exploring the impact of assistive device use on disability measurement

National Center for Health Statistics, CDC

104/22/23

Exploring the Impact of Assistive Device Use on Disability Measurement

Jennifer MadansBeth Rasch

Barbara Altman


204/22/23

What is Being Measured? Disability Prevalence

0

5

10

15

20

25

2005 2010 2015 2020 2025 2030

% with Disability


304/22/23

What is being Measured?Disability as a Demographic

83

710

35

5

60

0102030405060708090

No Disability Disabled

EmployedIn Labor ForceUnemployed


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.


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?


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


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?


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


904/22/23

Duration of Equipment Use Among Equipment Users

92.1

7.9

0102030405060708090

100

Long TermTemp


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


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


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


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


1404/22/23

Report of Hearing Limitations among Persons with Other Hearing Equipment Use

0

97.4

2.6

0102030405060708090

100

NoneMild/ chronicSevere


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


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


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


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


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.


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.


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?


2204/22/23

Where do Device Users Fit in Prevalence Data?

02468

1012141618

2000 2005 2010 2015 2020 2025

Device Use onlyDisability


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


2404/22/23

Combining Device Use with Disability Indicator

0

10

20

30

40

50

60

Employed In L.F. Unemployed

Device Users OnlyDisabled

exploring the impact of assistive device use on disability measurement

Documents

health statistics

reportednational center

overnational center

demographicnational

monthsnational center

hearing aid usenational

equipment usersnational

brace usenational center