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Some Other Race, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lived in group quarters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Education  Less than some college (reference). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Some college. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Bachelor’s degree or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Income-to-poverty ratio  Less than 150 percent (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  150 percent to 299 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  300 percent to 499 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  500 percent or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Received public assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X X X X X X X X X X X X X X X X X X X X X X X X X X Odds ratio *1.03 X *1.32 *8.43 *1.14 *1.01 X *1.22 *1.36 *1.22 *1.44 *1.13 X *1.23 *0.91 X 1.00 *1.17 *1.05 *1.52 Standard error 0.001 X 0.012 0.047 0.010 Z X 0.009 0.015 0.011 0.048 0.005 X 0.007 0.006 X 0.008 0.009 0.009 0.011 * p < .001. X Not applicable. Z Indicates a value of less than 0.000. Source: U.S. Census Bureau, 2008 through 2019 and 2021 through 2022 American Community Survey 1-year estimates. U.S. Census Bureau 19 Appendix Table B-4. Logistic Regression Predicting Likelihood of Cognitive Disability: 2008 and 2022 (Civilian adults aged 18 or over) Characteristic Year, 2022 (reference, 2008) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Model 1 Model 2 Odds ratio *1.13 Standard error 0.004 Odds ratio *1.10 Standard error 0.005 Veteran status  Not a veteran (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Veteran, served before September 2001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Veteran, served September 2001 or later . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Age (in years) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X *1.47 *1.37 X X X 0.010 0.023 X X Race and Hispanic origin  White, non-Hispanic (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Black, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Some Other Race, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lived in group quarters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Education  Less than some college (reference). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Some college. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Bachelor’s degree or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Income-to-poverty ratio  Less than 150 percent (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  150 percent to 299 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  300 percent to 499 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  500 percent or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Received public assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * p < .001. X Not applicable. Z Indicates a value of less than 0.000. Source: U.S. Census Bureau, 2008 and 2022 American Community Survey 1-year estimates. X X X X X X X X X X X X X X X X X X X X X X X X X X X X X *1.27 *2.45 *1.07 *1.02 X *0.78 *0.97 *0.66 *6.46 *0.52 X *0.71 *0.48 X *0.79 *0.64 *0.50 *3.25 X 0.011 0.047 0.005 Z X 0.007 0.009 0.006 0.145 0.003 X 0.004 0.004 X 0.005 0.005 0.005 0.021 20 U.S. Census Bureau Appendix Table B-5. Logistic Regression Predicting Likelihood of Cognitive Disability by Service-Connected Disability: 2008–2019 and 2021–2022 (Civilian veterans aged 18 or over) Characteristic Year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Period of service  Before September 2001 (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  September 2001 or later . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Has service-connected disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enrolled for Veterans Affairs health care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Age (in years). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Race and Hispanic origin  White, non-Hispanic (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Black, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Some Other Race, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lived in group quarters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Education  Less than some college (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Some college . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Bachelor’s degree or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Income-to-poverty ratio  Less than 150 percent (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  150 percent to 299 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  300 percent to 499 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  500 percent or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Received public assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Model 1 Model 2 Odds ratio *1.01 X *0.65 *2.47 X X X X X X X X X X X X X X X X X Standard error Odds ratio Standard error 0.001 1.00 0.001 X 0.005 0.012 X X X X X X X X X X X X X X X X X X *1.63 *2.50 *1.47 *0.84 *1.03 X 1.00 *1.32 *1.19 *4.27 *0.78 X *0.84 *0.66 X *0.76 *0.61 *0.43 *2.27 X 0.016 0.013 0.007 0.008 Z X 0.007 0.012 0.011 0.116 0.004 X 0.006 0.005 X 0.005 0.004 0.003 0.015 * p < .001. X Not applicable. Z Indicates a value of less than 0.000. Source: U.S. Census Bureau, 2008 through 2019 and 2021 through 2022 American Community Survey 1-year estimates. U.S. Census Bureau 21 Appendix Table B-6. Logistic Regression Predicting Likelihood of High Service-Connected Disability Rating: 2008–2019 and 2021–2022 (Civilian veterans with a service-connected disability, aged 18 or over) Characteristic Year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Model 1 Model 2 Odds ratio *1.08 Standard error 0.001 Odds ratio *1.07 Standard error 0.001 Period of service Before September 2001 (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . September 2001 or later . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enrolled for Veterans Affairs health care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Age (in years). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X *1.26 X X X X 0.009 X X X Race and Hispanic origin White, non-Hispanic (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Black, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Some Other Race, non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lived in group quarters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Education Less than some college (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Some college . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bachelor’s degree or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Income-to-Poverty Ratio Less than 150 percent (reference) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 percent to 299 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300 percent to 499 percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 500 percent or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Received public assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X X X X X X X X X X X X X X X X X X X X X X X X X X X *1.64 *2.74 *0.92 1.01 X *1.60 *1.31 *1.37 *1.36 1.00 X *0.89 *0.75 X 1.00 *1.34 *1.30 *1.16 X 0.016 0.021 0.009 Z X 0.014 0.019 0.018 0.076 0.006 X 0.006 0.006 X 0.012 0.014 0.016 0.013 * p < .001. X Not applicable. Z Indicates a value of less than 0.000. Source: U.S. Census Bureau, 2008 through 2019 and 2021 through 2022 American Community Survey 1-year estimates. 22 U.S. Census Bureau APPENDIX C. STANDARD ERRORS Appendix Table C-1. Standard Errors for Prevalence of Service-Connected and American Community Survey (ACS) Disabilities by Type and Service Cohorts: 2022 (In percent, civilian veterans aged 18 or over) Characteristic All veterans Post-9/11 Peacetime (1975 or later) Gulf War Vietnam War Korean War World War II Peacetime (before 1975) Has service-connected disability. . . . . . . Has ACS disability . . . . . . . . . . . . . . . . . . . .  Hearing . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Vision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Ambulatory . . . . . . . . . . . . . . . . . . . . . . . .  Cognitive . . . . . . . . . . . . . . . . . . . . . . . . . .  Self-care . . . . . . . . . . . . . . . . . . . . . . . . . . .  Independent living . . . . . . . . . . . . . . . . . . 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.3 0.2 0.1 0.1 0.1 0.2 0.1 0.1 0.3 0.3 0.2 0.1 0.2 0.2 0.1 0.2 0.2 0.3 0.2 0.2 0.2 0.2 0.1 0.2 0.2 0.2 0.2 0.1 0.1 0.1 0.1 0.1 0.4 0.5 0.7 0.4 0.6 0.5 0.5 0.6 0.9 1.1 1.4 1.1 1.4 1.2 1.2 1.4 0.3 0.5 0.4 0.3 0.5 0.3 0.3 0.4 Note: Veterans can have more than one type of disability. As a result, estimates will not sum to the total. In addition, periods of service are not mutually exclusive. Data based on sample. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <www.census.gov/acs>. Source: U.S. Cenusu Bureau, 2022 American Community Survey 1-year estimates. U.S. Census Bureau 23