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Chronic Conditions and Impairments Causing Disability

 
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*** II. Chronic Conditions and Impairments Causing Disability ***

Table 13.Average Annual Number of Selected Chronic Conditions and Percent 
of Conditions Causing Limitation of Activity by Nature of Limitation and 
Gender All Ages: United States, 1983-1986


** Highlights

As a group, orthopedic impairments (which appear under the "Impairments"
category, as "curvature of back or spine" through "other orthopedic
impairments") were most frequently reported as causing a limitation in either
major or outside activity.  Arthritis (primarily osteoarthritis) (under the
"Skin and Musculoskeletal" category), and heart disease and hypertension
(high blood pressure) (under the "circulatory" category) were the second,
third, and fourth most frequently reported cause of activity limitation.

Low prevalence conditions which have a high rate of activity limitation,
among those who have them, include mental retardation and absence of leg(s)
(under impairments), lung or bronchial cancer (under respiratory), multiple
sclerosis (under miscellaneous), and cerebral palsy and blind in both eyes
(under impairments).

Marked differences exist between the most prevalent chronic conditions and
the conditions most frequently reported as causing activity limitation.  High
prevalence conditions not strongly associated with disability include chronic
sinusitis, hay fever (without asthma), and chronic bronchitis (under
respiratory), and psoriasis and dermatitis (under skin and musculoskeletal).

The need for assistance in basic life activities (ADL/IADL limitation)
constitutes a more severe disability and involves fewer reported conditions
than an activity limitation.  While 11.7 percent of all reported conditions
cause an activity limitation, only 2.6 percent cause a need for help in basic
life activities.

Females have a higher prevalence of conditions and percent causing activity
limitation than men for arthritis and high blood pressure, but this may be a
function of age rather than gender since there are more women of advanced age
than men.  Men have a higher prevalence and percentage causing activity
limitation for ischemic (coronary) heart disease, speech impairments, and
intervertebral disc disorders (men also report more absence of extremities
than women, although the activity limitation rates are somewhat lower).
Although women report having more chronic conditions than men (230,096 versus
163,803), gender differences in the percent causing an activity limitation
are small (12.5 for males versus 11.2 percent for females).  However, women
generally report more ADL/IADL limitations than men (3.1 versus 2.0 percent).

** Explanatory Notes

This table presents prevalence estimates for select chronic conditions and
the percent causing activity limitation and need for help in basic life
activities (ADL/IADL limitation) among the civilian non-institutionalized
population in the United States.  The figures are counts of conditions, which
exceed the number of separate individuals involved because a person may
report multiple conditions or be counted more than once within the same
condition.  These estimates are based on the National Health Interview Survey
(NHIS) conducted by the National Center for Health Statistics (NCHS) for the
years 1983-1986.  Combining data for four years increases the stability of
the estimates and reduces sampling error.  Data are annual averages for the
four years.  Annually, the sample consists of approximately 40,000 eligible
households containing about 120,000 persons living at the time of the
interview (see Table 1 for a description of the NHIS).

The numbers and percentage of chronic conditions presented are for all causes
of activity limitation and need for help in basic life activities.  Activity
limitation is a broad measure of disability in terms of one's major activity
(e.  g., play, school, and work) or in terms of other, non-major activity.
The need for help in basic life activities measures severe disability in
terms of an ADL limitation (needing the help of other persons with personal
care needs such as eating, bathing, dressing, or getting around one's home),
or, in the absence of an ADL limitation, if one needs the help of other
persons in handling routine needs, such as everyday household chores, doing
necessary business, shopping or getting around for other purposes (IADL).




