Disability, retirement and Medicare

In the least deprived tenth of American census tractsCensus tractA small area drawn by the Census Bureau to stand in for a neighborhood. Boundaries are redrawn after each decennial census., 23.3%23.3% percent of adults with any disabilityEstimandmean of tract prevalence (crude, modeled), weighted by adult population, bootstrap interval over countiesInterval95% CI 22.3% to 24.1%n8,274 tractsWeightsadult population of the tract (PLACES)Populationadults in the least deprived tenth of tracts by ADI national rankPeriod2024 release of CDC PLACES (BRFSS responses from 2022); ADI 2023SourceCDC PLACESNotePLACES models these values from survey responses and census inputs that overlap the ADI, so part of the gradient is built in. of adults had any disability, as CDC PLACES models it from survey responses in 2022. In the most deprived tenth the share was 42.9%42.9% percent of adults with any disabilityEstimandmean of tract prevalence (crude, modeled), weighted by adult population, bootstrap interval over countiesInterval95% CI 42.5% to 43.2%n8,213 tractsWeightsadult population of the tract (PLACES)Populationadults in the most deprived tenth of tracts by ADI national rankPeriod2024 release of CDC PLACES (BRFSS responses from 2022); ADI 2023SourceCDC PLACESNotePLACES models these values from survey responses and census inputs that overlap the ADI, so part of the gradient is built in.. A disability here means reported difficulty with hearing, vision, thinking, walking, self-care or living independently. This chapter follows that gradient from the neighborhood into the programs of old age, Social Security and Medicare, at the grain of tracts, ZIP codes and counties.

Adult disability rises with neighborhood deprivation

Deprivation is measured by the Area Deprivation IndexArea Deprivation Index (ADI)A score that ranks neighborhoods by income, education, employment and housing conditions drawn from the American Community Survey. In this book a higher national percentile means a more deprived neighborhood. (ADI), a national percentile rank on which a higher value means a more deprived neighborhood.[1] The chapter splits tracts into tenths that hold equal numbers of tracts and averages the tract values in each tenth, weighted by adult population. Disability in the most deprived tenth was 1.8 (95% CI 1.8 to 1.9)1.8 ratio of disability prevalence in the most deprived tenth of tracts to that in the least deprived tenthEstimandratio of two adult-population-weighted means, bootstrap interval over counties (shared draws)Interval95% CI 1.8 to 1.9n82,779 tractsWeightsadult population of the tract (PLACES)Populationadults aged 18 and over in tracts with a PLACES disability estimate, an ADI rank and an ACS age sharePeriod2024 release of CDC PLACES (BRFSS responses from 2022); ADI 2023SourceCDC PLACES times as high as in the least deprived. The means rise at every step across the tenths, though the intervals of some neighboring tenths overlap. Among older adults, the share who have lost all their teeth rises across the same tenths, and it rises fastest at the deprived end.

The age of residents does not account for the gradient.PLACES values are crudeCrude rateDeaths or births divided by the population, with no adjustment for age. A place with older residents has a higher crude death rate even if health at each age is the same. prevalence, not adjusted for age, so a tract with more older residents would have a higher value if age mattered much. Disability in the tenth of tracts with the most older residents is 1.8 (95% CI 0.9 to 2.7)1.8 percentage points of adult disability prevalence, tenth of tracts with the most residents aged 65 and over minus the tenth with the fewestEstimanddifference of two adult-population-weighted means (tenths of tracts by age share), bootstrap interval over counties (shared draws)Interval95% CI 0.9 to 2.7n82,779 tractsWeightsadult population of the tract (PLACES)Populationadults aged 18 and over in tracts with a PLACES disability estimate, an ADI rank and an ACS age sharePeriod2024 release of CDC PLACES (BRFSS responses from 2022); ADI 2023SourceCDC PLACES points higher than in the tenth with the fewest.

