.gif){kind=spacer}
CODI: Cornucopia of Disability Information
General Measures of Disability |
|
|
|
*** Prevalence and Characteristics of Persons with Disabilities ***
** General Measures of Disability
Using two broad measures of functioning, activity limitation in the NHIS and
functional limitation in the 1984 SIPP, the following discussion presents
those demographic characteristics most associated with disability.
Age: As the NHIS data in Table A show, disability and age are strongly
related, although in sheer numbers, the vast majority of persons with an
activity limitation are under the age of 65. At the same time, most persons
65 and over have no activity limitation at all. Overall, however, disability
increases substantially with age.
In terms of the percentage of the elderly with a disability, persons 65 years
and older were more than three and one- half times as likely to have an
activity limitation and over three times as likely to be unable to carry out
their major activity as their younger counterparts. Of all persons 65 years
of age and over, 38.3 percent had an activity limitation including 10.1
percent who were unable to carry on their major activity at all. For persons
under the age of 65, 10.7 percent had an activity limitation including 3.2
percent who are unable to carry out their major activity (re-computed from
Table A data).
Table A. Number of Persons and Percent Distribution by Degree of Activity
Limitation Due to Chronic Conditions by Race and Age: United States, 1989
Limited in
Total With Unable to Amount or Limited, but
Age All Persons Activity Carry on Kind of not in Major
(years) (Number in Limitation* Major Major Activity
Thousands) Activity Activity
--------------- Percent Distribution ----------------
All Ages 243,532 14.1 4.1 5.4 4.5
< 18 64,003 5.3 0.6 3.2 1.5
18-44 104,196 9.0 2.6 3.7 2.7
45-64 46,114 22.2 8.8 7.7 5.6
>= 65 29,219 38.3 10.1 12.7 15.5
65-69 9,903 36.9 15.7 13.4 7.7
>= 70 19,316 39.0 7.2 12.3 19.4
* This total of the three adjacent percentages may not add exactly due to
rounding.
Source: National Center for Health Statistics, 1989 National Health Interview
Survey. Vital and Health Statistics, Series 10, No. 176, Table 68.
As previously stated, the definition of major activity in the NHIS varies by
age and, as a practical matter, by gender since more women than men in the
18-69 age group report "keeping house" as their major activity. The purpose
of this definitional variation is to measure disability in the context of
one's particular environment and associated challenges. This results in an
apparent reversal of the direct relationship between disability and age among
specific groups. For example, there is a reduction in the prevalence of
those unable to carry out their major activity when comparing ages 65-69, at
15.7 percent (where work is the predominant major activity), and age 70 and
above, which drops to 7.2 percent (where "living independently" is the major
activity). This change in the degree of activity limitation after age 69
simply means that many persons with a work disability can, upon reaching age
70, care for themselves.
Given the narrow definition of major activity after age 69 (living
independently), there is a corresponding increase in the numbers of persons
reporting limitations in a broad range of non-major activity which includes
work and social and recreational activities. For this reason, the percentage
of persons with a non-major activity limitation rises dramatically after age
69, from 7.7 percent to 19.4 percent. After age 75 major activity limitation
rates rise and non- major ones fall. For those 85 years of age and over,
nearly 20 percent cannot perform their major activity, another 27 percent are
otherwise limited in their major activity, and nearly 13 percent have a
non-major activity limitation (data not shown).
In Table B on functional limitation status, the 1984 SIPP data confirm and
augment information on the relationships found in the NHIS between disability
and age. Again, because the SIPP uses questions different from the NHIS and
a single set of functional activities to measure disability, regardless of
age, the figures differ and do not show the abrupt changes found in the NHIS
across specific age groupings.
As the table shows, persons 65 years of age and older were more than four
times as likely to have a functional limitation and over seven times as
likely to have a severe one than their younger counterparts. The
relationship between age and disability is particularly pronounced for those
75 years of age and over where nearly three-quarters have a functional
limitation.
As with all demographic characteristics, the interplay between age and the
other correlates of disability suggests caution when interpreting the data.
For example, since many elderly persons also have limited income and low
levels of formal schooling, and, at advanced ages, are predominantly women,
the relationships between disability and income, education, and gender, as
presented below, are often a function of age. For this reason, many of the
tables in this Digest present the characteristics of persons with a
disability according to age, as well as the other factors associated with
disability.