     Table 13. Average Annual Number of Selected Chronic Conditions and
      Percent of Conditions Causing Limitation of Activity by Nature of
	  Limitation and Gender All Ages: United States, 1983-1986

	Column titles: -A-   Number of Conditions (1,000s)
		       -B-   Any Activity Limitation
		       -C-   Need for Help in Basic Life Activities+

		Both Genders 		Males 			Females
		Percent Causing 	Percent Causing 	Percent Causing
	  -A-	    -B-   -C-  	  -A-	    -B-   -C-  	   -A-	    -B-   -C-


   Chronic Condition

 All selected chronic conditions
	393,899    11.7   2.6   163,803    12.5   2.0    230,096   11.2   3.1

 Skin and Musculoskeletal 
Rheumatoid Arthritis 
	 1,223     51.0  14.9       321    43.9   4.4*	     902   53.6  18.7 
Osteoarthritis/Other Arthropathies 	              		              
	29,245	   19.6	  5.3    10,351	   18.3   3.4 	  18,893   20.4   6.3 
Intervertebral Disk Disorders 		              		              
	 3,987	   48.7	  5.3     2,212	   50.4   3.6 	   1,775   46.6   7.4 
Osteomyelitis/Bone Disorders  		              		              
	 2,998	   21.0	  5.9     1,116	   15.4   1.5*     1,882   24.3   8.5 
Bursitis       		            	              		              
	 4,539	    6.2	  0.7*    1,812	    6.1   0.0 	   2,727    6.2   1.2*
Psoriasis and Dermatitis             	              		              
	11,329	    1.9	  0.1*    4,578	    1.5   0.0 	   6,751    2.2   0.2*
Skin Cancer 		            	              		              
	 1,459	    2.3*  0.9*      874	    2.8*  1.5*	     586    1.6*  0.0 
Other Selected Skin and Musculoskeletal               		              
	27,747	    2.1	  0.4    11,502	    2.8   0.4*	  16,245    1.6   0.5 
Total	      		            	              		              
	82,527	   12.2	  2.8    32,766	   11.7   1.6 	  49,761   12.5   3.6 

 Impairments 
Absence of Arms(s)/Hand(s) 
	    84	   43.1   4.1*       78    46.5   4.4*         6*   0.0   0.0  
Absence of Leg(s)      	      	       	       	      	                       
	   289	   83.3	 39.0 	    234	   82.6	 35.0 	      56*  86.3* 55.8* 
Absence of Fingers, Toes, Feet 	       	       	      	                       
	 1,811	    7.0	  1.3*	  1,410	    5.5	  0.9*	     401   12.3*  2.9* 
Other Absence 	       	      	       	       	      	                       
	 1,031	   20.8	  4.4*	    451	   19.9	  2.6*	     581   21.4   5.8*
Complete Paralysis in Extremity        	       	      	                       
	   617	   52.7	 26.1 	    340	   50.6	 23.7 	     277   55.3   28.9 
Cerebral Palsy 	       	      	       	       	      	                       
	   274	   69.7	 22.8 	    189	   70.3	 20.4*	      85   68.3   28.2*
Partial Paralysis in Extremity	       	       	      	                       
	   578	   59.6	 27.5 	    319	   66.8	 27.3 	     259   50.8   27.7 
Paralysis in Other Sites (Complete/Partial) 	      	                       
	   247	   47.8	 14.1*	    138	   60.0	 10.9*	     109   32.4*  18.0*
Curvature of Back or Spine	       	       	      	                       
	 4,689	   14.7	  1.4 	  1,443	   15.4	  1.2*	   3,246   14.4    1.4*
Other Orthopedic Impairment of Back      	      	                       
	 9,898	   27.7	  2.8 	  4,550	   27.0	  2.0 	   5,348   28.2    3.5 
Orthopedic Impairment in Upper Extremity 	      	                       
	 3,106	   27.9	  2.9 	  1,728	   25.8	  1.0*	   1,377   30.6    5.4 
Orthopedic Impairment In Lower Extremity 	      	                       
	10,893	   26.5	  4.8 	  5,622	   26.3	  2.5 	   5,271   26.7    7.3 
Other Orthopedic Impairments 	       	       	      	                       
	   316	   58.7	 14.3*	    154	   56.6	 10.0*	     161   60.8   18.4*
Speech Impairment      	      	       	       	      	                       
	 2,469	   18.3	  2.3*	  1,633	   18.8	  1.6*	     836   17.4    3.7*
Blind in Both Eyes            	       	       	      	                       
	   396	   64.5	 38.1 	    191	   74.8	 48.1 	     205   54.9   28.8 
Cataracts 	       	      	       	       	      	                       
	 5,173	   10.6	  4.4 	  1,633	   10.2	  2.2*	   3,541   10.8    5.4 
Glaucoma      	       	      	       	       	      	                       
	 1,707	   14.9	  5.1 	    727	   12.8	  3.7*	     980   16.5    6.1 
Other Visual Impairment/Retinal Disorders 	      	                       
	 8,596	   14.0	  5.4 	  5,076	   11.0	  3.2 	   3,520   18.3    8.6 
Deaf in Both Ears Other	      	       	       	      	                       
	 1,700	   16.4	  3.2*	    959	   13.5	  3.0*	     741   20.1    3.5*
Hearing Impairments 	      	       	       	      	                       
	19,254	    4.6	  0.9 	 10,854	    4.4	  0.7 	   8,400    4.8    1.2 
Mental Retardation            	       	       	      	                       
	 1,202	   84.1	 19.9 	    762	   86.9	 18.7 	     440   79.3   22.0 
Other Selected Impairments	       	       	      	                       
	 1,371	   13.6	  2.5*	    756	   15.9	  3.3*	     615   10.7    1.7*
Total	      	       	      	       	       	      	                       
	75,701	   18.5	  4.1 	 39,247	   18.1	  3.1 	  36,455   19.0    5.1 

