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Abstract
Objective A national priority for disability research in the USA is the standardised identification of people with disabilities in surveillance efforts. Mandated by federal statute, six dichotomous difficulty-focused questions were implemented in national surveys to identify people with disabilities. The aim of this study was to assess the prevalence, demographic characteristics and social factors among people with disabilities based on these six questions using multiple national surveys in the USA.
Setting American Community Survey (ACS), Current Population Survey Annual Social and Economic Supplement (CPS-ASEC), National Health Interview Survey (NHIS) and the Survey of Income and Program Participation (SIPP).
Participants Civilian, non-institutionalised US residents aged 18 and over from the 2009 to 2014 ACS, 2009 to 2014 CPS-ASEC, 2009 to 2014 NHIS and 2008 SIPP waves 3, 7 and 10.
Primary and secondary outcome measures Disability was assessed using six standardised questions asking people about hearing, vision, cognition, ambulatory, self-care and independent living disabilities. Social factors were assessed with questions asking people to report their education, employment status, family size, health and marital status, health insurance and income.
Results Risk ratios and demographic distributions for people with disabilities were consistent across survey. People with disabilities were at decreased risk of having college education, employment, families with three or more people, excellent or very good self-reported health and a spouse. People with disabilities were also consistently at greater risk of having health insurance and living below the poverty line. Estimates of disability prevalence varied between surveys from 2009 to 2014 (range 11.76%–17.08%).
Conclusion Replicating the existing literature, we found the estimation of disparities and inequity people with disabilities experience to be consistent across survey. Although there was a range of prevalence estimates, demographic factors for people with disabilities were consistent across surveys. Variations in prevalence estimates can be explained by survey context effects.
- disability
- surveillance
- survey methods
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Footnotes
Contributors EAL contributed to the study design, created and coded datasets, conducted all analyses and produced (and edited) the initial manuscript. AJH contributed to the study design, analytic choices, interpretation of results and edited the manuscript.
Funding This research report is a product of the Rehabilitation Research and Training Center on Disability Statistics and Demographics (grant number 90RT5022-02-01), which is funded by the US Department of Health and Human Services’ Administration For Community Living, National Institute for Disability, Independent Living, and Rehabilitation Research under cooperative agreement H133B130015.
Disclaimer This article does not necessarily represent the policy of the US Department of Health and Human Services, and readers should not assume endorsement by the Federal Government (Edgar, 75.620 (b)).
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Datasets are publicly available from the US Census Bureau and US Centers for Disease Control and Prevention National Center for Health Statistics websites.