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Trends in Prevalence of Disability
Barbara M. Altman, PhDDisability Statistics Consultant
Functional Capacity as a Continuum
The term “Disability” is a shorthand expression. It is used to identify impairments, functional limitations, participation restriction and other conceptual components along the ability continuum. It represents the point at which a person has reached the place on the functional continuum where he/she exhibits a marked difference in functional capacity from others or from the person’s own previous capacity. This point may change or fluctuate based on the environmental context.
Definitions Disability is defined in many contexts:
– Legal definitions to protect civil rights.– Benefit recipient definitions to identify
persons eligible for particular kinds of monetary or social service benefits.
– Health professional’s definitions used to direct treatment.
– Theoretical definitions to organize the relationships of different aspects of disability into a whole.
– Self definitions to explain functioning or activity comparisons with peers.
Definitions Identify a Wide Range of Conceptual Elements
Civil rights purposes are to provide equalization of opportunity for a broad population– Civil rights protections: e.g. ADA, Fair Housing, Air
Carriers act, 504, 508
Program benefits and service purposes are to address problem areas for a specific group– Program benefits: e.g. paratransit, SSDI,
Theoretical models purposes are to integrate our knowledge about disability – International Classification of Functioning, Disability and
Health (ICF)
Data Source
National Health Interview Survey – Conducted by NCHS, CDC annually– Yearly data represents 2000 and 2009– Two measures reflect either functional
difficulties or participation limitations Functional Difficulties are reflected in measures of
Basic Actions identified as seeing, hearing, movement, cognitive functioning and emotional functioning.
Participation Limitations are reflected in measures of Complex Activities identified by involvement in work, leisure or social activities and by measures of independence reflected in managing one’s activities of daily living.
–
Findings Functioning limitation prevalence in general is
significantly higher than 10 years ago and increasing an average of approximately 0.37% per year.
Participation restrictions appear to be increasing but with less rapidity, about 0.2% per year.
Age is a key element in these trends, particularly notable among those 40-69 where it is increasing an average of 0.43% per year.
Mobility difficulties are associated with the largest proportion of disability noted but not all. Between 31.5% and 49.8% of disabled population is in the more serious range of mobility limitations.
F ig ure 1. P erc entag es of adults 18+ years of ag e with a bas ic ac tion diffic ulty: United S tates , 2000-2009
61.5
27.2
30.328.3 28.9 28.7 29.0 29.4 30.6 31.4 30.9
13.616.2
14.5 14.9 14.2 14.1 14.1 15.4 16.2 15.3
31.334.2
32.2 32.8 32.6 33.2 33.5 34.7 35.8 35.6
60.8
65.663.1
64.3 63.465.6 66.6
65.663.7
0
10
20
30
40
50
60
70
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Pe
rce
nta
ge
T otal 18-39 years 40-69 years 70+ years
SOURCE: CDC/NCHS, National Health Interview Survey, 2000-2009.
F ig ure 2. P erc entag es of adults 18+ years of ag e with a c omplex
ac tivity limitation: United S tates , 2000-2009
16.5 16.2
13.3 14.2 14.2 14.4 14.2 14.4 14.3 14.9 14.9 15.1
5.4 6.0 5.5 5.8 6.1 5.9 5.7 6.2 6.3 6.4
15.216.2 16.9 16.0 16.4 17.1 17.3 17.5
34.736.0 35.9 35.5 36.8 36.3 36.9 36.1
34.9 34.2
0
10
20
30
40
50
60
70
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Pe
rce
nta
ge
T otal 18-39 years 40-69 years 70+ years
SOURCE: CDC/NCHS, National Health Interview Survey, 2000-2009.
Movement Difficulty
21.7
69.2
6.1
19.4
5.8
18.3
5
15.7
2.99.4
26.4
0
10
20
30
40
50
60
70
Any Level 1 Level 2 Level 3 Level 4 Level 5
%of total Pop % of Disabled Pop
Source: Disability and Health in the U.S. 2000-2005; CDC, NCHS
Relationship of Prevalence Estimate Definitions to One DOT Definition
Department of Transportation Definition Individual With a Disability means an individual who, because of illness, injury, age, congenital malfunction, or other incapacity or temporary or permanent disability (including an individual who is a wheelchair user or has semi-ambulatory capability), cannot use effectively, without special facilities, planning or design, public transportation service or a public transportation facility. 49 U.S.C. 5302(a)(5).
Relationship - continued
Prevalence Data from NHIS does not identify either medical condition or ability to use transportation services or facilities. Provides a proxy for functional limitations that may limit use of transportation services and facilities.
Prevalence Data from ACS (source of program funds distribution info) based on most common functional limitations and basic participation restrictions.