Figure 1

Adult disability is 23.3% in the least deprived tenth of census tracts and 42.9% in the most deprived, and it differs by 1.8 points between tenths of tracts with few and many older residents

Percent of adults with any disability and percent of older adults who have lost all their teeth, by tenth of the Area Deprivation Index, and disability against the share of older residents, census tracts, 2024 PLACES release

By deprivationBy age structure

Disability and tooth loss both rise across tenths of tracts by deprivation, tooth loss from 6.9% to 25.1% and disability from 23.3% to 42.9%

Tooth loss is 3.6 times as common in the most deprived tenth as in the least deprived, and disability is 1.8 times as common. Each point is a weighted mean of tract values with a 95% interval from a bootstrap over counties.

Show data

Data for Adult disability is 23.3% in the least deprived tenth of census tracts and 42.9% in the most deprived, and it differs by 1.8 points between tenths of tracts with few and many older residents, By deprivation

conf_high	conf_low	decile	estimate	n	series
24.07	22.30	1	23.28	8,274	Any disability among adults
27.45	24.50	2	25.97	8,118	Any disability among adults
27.99	26.08	3	27	8,509	Any disability among adults
28.73	27.60	4	28.17	8,261	Any disability among adults
30.32	29.39	5	29.84	8,189	Any disability among adults
32.06	31.21	6	31.62	8,318	Any disability among adults
33.88	33.16	7	33.53	8,305	Any disability among adults
35.81	35.15	8	35.48	8,238	Any disability among adults
38.39	37.74	9	38.06	8,354	Any disability among adults
43.21	42.50	10	42.86	8,213	Any disability among adults
7.91	6.24	1	6.94	8,258	All teeth lost among older adults
9.17	7.72	2	8.48	8,111	All teeth lost among older adults
9.65	8.65	3	9.12	8,498	All teeth lost among older adults
10.29	9.66	4	9.97	8,251	All teeth lost among older adults
11.53	10.90	5	11.20	8,179	All teeth lost among older adults
12.90	12.32	6	12.61	8,299	All teeth lost among older adults
14.49	13.95	7	14.22	8,298	All teeth lost among older adults
16.51	15.96	8	16.23	8,214	All teeth lost among older adults
19.15	18.58	9	18.87	8,341	All teeth lost among older adults
25.56	24.65	10	25.10	8,213	All teeth lost among older adults

How we know

PLACES does not count anyone. Its values are modeled estimatesModeled estimateA figure produced by a statistical model instead of a direct count or measurement, usually for small areas where direct data are thin, borrowing strength from surveys, neighboring areas or other data. Neighboring areas can share errors, so single extremes call for caution.. It fits a model to survey responses from 2022 and applies it to each tract using census and American Community Survey inputs, in its 2024 release.[2] The chapter uses the 82,77982,779 tractsEstimandcount of tractsWeightsnone (full count)Population2020 census tracts with a PLACES any-disability estimate, an ADI rank and an ACS 2019-2023 share aged 65 and overPeriod2024 release of CDC PLACES (BRFSS responses from 2022); ADI 2023SourceCDC PLACES tracts with an estimate, an ADI rank and an age share. The ADI is built from American Community Survey data as well, so part of the disability gradient is built in. The tract file carries no intervals of its own, and the intervals here come from resampling counties. The Social Security counts and the Medicare payments are different in kind, since they come from administrative records rather than a model. The report gives every estimate with its interval and sample size.