Table B. Functional Limitation Status, by Age, 1984
(Persons 15 years and over. Numbers in Thousands)
------- With a Functional Limitation --------
------ Total --------- ------- Severe --------
Age (years) Total Number Percent Number Percent
Total 180,987 37,304 20.6 13,537 7.5
15 to 24 39,297 2,054 5.2 346 0.9
25 to 34 40,464 3,049 7.5 596 1.5
35 to 44 30,480 4,074 13.4 890 2.9
45 to 54 22,264 5,110 23.0 1,431 6.4
55 to 64 22,060 7,552 34.2 2,734 12.4
65 and over 26,422 15,465 58.5 7,539 28.5
65 to 69 8,928 4,052 45.4 1,682 18.8
70 to 74 7,378 4,078 55.3 1,691 22.9
75 and over 10,116 7,335 72.5 4,166 41.2
Source: U.S. Bureau of the Census, 1984 Survey of Income and Program
Participation. Current Population Reports, Series P-70, No. 8, Table C.
|-------------------------------------------------|
Income: Using NHIS data, | Persons with Activity Limitations |
Figure 5 shows that | Caused by Chronic Conditions: |
disability and income (from | Percent by Annual Family Income, 1989 |
all sources/persons) are | |
clearly related in terms of | Income Category |
both prevalence and |Less Than 10,000 OOOOOOOMMMMMMMMMMXXXXXXXXXX 28.8
severity of activity | $10,000 - 19,999 OOOOOOMMMMMMMXXXXXX 19.4 |
limitations. Persons with | $20,000 - 34,999 OOOOMMMMMXXX 11.9 |
family incomes below | $35,000 or more OOOMMMMX 8.2 |
$10,000 were more than | 0 5 10 15 20 25 30 |
three times as likely to | Percent of Category with a Limitation |
have some form of activity | |
limitation and more than | Type of Limitation |
five times as likely to be | OOO Outside Activity |
unable to perform their | MMM Major Activity |
major activity as those | XXX Cannot Do Major Activity |
with incomes of $35,000 or | |
more. For persons with | Figure 5 |
family incomes under | Source: National Center for Health |
$10,000, 26.8 percent had | Statistics, 1989 National Health |
some form of activity | Interview Survey. Vital and Health |
limitation including 9.7 | Statistics, Series 10, No. 176, |
percent who were unable to | Table 68. |
carry on their major | |
activity. Conversely, for |-------------------------------------------------|
persons with family incomes
of $35,000 or more, only 8.2 percent experienced an activity limitation
including 1.7 percent who were unable to carry on their major activity.
Table C, with data from the 1984 SIPP, shows that persons with low incomes
(less than $600 per month) were nearly four times as likely to have a
functional limitation and over six times as likely to have a severe limitation
as persons with monthly incomes of $3,000 and over. Income includes all
household sources/persons.
Table C: Functional Limitation Status of
Persons 15 years and over, by Income, 1984
(Numbers in Thousands)
With a Functional Limitation
------- Total --------- ------- Severe --------
Characteristic Total Number Percent Number Percent
Total 180,987 37,304 20.6 13,537 7.5
Monthly Household Income
Under $600 20,690 8,262 39.9 3,746 18.1
$600 to $1,199 27,866 8,944 32.1 3,731 13.4
$1,200 to $1,999 38,648 8,211 21.2 2,826 7.3
$2,000 to $2,999 40,999 6,249 15.2 1,804 4.4
$3,000 and over 52,784 5,639 10.7 1,430 2.7
Source: U.S. Bureau of the Census, 1984 Survey of Income and Program
Participation. Current Population Reports, Series P-70, No. 8, Table C.
Related to income, the dependence on public benefit programs increased with
the prevalence of functional limitations, as shown in Table D. For example,
over 45 percent of all Medicaid recipients and nearly 37 percent of all Food
Stamp recipients have a functional limitation, compared to the 20.6 percent
figure for all persons 15 years of age and over. This shows that, beyond the
chronic conditions and functional limitations they cause, persons with
disabilities must contend with other barriers to full participation in
society, such as low income, and they rely heavily on public benefit programs
to help gain access to cash assistance, medical care, food, and housing,
among other required services. The Census Bureau found that, among persons
with a functional limitation, these utilization rates generally increased
with age. The exception was Medicare which had a participation rate of 84.6
percent for the 15 to 64 age group with a functional limitation, compared to
only 58.6 percent for those 65 years of age and over.
