More than 42 million Americans live with a disability according to 2022 American Community Survey (ACS) estimates, which is the most recent data available as of April 2024. This includes over 18 million people 65 years and older.
Even though such a large portion of the U.S. population lives with disabilities, life with a disability can still pose unique legal, financial, and societal challenges. For example, there are legal protections for people with disabilities — like the Americans with Disabilities Act (ADA), which makes it illegal to discriminate against individuals with a disability — but it can be difficult to hold institutions accountable when they fail to follow ADA requirements.
Economic inequality also presents a challenge to people with disabilities, who earn $13,931 less per year than workers without a disability, according to the American Community Survey. And the poverty rate for people with disabilities is almost 19.8% — for people without a disability the poverty rate is 10%.
To get a better sense of which states are more livable for people with disabilities, we analyzed state data across almost 30 metrics. We found that the best states for living with a disability are North Dakota, Wisconsin, and Iowa. The worst are Mississippi, California, and Texas.
What makes a state better or worse for residents with disabilities?
Policygenius created this index to paint a clearer picture of which states are more livable for Americans with disabilities. Using the most recent data available — primarily from government sources — we ranked all 50 states and Washington, D.C., across 27 factors.
The factors we considered are broadly grouped into four categories:
Economic conditions: Factors such as median incomes, unemployment rates, and access to certain free career services
Affordability: Factors such as the cost of housing, the general cost of living, and the livable wage in a state
Livability: How easy it is for residents to get around and how much of a community may exist in the state
Health care: Factors such as the cost of and ease of access to health care plus the prevalence of certain programs, like Medicare, for people with disabilities
A higher ranking indicates a higher average score across the four categories, and a better place to live if you have a disability. We’ve included more detailed information on where we got our data and how we created the index at the end of this article.
The map above shows how each state scores in the four categories of data that we considered. You can change the category you’re looking at by clicking on a different tab, and you can hover over a given state to see its ranking in that category plus some notable statistics for the state.
For example, hovering over North Dakota while you’re in the Economic data tab will show you that the state ranked first in that category and that the median earnings in North Dakota are $30,625 for residents with disabilities. You can also filter out states that performed better or worse by clicking on the bar beneath the map.
To protect your income if you become disabled, consider getting disability insurance. A long-term disability policy can replace up to 60% of your salary.
How to use these rankings
In addition to a state’s overall ranking, looking at the data within each category allows you to focus on the factors that matter more to you personally. To explain how you can use this index, it’s useful to look at an example. Let’s consider California.
California ranks 47th on our index, which means it has a low overall score — not that it scored poorly in every category. California scored seventh-highest in the livability category because many of its cities are walkable with above-average ADA-accessible public transportation. Average commute times are longer than in other states, but someone who drives may not be as worried about commute time if they rely on Medicare and want to make sure they’re in a state with many Medicare providers, which California has.
In the economic category, even though the Golden State scored in the bottom half overall, it has the 10th-highest annual earnings ($31,831) for residents with disabilities. The state’s average benefit amount for the SSDI and OASDI programs rank in the top 10. But California has some of the country’s highest housing costs in addition to high unemployment and low labor force participation for residents with disabilities.
So California may not be the best choice for the average person, but it does well in certain areas and could be suitable for people who can afford the high cost of living. The maps above detail how states score in each category to help you compare according to the factors that matter most to you.
The top 3 states for living with a disability
No. 1: North Dakota
North Dakota ranks as our most livable state for a person living with a disability. It does particularly well in the economic and affordability metrics (it ranks first in the economic metric and fourth for affordability). North Dakota has one of the lowest rates of unemployment for people with disabilities (under 7%). At the same time, North Dakota has the highest concentration of Ticket to Work offices, which provide free career services to people receiving Social Security disability benefits.
The median earnings of $30,625 are 13th-highest and the poverty rate for those with a disability is 22nd at 11%. Living in North Dakota is also more affordable than other states — the median monthly housing cost of $939 is eighth-lowest, and the minimum hourly wage needed to live comfortably is fourth-lowest at $19.36.
No. 2: Wisconsin
Wisconsin is our second-best state for living with a disability. It ranks in the top 20 for all four categories we considered: health care, livability, and economic conditions. It ranked especially well (10th overall) in our health care category. Almost 97% of people with a disability in Wisconsin have health insurance. Wisconsin also ranks 8th for number of accredited health care departments per capita. Even though Wisconsin residents with disabilities have a fairly low median annual earnings ($26,910) and the annual cost for disability-related care is right in the middle of all states, Wisconsin manages to be balanced enough to rank up at the top of our list.
No. 3: Iowa
Iowa is our second Midwestern state in the top 10 this year (in a previous version of this list from 2021 it ranked 11th).
Iowa has a relatively low unemployment rate among people with disabilities in the workforce (just under 9%). It also has the fourth-highest concentration of Ticket to Work offices per beneficiary. Iowa also scores well on the health care metric — 97% of people in Iowa with disabilities have health insurance. Iowa also scores fourth-best for the size of Medicare bills per person.