Disabled workers are a larger share in deprived ZIP codes

Social Security's Old-Age, Survivors and Disability InsuranceOASDIOld-Age, Survivors and Disability Insurance, the Social Security programs that pay retirement, survivor and disability benefits. pays benefits to retired workers, to disabled workers, to survivors, and to spouses and children. The Social Security Administration counts its beneficiaries by ZIP code. The chapter uses the 31,81531,815 ZIP codesEstimandcount of ZIP codesWeightsnone (full count)PopulationZIP codes in the 50 states and DC with OASDI beneficiaries that match a ZCTA with an ADI rank, a population and a countyPeriodDecember 2024SourceSSA beneficiaries by ZIP code ZIP codes in the states and the District of Columbia that match a ZIP code areaZCTAZIP Code Tabulation Area, the Census Bureau's approximation of a ZIP code as a set of census blocks. It lets census data be reported by ZIP code, though some ZIP codes have no matching ZCTA. with an ADI rank, in December 2024. In the least deprived fifth of these ZIP codes, disabled workers were 7.2% (95% CI 6.9% to 7.5%)7.2% percent of OASDI beneficiaries who are disabled workersEstimandshare of the fifth's beneficiaries, pooled over its ZIP codes, bootstrap interval over countiesInterval95% CI 6.9% to 7.5%n6,363 ZIP codesWeightsbeneficiaries (each ZIP code counts by its beneficiary count)PopulationOASDI beneficiaries in the least deprived fifth of ZIP codes by ADI national rankPeriodDecember 2024SourceSSA beneficiaries by ZIP codeNoteDisabled-worker benefits become retired-worker benefits at full retirement age, so former disabled workers are counted as retired workers after it. of beneficiaries. In the most deprived fifth they were 16.8% (95% CI 16.4% to 17.3%)16.8% percent of OASDI beneficiaries who are disabled workersEstimandshare of the fifth's beneficiaries, pooled over its ZIP codes, bootstrap interval over countiesInterval95% CI 16.4% to 17.3%n6,363 ZIP codesWeightsbeneficiaries (each ZIP code counts by its beneficiary count)PopulationOASDI beneficiaries in the most deprived fifth of ZIP codes by ADI national rankPeriodDecember 2024SourceSSA beneficiaries by ZIP codeNoteDisabled-worker benefits become retired-worker benefits at full retirement age, so former disabled workers are counted as retired workers after it..

This is a different measure from the PLACES share. PLACES describes adults who report a difficulty, while the SSA share describes beneficiaries who receive a disabled worker's benefit. A disabled worker's benefit becomes a retired worker's benefit at full retirement age, so the disabled-worker share counts only those still below that age. In a regression across ZIP codes that also includes median household income and the share of older residents, the disabled-worker share moves with both the ADI rank and income. With the average retired worker's benefit as the outcome, the benefit moves with income and not with the ADI rank. The benefit formula starts from a worker's earnings over a career.

Figure 2

Disabled workers are 16.8% of Social Security beneficiaries in the most deprived fifth of ZIP codes and 7.2% in the least deprived, and retired workers are 65.9% against 80.5%

Share of OASDI beneficiaries by type, percent, ZIP codes in fifths of the Area Deprivation Index national rank, December 2024

Fifth of ZIP codes by ADI

• Retired workers
• Disabled workers
• Widowed
• Spouses and children

Show data

Data for Disabled workers are 16.8% of Social Security beneficiaries in the most deprived fifth of ZIP codes and 7.2% in the least deprived, and retired workers are 65.9% against 80.5%

Fifth of ZIP codes by ADI	Type of beneficiary	Share of beneficiaries (%)	Lower limit of the 95% interval	Upper limit of the 95% interval	ZIP codes	Beneficiaries
1 (least deprived)	Retired workers	80.5	79.9	81.0	6,363	23,011,380
1 (least deprived)	Disabled workers	7.2	6.9	7.5	6,363	23,011,380
1 (least deprived)	Widowed	4.8	4.7	4.9	6,363	23,011,380
1 (least deprived)	Spouses and children	7.5	7.2	7.8	6,363	23,011,380
2	Retired workers	77.2	76.9	77.6	6,363	17,037,990
2	Disabled workers	10.1	9.8	10.3	6,363	17,037,990
2	Widowed	5.1	5.0	5.1	6,363	17,037,990
2	Spouses and children	7.6	7.5	7.8	6,363	17,037,990
3	Retired workers	73.9	73.6	74.3	6,363	11,839,725
3	Disabled workers	12.3	12.1	12.5	6,363	11,839,725
3	Widowed	5.5	5.5	5.6	6,363	11,839,725
3	Spouses and children	8.3	8.1	8.4	6,363	11,839,725
4	Retired workers	70.4	70.0	70.7	6,363	8,506,535
4	Disabled workers	14.4	14.2	14.7	6,363	8,506,535
4	Widowed	6.1	6.0	6.2	6,363	8,506,535
4	Spouses and children	9.1	8.9	9.2	6,363	8,506,535
5 (most deprived)	Retired workers	65.8	65.3	66.4	6,363	5,518,365
5 (most deprived)	Disabled workers	16.8	16.4	17.3	6,363	5,518,365
5 (most deprived)	Widowed	6.6	6.5	6.8	6,363	5,518,365
5 (most deprived)	Spouses and children	10.7	10.4	10.9	6,363	5,518,365