Table D: Functional Limitation Status of Persons 15 Years and Over,
by Public Benefit Program Participation, 1984
(Numbers in Thousands)
With a Functional Limitation
------- Total --------- ------- Severe --------
Characteristic Total Number Percent Number Percent
Total 180,987 37,304 20.6 13,537 7.5
Program Participation
Received -
Cash assistance 10,037 4,594 45.8 2,342 23.3
other than SSI
SSI 3,473 2,683 77.3 1,674 48.2
Food Stamps 10,867 3,994 36.8 1,776 16.3
Medicaid Coverage 10,610 4,788 45.1 2,527 23.8
Public or subsidized 5,932 2,243 37.8 1,019 17.2
housing
VA Payments 3,460 1,979 57.2 974 28.2
Social Security 32,832 18,543 56.5 9,051 27.6
Medicare Coverage 27,948 16,932 60.6 8,549 30.6
Source: U.S. Bureau of the Census, 1984 Survey of Income and Program
Participation. Current Population Reports, Series P-70, No. 8, Table C.
Education: According to the NHIS, low educational attainment has a strong
correlation with disability. For persons 18 years of age and over without an
eighth grade education, 38.0 percent have some form of activity limitation
and 13.6 percent cannot perform their major activity, compared to 10.5
percent and 1.9 percent, respectively, for persons with at least four years
of college (data not shown).
This relationship between disability and years of schooling also appears in
the 1984 SIPP data, as Figure 6 shows. In this case, persons without a high
school diploma were almost two and one-half times as likely to have a
functional limitation and almost four times as likely to have a severe
limitation as those who were high school graduates. Of the 56 million
persons 15 years of age and older without a high school diploma in 1984, 19.6
million, or 35.1 percent, had a functional limitation, and 8.6 million, or
15.4 percent, had a severe limitation (see Table 3). The contrasting figures
for the 125 million high school graduates are 17.7 million, or 14.1 percent
with a functional limitation, and 4.9 million, or 3.9 percent with a severe
limitation.
In combination, low educational attainment and advanced age correlate with
higher rates of disability than does either of these characteristics
individually. As Table 3 shows, among persons 65 years of age and over,
those without a high school education have a functional limitation rate of
68.6 percent, including 36.6 percent with a severe one. Conversely, for
persons 15 to 64 years of age with a high school diploma, only 10.7 percent
had a functional limitation, including 2.4 percent with a severe one.
Ethnicity: As the NHIS |------------------------------------------------|
data shows in Table E, | Functional Limitation Status by |
overall differences in | Educational Attainment among |
activity limitation | Persons 15 Years and Over, 1984 |
between the white and | |
black population are | Percent with a Functional Limitation |
small, but these | |
differences increase with | 40% |
age and the severity of | 35.1% |
the limitation involved. | ///// |
For all age groups, 14.2 | ///// |
percent of the white | 30% ///// |
population and 14.9 | ///// |
percent of the black | ///// |
population had an activity | ///// |
limitation. This | 20% ///// |
difference is, in reality, | 14.1% /////15.4% |
greater because the black | ///// /////\\\\\ |
population as a whole is | ///// /////\\\\\ |
younger than the white, | 10% ///// /////\\\\\ |
and activity limitation | ///// /////\\\\\ |
increases with age. By | ///// 3.9% /////\\\\\ |
comparing a younger black | /////\\\\\ /////\\\\\ |
population with an older | 0% /////\\\\\ /////\\\\\ |
white one, real | High School Grad Not a Graduate |
differences are masked. | Type of Limitation |
| //// With a Limitation \\\\ Severe Limitation|
| |
Looking at particular | Figure 6 |
subgroups presents a | Source: U.S. Bureau of the Census, 1984 Survey|
different picture than for | of Income and Program Participation. Current |
the population as a whole. | Population Reports, Series P-70, No. 8, |
In the 45 to 64 and 65 to | Table 1. |
69 age groups, blacks were |------------------------------------------------|
nearly twice as likely to
be unable to carry out
their major activity as whites. For person 70 years and older, 38.2 percent
of the white population had someform of activity limitation compared to 48.2
percent of their black counterparts.
Table E: Number of Persons and Percent Distribution by Degree of Activity
Limitation Due to Chronic Conditions by Race and Age: United States, 1989
Limited in
Total With Unable to Amount or Limited, but
Race and Age All Persons Activity Carry on Kind of not in Major
(Number in Limitation* Major Major Activity
Thousands) Activity Activity
Percent Distribution
All Ages - White 205,312 14.2 3.9 5.5 4.7
Under 18 Years 51,549 5.4 0.5 3.3 1.6
18-44 Years 87,429 9.0 2.4 3.8 2.8
45-64 Years 40,022 21.5 8.0 7.8 5.7
65-69 Years 8,814 35.6 14.7 13.2 7.7
70+ Years 17,498 38.2 6.9 11.7 19.6
All Ages - Black 29,891 14.9 5.9 5.3 3.6
Under 18 Years 9,959 5.6 0.8 3.2 1.6
18-44 Years 12,766 10.2 4.2 3.7 2.3
45-64 Years 4,712 29.5 15.8 7.9 5.8
65-69 Years 905 48.8 25.6 14.6 8.6
70+ Years 1,548 48.2 11.2 18.6 18.3
* This total of the three adjacent percentages may not add exactly due to
rounding.