		   
 Digestive 
Ulcers
	 4,469	    9.7   1.0*    2,107    11.8   0.9*	   2,362    7.8    1.1*
Abdominal Hernia       	      	       	       	      	               	       
	 4,830	   12.5	  2.4 	  2,427	   11.3	  1.2*	   2,403   13.7	   3.6 
Enteritis and Colitis 	      	       	       	      	               	       
	 2,392	    7.2	  0.8*	    721	    8.7	  0.4*	   1,671    6.6	   1.0*
Cancer of Digestive Sites      	       	       	      	               	       
	   228	   45.3	 15.9*	    107	   45.1	 10.5*	     121   45.4	  20.6*
Other Selected Digestive Disorders 	       	      	               	       
	20,556	    3.6	  0.8 	  7,296	    3.1	  0.3*	  13,260    3.9	   1.1 
Total	      	       	      	       	       	      	               	       
	32,475	    6.3	  1.2 	 12,658	    6.8	  0.7 	  19,817    6.0	   1.5 


 Circulatory 
Rheumatic Fever 
	 1,536	   15.7	  1.9*	    537	   11.2   0.6*	     999   18.2    2.6*
Ischemic Heart Disease 	      	       	       	      	               	       
	 6,948	   35.0	  8.1 	  3,978	   36.1	  4.4 	   2,970   33.6	  13.0 
Heart Rhythm Disorders 	      	       	       	      	               	       
	 7,404	    7.2	  1.5 	  2,735	    8.1	  1.4*	   4,669    6.7	   1.5 
Other Heart Disease Disorders 	       	       	      	               	       
	 4,708	   46.9	 13.6 	  2,075	   48.7	 11.7 	   2,633   45.4	  15.0 
Hypertension 	       	      	       	       	      	               	       
	28,689	   12.4	  2.2 	 12,242	    9.9	  1.2 	  16,446   14.2	   2.9 
Cerebrovascular Disease       	       	       	      	               	       
	 2,599	   38.2	 22.9 	  1,269	   39.6	 20.3 	   1,331   36.8	  25.3 
Arteriosclerosis       	      	       	       	      	               	       
	 3,008	   12.1	  5.1 	  1,532	   12.0	  3.8*	   1,476   12.2	   6.5 
Phlebitis, Varicose Veins      	       	       	      	               	       
	 7,891	    5.5	  0.8 	  1,584	    7.5	  0.8*	   6,306    4.9	   0.8*
Other Selected Circulatory 	       	       	      	               	       
	11,519	    3.8	  1.2 	  5,153	    4.0	  0.8*	   6,365    3.6	   1.5 
Total	      	       	      	       	       	      	               	       
	74,302	   15.1	  3.9 	 31,105	   15.9	  3.1 	  43,195   14.4	   4.5 