How COVID-19 affects people with disabilities
Our study looks at how well states treat residents living with a disability under normal circumstances. But people living with a disability are also disproportionately at risk from COVID-19. Studies have shown that people with disabilities, especially women of color who are below the poverty line and living with a disability, have a significantly higher risk of getting COVID-19 and suffering more serious complications from it than others in their community.
People with disabilities also aren’t getting vaccinated as quickly as the general population. According to a CDC and Census Bureau survey conducted in the top 15 metropolitan statistical areas between July and September of 2023, 80.8% of eligible people with disabilities have received at least one dose of the COVID-19 vaccine, compared to 84.0% of the general population who are eligible.
→ Learn more about disability insurance and COVID
About our data
Policygenius created this ranking of the best and worst states for living with a disability by considering 27 factors spread across four general categories: economics, affordability, livability, and health care.
To determine our final rankings, we scored each individual factor and then averaged those scores to create category scores. The final index is the average of the four category scores.
Economics
Within our economic score we looked at six metrics related to the financial situation of residents with disabilities:
Median earnings for people with a disability: Data comes from the U.S. Census Bureau and is for 2022.
Labor force participation rate for people with a disability: Data comes from the U.S. Census Bureau and is for 2022.
Unemployment rate for people who have a disability and are in the labor force: Data comes from the U.S. Census Bureau and is for 2022.
Poverty rate for people with a disability: Data comes from the U.S. Census Bureau and is for 2022.
Ticket to Work offices: This is the total number of Ticket to Work offices in a state. An office is a location where ticket recipients can receive free career services. Data comes from the Social Security Administration and is for 2023.
Ticket to Work tickets: This is the number of tickets available through the Ticket to Work program as a percent of the number of eligible beneficiaries. Data comes from the Social Security Administration and is for 2023.
Affordability
There were six factors in our affordability score:
Livable wage: This is the wage that allows residents to meet minimum standards of living within a state. Data comes from MIT’s Living Wage Calculator and is from 2024.
Monthly housing costs: This is the median housing cost in a state. Data comes from the U.S. Census Bureau and is for 2022.
Housing costs as a percent of income: This is the median housing cost in a state as a percent of the median earnings for residents with disabilities. Data is for 2022.
Percent of residents with a disability in public housing: Data comes from the Department of Housing and Urban Development and is for 2023.
Percent of households receiving SNAP benefits: Of the households having at least one member with a disability, this is the percent that received SNAP benefits (food stamps). Data comes from the U.S. Census Bureau and is for 2022.
Average SNAP benefit per person: Data comes from the USDA and is for 2022.
Livability
Our livability score considered seven metrics:
Walk Score: This factor measures the walkability of cities within a state. Data is for 2024 and comes from Walkscore.com.
Transit Score: This measures how useful public transit is by considering factors like the type of transit available, typical distance to the nearest transit route, and the frequency of the route. Data is for 2024 and comes from Walkscore.com.
ADA-accessible transit stations: This is the number of ADA-accessible public transit stations per resident with a disability. Data comes from the American Public Transportation Association (APTA) and is for 2020.
Percent of population using public transportation: This is the percent of a state’s population that uses public transportation to get to work. Data is for 2022 and comes from the U.S. Census Bureau.
Average commute time to work: Data comes from the U.S. Census Bureau and is for 2022.
Population of residents with a disability: This is the total number of residents in a state who have a disability. Data comes from the U.S. Census Bureau and is for 2022.
Percent of state residents that have a disability: Data comes from the U.S. Census Bureau and is for 2022.
Health care
Our health care category used these metrics related to health care and different types of disability insurance:
Accredited health departments per capita: This is the number of state, tribal, and other local public health departments that have achieved five-year accreditation through the Public Health Accreditation Board divided by state population. Data comes from the Centers for Disease Control and Prevention and is from 2024.
Percent of residents with a disability who have health insurance: Data comes from the U.S. Census Bureau and is for 2022.
Medicare enrollees: This is the number of residents enrolled in Medicare parts A and B as a percentage of the total number of state residents who both have a disability and are at least 65 years old. Data on Medicare enrollment comes from the U.S. Centers for Medicare & Medicaid Services and is for 2021.
Medicare providers per capita: This is the number of Medicare providers in the state per resident who both has a disability and is age 65 or older. Data on Medicare providers comes from the U.S. Centers for Medicare & Medicaid Services and is for 2021.
Average Medicare bill per person: Data comes from the U.S. Centers for Medicare & Medicaid Services and is for 2021.
Average OASDI benefit: This is the average benefit for people who receive OASDI benefits for reasons related to a disability. Data comes from the Social Security Administration and is for 2022.
Population receiving SSDI benefits: Of the people who are living with a disability, this shows the percentage who receive SSDI benefits. Data comes from the Social Security Administration and is for 2022.
Average SSDI benefit: Data comes from the Social Security Administration and is for 2022.