Source: National Center for Health Statistics, 1989 National Health Interview
Survey. Vital and Health Statistics, Series 10, No. 176, Table 68.
The 1984 SIPP data in Table F exhibit a similar pattern of increased
disability rates among blacks relative to whites, with advancing age and
severity of limitation. According to the Census Bureau, 20.2 percent of
whites 15 years of age and over had a functional limitation including 7.3
percent with a severe one, compared to 24.9 and 9.5 percent, respectively,
for blacks. The corresponding figures for Hispanics, 19.2 and 7.6 percent,
were not statistically different from whites. Among the elderly 65 years of
age and over, the functional limitation rates for blacks and whites were 75.0
and 56.9 percent, respectively. The 58.6 percent rate for Hispanics was not
statistically different from whites. In terms of severity of limitation
among the elderly, the white, black, and Hispanic rates of functional
limitation were 27.4, 41.5 and 35.7, respectively.
Table F: Functional Limitation Status of Persons 15 Years and Over,
by Age, Race, and Spanish origin, 1984
(Numbers in Thousands)
With a Functional Limitation
------ Total ------- ------ Severe ---------
Characteristic Total Number Percent Number Percent
Total*1 180,987 37,304 20.6 13,537 7.5
White:
Total Ages 15+ 156,009 31,568 20.2 11,394 7.3
15 to 64 32,087 17,951 13.6 4,844 3.7
65+ 23,921 13,617 56.9 6,550 27.4
Black:
Total Ages 15+ 20,018 4,975 24.9 1,907 9.5
15 to 64 17,838 3,340 18.7 1,003 5.6
65+ 2,181 1,635 75.0 905 41.5
Spanish Origin*2:
Total Ages 15+ 9,394 1,808 19.2 710 7.6
15 to 64 8,710 1,407 16.2 466 5.4
65+ 684 401 58.6 244 35.7
*1 Includes other races
*2 Persons of Spanish origin may be of any race Source: U.S. Bureau of the
Census, 1984 Survey of Income and Program Participation. Current Population
Reports, Series P-70, No. 8, Table B.
Gender: Table G shows that gender differences are less frequently associated
with levels of disability than race, with women having only a slightly higher
prevalence of activity limitations than men (14.4% versus 13.7%). In addition
to those reasons cited in the discussion on age, above, gender variations in
the NHIS data which do appear for those 45 to 69 years, especially for those
unable to carry on their major activity, are due to the fact that women are
less likely to report limitations in keeping house than men in performing
work, with the opposite occurring for non-major activities, where house
keeping as a major activity includes work as an outside activity. There are
more women than men in the high age groups associated with increased
disability, and for this reason age adjusting the figures slightly reduces the
rates for females and slightly increases them for males.
Table G: Number of Persons and Percent Distribution by Degree of Activity
Limitation Due to Chronic Conditions by Race and Age: United States, 1989
Total With Unable to Limited in Limited, but
All Persons Activity Carry on Amount or not in Major
Gender and Age (Number in Limitation* Major Kind of Activity
Thousands) Activity Major
Activity
--------- Percent Distribution ---------------
All Ages - Male 118,009 13.7 4.6 5.0 4.0
Under 18 32,752 6.3 0.6 4.0 1.7
18-44 51,044 9.1 2.9 3.8 2.4
45-64 22,070 21.4 10.4 6.5 4.5
65-69 4,553 38.3 20.8 12.6 4.9
70+ 7,590 38.7 7.2 9.0 22.5
All Ages - Female 125,523 14.4 3.6 5.8 4.9
Under 18 31,251 4.3 0.5 2.5 1.3
18-44 53,152 9.0 2.3 3.7 3.0
45-64 24,044 22.8 7.3 8.9 6.7
65-69 5,350 35.7 11.4 14.1 10.1
70+ 11,726 39.1 7.2 14.5 17.4
* This total of the three adjacent percentages may not add exactly due to
rounding.
Source: National Center for Health Statistics, 1989 National Health
Interview Survey. Vital and Health Statistics, Series 10, No. 176,
Table 68.
As with the NHIS, gender differences in functional limitation status from
the 1984 SIPP are influenced by age, since there are more women than men in
the high age groups associated with disability. As Table H shows, for
persons 15 to 64 years of age, 12.6 percent of males had a functional
limitation, compared to 15.6 percent of females. The percentages with a
severe limitation were 3.1 for males and 4.7 for females in this age group.