 Respiratory 
Chronic Bronchitis
	11,196      3.6   0.6     4,465     3.4   0.5*     6,732    3.8    0.7*
Asthma 	      	              	                      	                       
	 8,869	   20.6   1.3 	  4,069    19.1   0.7*	   4,800   21.8    1.7 
Hay Fever 	              	                      	                       
	20,431	    1.5   0.0 	  9,424     1.7   0.0 	  11,007    1.3    0.1*
Sinusitis 	              	                      	                       
	31,969	    0.4   0.1*	 13,455     0.5   0.1*	  18,514    0.4    0.1*
Emphysema 	              	                      	                       
	 2,074	   43.6   9.6 	  1,399    44.0   8.4 	     675   42.8   12.2 
Lung or Bronchial Cancer      	                      	                       
	   200	   74.8  34.5 	    110    79.9  32.4*	      90   68.7   37.1*
Pneumoconiosis/Asbestosis      	                      	                       
	   368	   38.5   8.1*	    346    40.0   8.6*	      22*  13.7*   0.0 
Other Selected Respiratory 	                      	                       
	 8,729	    5.5   1.2 	  3,417     8.1   1.4*	   5,312    3.7    1.0 
Total	      	              	                      	                       
	83,836	    5.2   0.7 	 36,685     6.2   0.8 	  47,152    4.4    0.7 


 Miscellaneous
Diabetes 
         6,096     35.4   9.4     2,609    32.3   5.8      3,487   37.8   12.0
Anemias
	 3,409 	    4.6   0.3*	    547     1.5*  0.0 	   2,862    5.2    0.3*
Kidney Disorders
	 3,559 	    9.6   2.4 	  1,187     9.0   1.0*	   2,371    9.9    3.2 
Female Genital Disorders 
	 6,379 	    3.7   0.2*	   na       na     na 	   6,379    3.7    0.2*
Epilepsy 
	 1,162 	   41.0   6.3 	    578    36.4   2.0*	     584   45.5   10.5 
Multiple Sclerosis 
	   171 	   70.6  40.7 	     48*   36.7* 20.0*	     123   84.0   48.9 
Migraine Headache 
	 7,934 	    2.9   0.3*	  2,023     4.0   0.0 	   5,911    2.6    0.4*
Cancer of Female Breast 
	   443 	   27.4   4.6*	   na       na     na 	     443   27.4    4.6*
Cancer of Genitourinary Sites 
	   302 	   41.8   8.5*	    100    55.3  15.3*	     202   35.2    5.1*
Other Selected Miscellaneous 
	15,602 	    4.0   1.0 	  4,251     4.7   0.6*	  11,352    3.8    1.1 
Total 
	45,057 	   10.2   2.3 	 11,343    13.4   2.0 	  33,714    9.1    2.4


 * Figure has low statistical reliability or precision (relative standard 
   error exceeds 30 percent). 
 + Includes Activities of Daily Living (persons aged 6 years and over) and 
   Instrumental Activities of Daily Living (persons aged 18 years and over).

   Source: National Health Interview Survey, 1983-1986.  Data are estimates 
	   based on household interviews of the civilian non-institutionalized
	   population, as presented in LaPlante, M.  P., Disability Risks of 
	   Chronic Illness and Impairments. Disability Statistics Report 2 
   	   (National Institute on Disability and Rehabilitation Research, 
	   1991), Table 1.



Table 14. Average Annual Number of Days of Restricted Activity from Selected
Chronic Conditions and Number of Days per Condition, by Age and Sex: United
States, 1986-88

** Highlights

Among reported chronic conditions, orthopedic impairments, collectively,
caused the greatest number of restricted activity days, or 416.5 million
annually.  Arthritis and heart disease were second and third, respectively,
with 377.7 and 338.5 million restricted activity days.  This follows a
pattern similar to the conditions causing activity limitation, as shown in
the previous table.

These three conditions caused the greatest number of restricted activity days
in both males and females but in different orders.  For males the sequence
was orthopedic impairments, heart disease, and arthritis.  For females it was
arthritis, orthopedic impairments, and heart disease.