Whether Medicare payments differ depends on how counties are weighted

The Medicare Geographic Variation file reports, for each county, Part A and Part B payments per beneficiary with local prices removed, called price-standardizedPrice-standardized spendingMedicare spending adjusted to remove differences in local prices and payment rules, so that counties are compared on the care paid for rather than on local prices. It does not adjust for how sick the beneficiaries are. payments.[3] They cover beneficiaries enrolled in Original Medicare, the fee-for-service program, with both parts. Medicare Advantage enrollees, who were 54.5%54.5% percent of beneficiaries with Parts A and B who are in Medicare AdvantageEstimandMedicare Advantage beneficiaries divided by Medicare Advantage plus Original Medicare beneficiariesWeightsnone (full count)Populationbeneficiaries with Parts A and B in the counties countedPeriod2024SourceMedicare Geographic Variation of beneficiaries with both parts in these counties, are not in them. The file counts beneficiaries of all ages, including people under 6565 years of ageEstimandage at which eligibility for Medicare begins (a definition)Weightsnone (definition)Populationpeople who become eligible for Medicare through agePeriod2024SourceMedicare Geographic Variation who qualify through disability, and standardization does not adjust for how sick beneficiaries are.

The chapter ranks counties by the mean ADI rank of their tracts, weighted by population, and splits them into fifths. Weighted by fee-for-service beneficiaries, payments in 2024 differ between the most and the least deprived fifth by $496 (95% CI −$290 to $1406)$496 dollars per fee-for-service beneficiary per yearEstimandmean in the most deprived fifth of counties minus mean in the least deprived fifth, weighted by fee-for-service beneficiaries, bootstrap interval over states (shared draws)Interval95% CI −$290 to $1406n3,128 countiesWeightsfee-for-service beneficiariesPopulationfee-for-service (Original Medicare) beneficiaries in counties with a standardized payment and an ADI rankPeriod2024SourceMedicare Geographic Variation per beneficiary. That interval includes zero, so the data show no detectable difference, though the interval is wide.

The fifths are different kinds of counties. In the most deprived fifth, 87.3%87.3% percent of the fifth's fee-for-service beneficiaries who live in counties below the size cutoffEstimandbeneficiaries in counties with fewer than the cutoff divided by all beneficiaries of the fifthn624 countiesWeightsfee-for-service beneficiariesPopulationfee-for-service beneficiaries in the most deprived fifth of counties by county ADIPeriod2024SourceMedicare Geographic Variation of fee-for-service beneficiaries live in counties with fewer than 5,0005,000 fee-for-service beneficiariesEstimandcounty size below which a county is called smallWeightsnone (cutoff)Populationcounties in the size check of the spending comparisonPeriod2024SourceMedicare Geographic Variation such beneficiaries, against 3.1%3.1% percent of the fifth's fee-for-service beneficiaries who live in counties below the size cutoffEstimandbeneficiaries in counties with fewer than the cutoff divided by all beneficiaries of the fifthn625 countiesWeightsfee-for-service beneficiariesPopulationfee-for-service beneficiaries in the least deprived fifth of counties by county ADIPeriod2024SourceMedicare Geographic Variation in the least deprived fifth. The comparison of fifth means therefore sets mostly small counties against mostly large ones. Among counties below that size, payments rise from $10,893 (95% CI $10,526 to $11,270)$10,893 dollars per fee-for-service beneficiary per year, price-standardizedEstimandmean of county price-standardized payments per capita, weighted by fee-for-service beneficiaries, bootstrap interval over statesInterval95% CI $10,526 to $11,270n181 countiesWeightsfee-for-service beneficiariesPopulationcounties with fewer than 5,000 fee-for-service beneficiaries, least deprived fifth by county ADIPeriod2024SourceMedicare Geographic Variation in the least deprived fifth to $13,295 (95% CI $12,601 to $13,903)$13,295 dollars per fee-for-service beneficiary per year, price-standardizedEstimandmean of county price-standardized payments per capita, weighted by fee-for-service beneficiaries, bootstrap interval over statesInterval95% CI $12,601 to $13,903n603 countiesWeightsfee-for-service beneficiariesPopulationcounties with fewer than 5,000 fee-for-service beneficiaries, most deprived fifth by county ADIPeriod2024SourceMedicare Geographic Variation in the most deprived, and the intervals do not overlap. Among larger counties, the intervals for the least and the most deprived fifth overlap.