For persons 65 years of age and over, 53.5 percent of males and 62.0 percent
of females had a functional limitation. The corresponding figures for a
severe limitation are 21.8 percent for elderly males and 33.2 percent for
elderly females.
Table H: Functional Limitation Status of Persons 15 Years and Over,
by Gender and Age, 1984 (Numbers in Thousands)
With a Functional Limitation
------ Total ------ ------ Severe ---------
Characteristic Total Number Percent Number Percent
Total 180,987 37,304 20.6 13,537 7.5
Male - Total 15+ 86,336 15,260 17.7 4,662 5.4
15 to 64 75,551 9,487 12.6 2,315 3.1
65+ 10,785 5,773 53.5 2,347 21.8
Females - Total 15+ 94,651 22,044 23.3 8,874 9.4
15 to 64 79,014 12,352 15.6 3,682 4.7
65+ 15,637 9,692 62.0 5,192 33.2
Source: U.S. Bureau of the Census, 1984 Survey of Income and Program
Participation. Current Population Reports, Series P-70, No. 8, Table B.
Living Arrangements: According to the NHIS, as Table I shows, the prevalence
of disability is greatest among those who are potentially isolated - widowed,
(40.4 percent with an activity limitation, many of whom are elderly),
separated (22.2 percent), divorced (22.0 percent) - compared to married
persons (16.0 percent with an activity limitation) and persons who have never
been married (10.9 percent, many of whom are relatively young).
Table I: Number of Persons and Percent Distribution by Degree of Activity
Limitation Due to Chronic Conditions by Marital Status: United States,
1983-1985 (Annual Average for Three-Year Period)
Total With Unable to Limited in Limited, but
All Persons Activity Carry on Amount or not in Major
Marital Status (Number in Limitation* Major Kind of Activity
Thousands) Activity Major
Activity
---------- Percent Distribution --------------
Under Age 18 62,650 5.1 0.4 3.2 1.5
Married 108,648 16.0 4.4 6.4 5.1
Widowed 12,808 40.4 10.3 16.6 13.6
Divorced 10,918 22.0 7.1 8.7 6.2
Separated 3,582 22.2 8.1 8.4 5.7
Never Married 32,150 10.9 4.2 3.9 2.8
Unknown 793 14.8 6.9 4.6 3.2
* This total of the three adjacent percentages may not add exactly due to
rounding.
Source: National Institute on Disability and Rehabilitation Research,
1983-1985 National Health Interview Survey, in LaPlante, Mitchell P.
(1988). Data on Disability form the National Health Interview Survey,
1983-85, Table 2.
The 1984 SIPP also shows |------------------------------------------------|
that vulnerability, such as | Percent of Persons 15 and Over Living |
living alone, increases for | Alone or with Non-Family Members, |
persons with disabilities, | By Functional Limitation Status, 1984 |
as presented in Figure 7. | |
Those with a functional | |
limitation were over twice | Percent |
as likely to live completely | 35% |
alone as those without such | 29.1 |
limitations (21.4 versus 9.1 | 30% \\\\ |
percent). Persons with a | 24.5\\\\ 26.0 |
severe functional limitation | 25% ////\\\\ \\\\ |
were nearly three times as | ////\\\\ 21.4\\\\ |
likely to live alone as | 20% ////\\\\ ////\\\\ |
their counterparts without a | ////\\\\ ////\\\\ |
functional limitation (26.0 | 15% ////\\\\13.6 ////\\\\ |
versus 9.1 percent). The | ////\\\\XXXX ////\\\\ |
percent of persons living | 10% ////\\\\XXXX ////\\\\ 9.1 |
either alone or with | ////\\\\XXXX ////\\\\XXXX |
non-relatives, are 24.5, | 5% ////\\\\XXXX ////\\\\XXXX |
29.1 and 13.6, respectively, | ////\\\\XXXX ////\\\\XXXX |
for those with a functional | 0% ////\\\\XXXX ////\\\\XXXX |
limitation, severe | |
limitation and no | Alone or Non-Family Alone |
limitation. This figure | Living Arrangement |
shows the percent of persons | |
who live alone according to | //// With a Limitation \\\\ Severe Limitation|
their functional limitation | XXXX Without a Limitation |
status. Presented another | Figure 7 |
way, as Table 3 shows, 37.9 | Source: U.S. Bureau of the Census, 1984 Survey|
percent of those living | of Income and Program Participation. Current |
alone had a functional | Population Reports, Series P-70, No. 8, |
limitation, compared to 20.0 | Table 1. |
percent of married persons |------------------------------------------------|
with the spouse present.
|
||
 |
||