Age influenced these patterns, with orthopedic impairments causing the
greatest number of restricted activity days among those under 65 years of age
and arthritis for those above that age.  Persons 65 years of age and over had
a higher number of days per condition than their younger counterparts, except
for ischemic (coronary) heart disease.

Regardless of the prevalence, malignant neoplasms (cancer) of lung, bronchus,
and other respiratory sites caused the greatest number of restricted activity
days per condition (88.1), followed by complete paralysis (39.2), disorders
of bone or cartilage (37.7), and cerebrovascular disease (36.7).

** Explanatory Notes

Data for this table come from the National Health Interview Survey (NHIS) for
the years 1986-1988.  The figures are average annual estimates for these
three years.  See Table 1 for a description of the NHIS annual sample.
Except for persons who are bed-ridden, restrictive activity days measure the
short-term (though recurring) effects of long- term disability.  The number
of restricted activity days is the number of days a person experienced at
least one of the following:

  1) a bed day, during which a person stayed in bed more than half a day 
     because of illness or injury,

  2) a work-loss day, on which a currently employed person 18 years of age or
     over missed more than half a day from a job or business,

  3) a school loss day, on which a student 5-17 years of age missed more than
     half a day from the school in which he or she was currently enrolled, or

  4) a cut-down day, on which a person cuts down for more than half a day on
     things he usually does.

The restricted activity days are condition days, that is the number of days
during which a chronic condition caused a person to restrict his or her
activity.  A person may have more than one condition causing the same day of
restricted activity or be counted more than once within a particular
category, e.g. heart disease.  For this reason the number of condition days
exceeds the number of persons involved.

Only conditions for which the total number of restricted activity days for
all persons exceeded 14 million days are used, which is the cutoff for
reliability.


    Table 14.  Average Annual Number of Days of Restricted Activity from
	Selected Chronic Conditions and Number of Days Per Condition,
		   by Age and Sex: United States, 1986-88
			       
      All Persons 	        Age 				Sex
		  Under 65 Years   65 Years +          Male         Female
	******** Number of Days in Thousands / Days per Condition ********
Selected Chronic Conditions

  Circulatory Conditions
Heart Disease
     338,541/17.4   157,624/14.0   180,917/22.1   173,602/19.4   164,939/15.7 
 Ischemic Heart Disease		               	             	              
     173,129/24.1   100,161/30.3    72,968/18.8   101,959/24.1 	  71,170/24.0 
 Heart Rhythm Disorders		               	             	              
      29,777/ 3.9    17,083/ 3.0   12,694*/ 6.1*    4,622/ 1.7*	  25,155/ 5.1 
 Other Selected Diseases of the Heart (Excludes hypertension) 
     127,871/33.0    37,664/21.0    90,208/43.4    62,403/38.5 	  65,468/29.1 
Rheumatic Fever with or without Heart Disease 	             	              
      15,487/ 8.9   10,111*/ 7.5*   5,376*/13.6*   4,139*/ 7.8*  11,349*/ 9.3* 
HighBlood Pressure (Hypertension) 
     116,934/ 4.1    66,347/ 3.6    50,587/ 4.7    48,905/ 3.9    68,030/ 4.2 
Cerebrovascular Disease 	               	             	              
      98,261/36.7    25,644/24.4    72,617/44.6    49,384/39.5 	  48,877/34.2 
Hardening of the Arteries	               	             	              
      42,155/16.4   12,644*/14.5*   29,512/17.3    25,769/19.2 	  16,386/13.2 
Poor Circulation                               	             	              
      18,099/19.1    4,851*/12.1*  13,248*/24.3    6,000*/16.9*  12,099*/20.5*