The correlation between a county's payments and its ADI also depends on the weights. It is −0.04 (95% CI −0.19 to 0.21)−0.04 correlation coefficientEstimandcorrelation of county price-standardized payments per capita with the county ADI, weighted by fee-for-service beneficiaries, bootstrap interval over statesInterval95% CI −0.19 to 0.21n3,128 countiesWeightsfee-for-service beneficiariesPopulationfee-for-service (Original Medicare) beneficiaries in counties with a standardized payment and an ADI rankPeriod2024SourceMedicare Geographic Variation weighted by fee-for-service beneficiaries and +0.30 (95% CI 0.20 to 0.39)+0.30 correlation coefficientEstimandcorrelation of county price-standardized payments per capita with the county ADI, each county counted once, bootstrap interval over statesInterval95% CI 0.20 to 0.39n3,128 countiesWeightsnone (each county counts once)Populationfee-for-service (Original Medicare) beneficiaries in counties with a standardized payment and an ADI rankPeriod2024SourceMedicare Geographic Variation counting each county once. Small counties carry little weight in the weighted correlation, which is part of why the two disagree. The total also hides changes in its parts. Between the least and the most deprived fifth, payments for procedures, tests, imaging and treatments differ by −$738 (95% CI −$971 to −$475)−$738 dollars per fee-for-service beneficiary per year, most deprived fifth minus least deprived fifth, payments for procedures, tests, imaging and treatmentsEstimanddifference of two fee-for-service-beneficiary-weighted means of county payments per capita, bootstrap interval over states (shared draws)Interval95% CI −$971 to −$475n2,867 countiesWeightsfee-for-service beneficiariesPopulationfee-for-service beneficiaries in counties with every shown service line reportedPeriod2024SourceMedicare Geographic Variation per beneficiary, and payments for skilled nursing facilities by $437 (95% CI $214 to $653)$437 dollars per fee-for-service beneficiary per year, most deprived fifth minus least deprived fifth, payments for skilled nursing facilitiesEstimanddifference of two fee-for-service-beneficiary-weighted means of county payments per capita, bootstrap interval over states (shared draws)Interval95% CI $214 to $653n2,867 countiesWeightsfee-for-service beneficiariesPopulationfee-for-service beneficiaries in counties with every shown service line reportedPeriod2024SourceMedicare Geographic Variation.

Figure 3

Price-standardized Medicare payments are $12,680 per fee-for-service beneficiary in the least deprived fifth of counties and $13,176 in the most deprived, a difference whose interval includes zero

Medicare Part A and Part B payments per Original Medicare beneficiary with local prices removed, by fifth of the county Area Deprivation Index, service lines, emergency department visits and county life expectancy, 2024

Service linesLife expectancyEmergency visits

Payments for procedures, tests, imaging and treatments fall from $2,508 to $1,770 across fifths of counties while payments for skilled nursing facilities rise from $865 to $1,302

Price-standardized payments per fee-for-service beneficiary by service line, dollars per year, fifths of counties by the county Area Deprivation Index

Fifth of counties by ADI

• Inpatient hospital stays
• Hospital outpatient and surgery centers
• Skilled nursing facilities
• Home health and hospice
• Evaluation and management visits
• Procedures, tests, imaging and treatments
• All other services

The totals are close. Differences between the most and the least deprived fifth, in dollars per beneficiary, are −$738 for procedures, tests, imaging and treatments, −$430 for evaluation and management visits, $437 for skilled nursing facilities, $410 for hospital outpatient departments and surgery centers and $480 for all other services; the intervals for inpatient hospital stays ($134) and for home health and hospice ($224) include zero. Each segment is a mean of county payments weighted by fee-for-service beneficiaries.

