National Center for Health Statistics, CDC
104/22/23
Exploring the Impact of Assistive Device Use on Disability Measurement
Jennifer MadansBeth Rasch
Barbara Altman
National Center for Health Statistics, CDC
204/22/23
What is Being Measured? Disability Prevalence
0
5
10
15
20
25
2005 2010 2015 2020 2025 2030
% with Disability
National Center for Health Statistics, CDC
304/22/23
What is being Measured?Disability as a Demographic
83
710
35
5
60
0102030405060708090
No Disability Disabled
EmployedIn Labor ForceUnemployed
National Center for Health Statistics, CDC
404/22/23
Exploring Use of Assistive Devices as a Partial Measure of Disability
This analysis examines how assistive device use can effect how a global measure of disability is developed.
The issues raised also apply to other measurement of participation or environment.
National Center for Health Statistics, CDC
504/22/23
Choices of Basis of Measurement
Questions can be structured to capture:Body/structure impairmentsActivity limitationsLimitations in participationEnvironmental factors
Includes device use How do these types of measures combine to
influence the two uses of measures?
National Center for Health Statistics, CDC
604/22/23
Data Source The data used in this analysis come
from the National Health Interview Survey – Disability Supplement collected in the U.S. in 1994-95.
Sample includes adults, aged 18 and over
National Center for Health Statistics, CDC
704/22/23
Variety of Question Format – Mobility Devices and Braces
Questions asked of or about everyone: Example: Does anyone in the family
now use any of these aids to get around? (a cane, crutches, walker, medically prescribed shoes, a wheelchair, or a scooter?) Which aids does –use?
Has – used or is – expected to use (aid identified) for 12 months or longer?
National Center for Health Statistics, CDC
804/22/23
Types of Equipment Use Reported
11.2
3.8
1.32
3.8
2.1 2.1
0.10
2
4
6
8
10
12
Any EqMobilityADL EqVisionHearingHearing aidsBracesProstheses
National Center for Health Statistics, CDC
904/22/23
Duration of Equipment Use Among Equipment Users
92.1
7.9
0102030405060708090
100
Long TermTemp
National Center for Health Statistics, CDC
1004/22/23
Report of No Limitation in Mobility Functions Among Mobility Device Users
12.8
23.7
0
5
10
15
20
25
Proportion Reporting no Limitation
Long Term TempDuration of Mobility Device Use
National Center for Health Statistics, CDC
1104/22/23
Report of No Mobility Limitations Among Persons with Brace Use
39.1
54.8
0
10
20
30
40
50
60
Proportion Reporting no Limitation
Long Term TempDuration of Device Use
National Center for Health Statistics, CDC
1204/22/23
Variety of Question Formats – Hearing Devices (or Vision)
Does anyone in the family now use a hearing aid? Asked of everyone.
(Besides a hearing aid), Does – now use an amplifier for the telephone, a TDD, TTY or teletype, closed caption TV, assistive listening or signaling devices, an interpreter, or any other equipment for people with hearing impairments? ASKED ONLY OF PERSONS WHO REPORTED HAVING TROUBLE HEARING AND EXPECTING TO HAVE IT FOR AT LEAST 12 MONTHS
National Center for Health Statistics, CDC
1304/22/23
Report of Hearing Limitations Among Persons with Hearing Aid Use
53.5
44.3
2.2
0
10
20
30
40
50
60
NoneMild/ chronicSevere
National Center for Health Statistics, CDC
1404/22/23
Report of Hearing Limitations among Persons with Other Hearing Equipment Use
0
97.4
2.6
0102030405060708090
100
NoneMild/ chronicSevere
National Center for Health Statistics, CDC
1504/22/23
Report of ADL Difficulty or Need for Help Among Persons with ADL Device Use
19.625.4
55
0
10
20
30
40
50
60
No DiffDiff OnlyHelp
National Center for Health Statistics, CDC
1604/22/23
Report of Limitations in Major Activities by Persons with Device Use
41.7
58.3
46.953.1
0
10
20
30
40
50
60
Long Term Temp
No LimitationsLimitations
National Center for Health Statistics, CDC
1704/22/23
Do Persons Who Use Devices Report Any Type of Activity Limitation?(Sensory Devices and Limitations Omitted)
11.3
88.7
31.2
68.8
0102030405060708090
Long Term Temp
No limitationLimitation
National Center for Health Statistics, CDC
1804/22/23
Influence of Self Identity as Disabled on Reporting No Limitations Among Users of Devices (Sensory Data Omitted)
1 1.3
25.3
44.3
05
1015202530354045
Proportion Repoting no Limitations
Disabled Not disabledSelf Identify as Disabled or Not-disabled
Long termTemp
National Center for Health Statistics, CDC
1904/22/23
General Characteristics of Persons Using Assistive Devices, but Reporting No Limitations (Sensory Devices and Limitations Omitted)
25.8% of persons aged 18 to 44 who are long term users of assistive devices report no limitations. Among those 45 to 64, 10.1%, and among those 65+, 5.7%
14.4% of men with long term device use indicate no limitations compared to 8.9% of women.
National Center for Health Statistics, CDC
2004/22/23
General Characteristics of Persons Using Assistive Devices, but Reporting No Limitations (Sensory Devices and Limitations Omitted)(continued)
18.5% of college graduates with long term device use report no limitations while only 5.4% of persons with less than 12 years of education report no limitations.
23.3% of persons using devices with greater than $50,000 family income report no limitations. Proportion lower among lower incomes.
National Center for Health Statistics, CDC
2104/22/23
Several Questions Arise with Prospect of Increasing Availability and Use of Assistive Devices
Is device use enough to include person in count of population with disability?
If not, where do these people fit into the picture?
National Center for Health Statistics, CDC
2204/22/23
Where do Device Users Fit in Prevalence Data?
02468
1012141618
2000 2005 2010 2015 2020 2025
Device Use onlyDisability
National Center for Health Statistics, CDC
2304/22/23
How do Device Users Fit into Disability Measures Used as a Demographic?
83
7 10
35
5
6051
7
42
0102030405060708090
No Disability Disabled Device UseOnly
EmployedIn Labor ForceUnemployed
National Center for Health Statistics, CDC
2404/22/23
Combining Device Use with Disability Indicator
0
10
20
30
40
50
60
Employed In L.F. Unemployed
Device Users OnlyDisabled