 Respiratory Conditions
Chronic Bronchitis 
      58,725/ 4.9    42,976/ 4.2    15,750/ 8.4    22,999/  4.7   35,726/ 5.0 
Emphysema 	                                                              
      55,010/27.8    22,674/26.3    32,336/28.9    33,894/ 26.9   21,116/29.2 
Asthma                                                                        
      88,742/ 9.1    65,029/ 7.6    23,713/20.6    36,783/  7.9   51,959/10.2 
Hay Fever or Allergic Rhinitis With out Asthma 	                              
      30,000/ 1.3    24,865/ 1.2    5,135*/ 2.6*  11,298*/  1.1*  18,701/ 1.6 
Chronic Sinusitis Malignant Neoplasms of Lung	                              
      51,651/ 1.6    46,411/ 1.6    5,240*/ 1.1*  13,284*/  1.0*  38,367/ 2.0 
Bronchus and Other Respiratory Sites 		                              
      16,563/88.1    6,782*/92.9*   9,781*/85.1*  12,964*/111.8*  3,599*/50.0*
OtherDiseases of the Lung	                                              
      27,902/23.3    15,985/17.9   11,916*/39.2*  10,652*/ 21.8   17,249/24.2 

 Digestive Conditions
Ulcer, Gastric, Duodenal and/or Peptic 
      29,224/ 6.8    23,372/ 6.7    5,852*/ 6.9*   13,205*/ 6.7*  16,019/ 6.9 
Hernia of Abdominal Cavity 	                                              
      36,786/ 7.9    28,122/ 9.6    8,664*/ 5.1*   22,754 / 9.7   14,032/ 6.1 
Gastritis and Duodenitis	                                              
      14,328/ 5.1   12,918*/ 5.8*   1,410*/ 2.3*    6,436*/ 5.9*  7,892*/ 4.5*
Enteri tis and Colitis		                                              
      19,135/ 8.3    14,042/ 8.0    5,093*/ 9.4*    2,954*/ 4.2*  16,181/10.1 

 Impairments
Blindness and Other Visual Impairments 
      34,986/ 4.3    22,248/ 3.9   12,739*/ 5.2*   11,938*/ 2.4*  23,048/ 6.9 
Absence of Extremities or Parts of Extremities 	                               
  (Excluding absence of tips of fingers or toes only) 		               
      21,086/12.7   10,764*/10.3*  10,322*/16.7*    14,669/11.2   6,417*/18.0* 
Absences of Bone, Joint, Muscle of Extremity 	                               
      14,274/23.6    3,537*/11.0*  10,737*/38.3*    3,024*/ 9.9* 11,250*/37.5* 
Paralysis of Extremities, Complete or Partial	                               
      42,778/31.2    27,741/29.6   15,038 /34.6     23,332/30.6   19,446/31.9  
Paralysis of Extremities, Complete                                             
      18,901/39.2    16,234/45.1    2,668*/21.9*    14,472/54.6   4,430*/20.3* 
Paralysis of Extremities, Partial                                              
      23,877/26.9   11,507*/20.0*  12,370*/39.5*    8,861*/17.8*  15,016/38.4  
Orthopedic Impairments, Total	                                               
     416,479/13.1   329,094/12.6   87,385 /15.6   200,533 /13.1  215,946/13.1  
 Orthopedic Impairments of Back	                                               
     195,289/12.3   156,433/11.7   38,856 /15.5    87,910 /12.9  107,380/11.8  
 Curvature of Other Impairments of Back or Spine                               
      39,152/ 8.2    36,530/ 9.4    2,621*/ 3.0*   16,268 /11.1   22,884/ 6.9  
 Orthopedic Impairments of Upper Extremities	                               
      62,292/19.5    54,342/20.7    7,950*/14.1*   36,533 /20.6   25,759/18.2  
 Orthopedic Impairment - Shoulder                                              
      48,358/22.4    42,406/23.3    5,952*/17.8*   30,573 /24.4   17,785/19.7  
 Orthopedic Impairments of Lower Extremities	                               
     153,541/12.5   114,285/11.6   39,256 /16.0    73,209 /11.2   80,333/13.9  