Show data

Data for Price-standardized Medicare payments are $12,680 per fee-for-service beneficiary in the least deprived fifth of counties and $13,176 in the most deprived, a difference whose interval includes zero, Service lines

Fifth of counties by ADI	Service line	Dollars per beneficiary	Lower limit of the 95% interval	Upper limit of the 95% interval	Counties
1 (least deprived)	Inpatient hospital stays	2,871	2,712	3,001	605
2	Inpatient hospital stays	2,869	2,765	2,963	585
3	Inpatient hospital stays	2,913	2,812	2,993	571
4	Inpatient hospital stays	2,955	2,858	3,036	565
5 (most deprived)	Inpatient hospital stays	3,005	2,919	3,073	541
1 (least deprived)	Hospital outpatient and surgery centers	2,516	2,401	2,684	605
2	Hospital outpatient and surgery centers	2,780	2,618	2,953	585
3	Hospital outpatient and surgery centers	2,864	2,708	3,035	571
4	Hospital outpatient and surgery centers	3,002	2,793	3,201	565
5 (most deprived)	Hospital outpatient and surgery centers	2,926	2,768	3,098	541
1 (least deprived)	Skilled nursing facilities	865	712	986	605
2	Skilled nursing facilities	771	721	829	585
3	Skilled nursing facilities	879	831	928	571
4	Skilled nursing facilities	1,004	925	1,081	565
5 (most deprived)	Skilled nursing facilities	1,302	1,122	1,462	541
1 (least deprived)	Home health and hospice	1,010	839	1,148	605
2	Home health and hospice	962	853	1,066	585
3	Home health and hospice	1,018	864	1,187	571
4	Home health and hospice	1,060	896	1,228	565
5 (most deprived)	Home health and hospice	1,234	975	1,460	541
1 (least deprived)	Evaluation and management visits	1,333	1,218	1,426	605
2	Evaluation and management visits	1,146	1,062	1,219	585
3	Evaluation and management visits	1,054	992	1,102	571
4	Evaluation and management visits	967	902	1,028	565
5 (most deprived)	Evaluation and management visits	903	831	967	541
1 (least deprived)	Procedures, tests, imaging and treatments	2,508	2,275	2,723	605
2	Procedures, tests, imaging and treatments	2,204	2,011	2,399	585
3	Procedures, tests, imaging and treatments	1,938	1,808	2,073	571
4	Procedures, tests, imaging and treatments	1,786	1,655	1,936	565
5 (most deprived)	Procedures, tests, imaging and treatments	1,770	1,635	1,884	541
1 (least deprived)	All other services	1,578	1,375	1,745	605
2	All other services	1,639	1,456	1,830	585
3	All other services	1,724	1,544	1,922	571
4	All other services	1,776	1,622	1,931	565
5 (most deprived)	All other services	2,058	1,863	2,226	541

Gradients across places, not forecasts for people

Across tracts, the share of adults with a disability rises with deprivation in a modeled survey estimate. Across ZIP codes, the share of Social Security beneficiaries who are disabled workers is larger in more deprived places, in administrative counts. Medicare payments per fee-for-service beneficiary show no detectable difference between the least and the most deprived fifth of counties when counties are weighted by beneficiaries. Among small counties they rise from the least to the most deprived fifth. These are descriptions of places. A ZIP code with a high disabled-worker share says nothing about whether any resident should receive a disability benefit. Equal payments do not mean equal care or equal need, since the payments are not adjusted for the health of the beneficiaries. The report describes studies of eligibility rules and benefits, among them a comparison of hospital patients just below and just above the age of Medicare eligibility.[4] These designs estimate what a program changes for the people it reaches at a threshold or on the margin of a decision. None of them estimates whether the programs would narrow the differences between places. The report also compares how much the expected age at death of the poorest and the richest income quartiles varies across counties, a comparison that changes when each county counts once.

What this cannot tell you

Every pattern here describes tracts, ZIP codes or counties, and a pattern across places need not hold for the people inside them, a problem called ecological inferenceEcological inferenceDrawing conclusions about individuals from data about places or groups. A pattern across counties need not hold for the people inside them.. The measures differ in vintage and in how they are made. PLACES values are modeled from survey responses in 2022, the Social Security counts are for December 2024 and rounded by SSA, and the Medicare payments are for 2024 and leave out Medicare Advantage enrollees. Matching a ZIP code to the ZIP code area of the same number leaves out ZIP codes such as post office boxes, and none of the gradients tells what would move a number.