 Musculoskeletal
Arthritis 
     377,703/12.1   198,389/11.2   179,314/13.2     92,421/ 8.6  285,282/13.9 
Sciatica (Including lumbago) 	               	                              
      23,632/12.1    18,662/13.2    4,971*/ 9.0*    5,628*/ 8.6*  18,004/13.8 
Intervertebral Disc Disorders	               	                              
     124,113/30.0   101,835/29.1    22,279/34.7     69,319/29.4   54,794/30.7 
Bone Spur or Tendinitis, Not Otherwise Specified                              
      22,716/10.7    18,264/10.5    4,452*/11.5*   11,300*/11.8*  11,416/ 9.8*
Disorders of Bone or Cartilage 	               	                              
      50,792/37.7    33,823/41.4    17,149/32.1     17,531/44.2   33,441/35.1 
Bursitis, Not Elsewhere Classified             	                              
      30,799/ 7.0    25,806/ 7.7    4,993*/ 4.8*    8,228*/ 4.7*  22,570/ 8.5 

 Miscellaneous
Conditions of Nervous System and Sense Organs
 Cataracts 
      24,510/ 4.4    7,466*/ 6.5*   17,044/ 3.9    10,298*/ 5.6*  14,213/ 3.8 
 Epilepsy 	                                                              
      20,048/17.4    20,048/18.9       --*/ --*    11,631*/22.8*  8,418*/13.1*
 Migraine Headache                                                            
      46,758/ 5.3    42,046/ 5.1    4,712*/ 9.1*   12,747*/ 5.7*  34,011/ 5.2 
 Other Headache (Excludes tension headache)	                              
      34,493/ 3.9    31,439/ 4.0    3,054*/ 3.3*   11,857*/ 4.5*  22,636/ 3.7 

 Endocrine, Nutritional and Metabolic Diseases and Immunity Disorders
Gout 
      15,794/ 7.2    9,002*/ 6.9*   6,793*/ 7.6*    8,807*/ 5.8*  6,987*/10.5*
Diabetes	                               	               	              
     100,719/15.5    59,965/15.9    40,754/15.0     40,240/13.3   60,479/17.5 

 Diseases of the Blood and Blood Forming Organs

Anemias
      17,619/ 5.1   12,022*/ 4.2    5,597*/ 8.9*    6,154*/ 8.9* 11,465*/ 4.1*

 Genitourinary Conditions

Kidney Infections 
      14,531/ 9.3   13,800*/10.6*     730*/ 2.8*    3,072*/12.0  11,458*/ 8.8  
Other Disorders of Female Genital Organs	               	              
      23,164/11.8    21,638/11.7    1,525*/11.9*      --  / -- 	  23,164/11.8 

 * Relative standard error is equal to or greater than 30 percent of
   the estimate -- The number of cases is too small for a valid estimate.

   Source: National Center for Health Statistics, National Health
	   Interview Survey, Vital and Health Statistics, upcoming Series 10
	   Report.


Table 15.Average Annual Days of Bed Disability from Selected Chronic
Conditions and Number of Days per Condition, by Age and Sex: United States,
1986-88

** Highlights

Heart disease, arthritis, and orthopedic impairments were responsible for the
greatest annual number of bed disability days, with 143.8 million, 126.7
million, and 120.1 million days, respectively.

For males, heart disease caused the most bed disability days (62.4 million
days), while for females it was arthritis (95.7 million days).

Regardless of their overall prevalence, the greatest number of bed disability
days per condition were caused by cerebrovascular disease (19.2), paralysis
of extremities, complete or partial (16.4), and emphysema (13.1).

For persons under 65 years of age, orthopedic impairments caused the greatest
number of bed disability days, while heart disease caused the most number of
days for those 65 and over.

** Explanatory Notes

Data for this table come from the National Health Interview Survey (NHIS) for
the years 1986-1988.  The figures are average annual estimates for these
three years.  See Table 1 for a description of the annual NHIS sample.

A bed disability day is a day during which a person stayed in bed more than
half a day because of illness or injury.  The bed disability days are
condition days, that is the number of days during which a chronic condition
caused a person to stay in bed.  A person may have more than one condition
causing the same day of bed disability or be counted more than once within a
particular condition category, e.g., heart disease.  For this reason the
number of condition days exceeds the number of persons involved.

Only conditions for which the total number of bed disability days for all
persons exceeded 14 million days are used, which is the cutoff for
reliability.




       Table 15.  Average Annual Number of Days of Bed Disability from
Selected Chronic Conditions and Number of Days Per Condition, by Age and Sex:
			   United States, 1986-88

      All Persons 	        Age 				Sex
		  Under 65 Years   65 Years +          Male         Female
	******** Number of Days in Thousands / Days per Condition ********
Selected Chronic Conditions

 Circulatory Conditions
Heart Disease
     143,786/ 7.4    59,484/ 5.3    84,302/10.3    62,434/ 7.0    81,353/ 7.7 
 Ischemic Heart Disease		                               	              
      70,900/ 9.9    36,986/11.2    33,914/ 8.7    38,695/ 9.1 	  32,205/10.9 
 Other Selected Diseases of the Heart (Excludes hypertension) 	              
      56,185/14.5   13,744*/ 7.7*   42,440/20.4    19,609/12.1 	  36,576/16.2 
High Blood Pressure (Hypertension)                             	              
      40,249/ 1.4    21,103/ 1.2    19,146/ 1.8    20,341/ 1.6 	  19,908/1.2  
Cerebrovascular Disease 	                               	              
      51,531/19.2    9,292*/ 8.9*   42,239/25.9    23,370/18.7 	  28,161/19.7 
Hardening of the Arteries	                               	              
      17,543/ 6.8    2,624*/ 3.0*   14,919/ 8.8    9,708*/ 7.2*	  7,835*/ 6.3*

 Respiratory Conditions
Chronic Bronchitis 
      26,963/ 2.2    16,799/ 1.7   10,164*/ 5.4*  12,204*/ 2.5*   14,758/ 2.1 
Emphysema 	                                               	              
      25,896/13.1   12,749*/14.8   13,147*/11.8*  13,782*/10.9*	 12,114*/16.8*
Asthma                                                         	              
      39,217/ 4.0    25,511/ 3.0   13,706*/11.9*   16,023/ 3.4 	  23,194/ 4.6 
Chronic Sinusitis                                              	              
      16,144/ 0.5    14,084/ 0.5    2,060*/ 0.5*   3,708*/ 0.3*	 12,436*/ 0.6*

 Impairments
Paralysis of Extremities, Complete or Partial Orthopedic
      22,426/16.4    15,372/16.4    7,054*/16.2   11,842*/15.5    10,584/17.4*
Orthopedic Impairments; Total	                                               
     120,079/ 3.8    97,523/ 3.7    22,555/ 4.0    45,349/ 3.0    74,730/ 4.5  
 Orthopedic Impairment of Back 	                                               
      74,602/ 4.7    63,056/ 4.7   11,546*/ 4.6    27,553/ 4.0    47,049/ 5.2  
 Orthopedic Impairments of Lower Extremities 	                               
      34,847/ 2.8    25,434/ 2.6    9,412*/ 3.8*  13,423*/ 2.1    21,424/ 3.7  

 Musculoskeletal
Arthritis 
     126,693/ 4.1    60,777/11.7    65,916/ 4.9    30,982/ 2.9    95,711/ 4.7
Intervertebral Disc Disorders	                               	             
      47,375/11.4    40,958/ 3.4    6,417*/10.0*   23,612/10.0 	  23,763/13.3
Disorders of Bone or Cartilage	                               	             
      14,663/10.9   10,267*/12.6*   4,397*/ 8.2    5,950*/15.0*	  8,713*/ 9.1

 Miscellaneous
Conditions of Nervous System and Sense Organs
Other Headache (Excludes Tension Headache)
      15,775/ 1.8   13,597*/ 1.7*   2,178*/ 2.3*   3,338*/ 1.3*  12,437*/ 2.0

Endocrine, Nutritional and Metabolic Diseases and Immunity Disorders
Diabetes
      51,884/ 8.0    26,608/ 7.0    25,276/ 9.3    17,516/ 5.8    34,368/ 9.9

 * Relative standard error is equal to or greater than 30 percent of
   the estimate -- The number of cases is too small for a valid estimate.

   Source: National Center for Health Statistics, National Health
	   Interview Survey, Vital and Health Statistics, upcoming Series 10
	   Report.

UB School of Public Health and Health Professions