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Go deeper

• The report: every estimate with its interval and sample size.
• Tables: every figure of the report as a table.

Reading paths that include this chapter:

• The argument in eight chapters
• Disadvantage as a dose
• Money and the institutions that follow the map

Data sources

• CDC PLACESAny disability and all teeth lost among adults, census tracts, 2024 release (BRFSS 2022 responses)Years: 2024 release (tracts); 2025 release (ZCTAs, 2023 data year) · Weights: adult population of the tract; estimated residents aged 65 and over for tooth loss · License: Public domain (CDC, U.S. Department of Health and Human Services)
• Area Deprivation IndexArea Deprivation Index national rank, 2023, tracts and ZCTAsYears: 2023 release (version 4.0.1; built on ACS 2019-2023) · Weights: none (index); the county rank is the population-weighted mean of tract ranks · License: Free for non-commercial use; cite the Neighborhood Atlas and Kind and Buckingham
• American Community SurveyACS 2019-2023 tract and ZCTA population, share aged 65 and over and median household incomeYears: 2019-2023 (5-year) · Weights: ACS population · License: Public domain (U.S. Census Bureau)
• SSA beneficiaries by ZIP codeOASDI beneficiaries and benefits by ZIP code, December 2024Years: December 2024 · Weights: none (full counts); beneficiaries or retired workers where pooled · License: Public domain (U.S. federal)
• IRS Statistics of IncomeTaxable pensions and annuities by ZIP code, tax year 2022Years: tax year 2022 · Weights: none (full counts); dollars where pooled · License: Public domain (IRS Statistics of Income)
• Medicare Geographic VariationPrice-standardized Medicare payments, emergency department visits and service lines per Original Medicare beneficiary, county, 2024Years: 2024 (from the 2014-2024 file) · Weights: fee-for-service beneficiaries · License: Public domain (CMS, U.S. federal government work)
• County Health RankingsCounty Health Rankings 2024: life expectancy (deaths 2019-2021), population and county measuresYears: 2024 release · Weights: county residents; each county once where stated · License: CC BY 4.0 (University of Wisconsin Population Health Institute)
• Health Inequality ProjectExpected age at death at age 40 by national household-income quartile and sex, county, 2001-2014 (Online Data Table 11)Years: 2001-2014 (pooled) · Weights: county residents (County Health Rankings 2024) · License: Open (cite Chetty and coauthors, 2016)

All data sources

References

1. Kind, Amy J. H.; Buckingham, William R. (2018). Making Neighborhood-Disadvantage Metrics Accessible: The Neighborhood Atlas. New England Journal of Medicine 378(26): 2456-2458. doi:10.1056/NEJMp1802313
2. Greenlund, Kurt J.; Lu, Hua; Wang, Yan; Matthews, Kevin A.; LeClercq, Jennifer M.; Lee, Benjamin; Carlson, Susan A. (2022). PLACES: Local Data for Better Health. Preventing Chronic Disease 19: 210459. doi:10.5888/pcd19.210459
3. Centers for Medicare & Medicaid Services (2026). Medicare Data for the Original Medicare Geographic Variation Public Use File: A Methodological Overview (May 2026 update). CMS Office of Enterprise Data and Analytics. data.cms.gov/sites/default/files/2026-05/Original%20Medicare%20Geographic%20Variation%20Public%20Use%20File%20Methods%20Paper.pdf
4. Card, David; Dobkin, Carlos; Maestas, Nicole (2009). Does Medicare Save Lives?. The Quarterly Journal of Economics 124(2): 597-636. doi:10.1162/qjec.2009.124.2.597

How to cite

@misc{singh2026disabilityretirementandmedicare,
  author = {Singh, Vishal},
  title = {Disability, retirement and Medicare},
  year = {2026},
  url = {https://vishalsingh.org/zipcode/disability-retirement-and-medicare},
  note = {In ZIP Code Destiny. Published 9 October 2026.}
}