measuring disability: results from the 2001 census and the 2001 post-censal disability survey...
TRANSCRIPT
Measuring Disability: Results from the 2001 Census and the 2001 Post-Censal Disability Survey
Statistics CanadaJanuary 10, 2003
Post-Censal Survey Approach
First phase: 2001 CensusSecond phase: Participation and Activity
Limitation Survey - PALS 2001
Objective
develop a comprehensive database on persons with disabilities:
to assist social policy development by governments of all levels
to support research in the area of disability
Survey Description
PALS collects information on: type and severity of disabilities needs and unmet needs for assistive devices and
social support disability impacts in various environments:
home life; school or work; community life socio-demographic characteristics of persons
with disabilities
Definition of Disability
Conceptual framework provided by the International Classification of Functioning, Disability and Health (ICF)
an activity limitation or participation restriction associated with physical or mental conditions or health problems, recognizing the role of the environment as providing barriers or facilitators
PALS Target PopulationAdults (15 and over) and children (under
15): residing in households residing in all provinces reporting an activity limitation
Exclusions: population in three northern territories institutional residents persons living on First Nations reserves
Overview of MethodologyTwo-phase surveyPopulation selected through two filter
questions on 2001 Census questionnaireRespondents contacted by phone about four
months after censusPALS repeats filter questions and uses
additional disability screening questions
2001 Filter Questions
1. Does this person have any difficulty hearing, seeing, communicating, walking, climbing stairs, bending, learning or doing any similar activities?
- Yes, sometimes
- Yes, often
- No
2001 Filter Questions (cont ’d)2. Does a physical condition, mental condition or health problem
reduce the kind or amount of activity this person can do:At home? - Yes, sometimes
- Yes, often- No
At work or at school? - Yes, sometimes- Yes, often- No- Not applicable
In other activities, such as transportation or leisure?- Yes, sometimes- Yes, often- No
2001 PALS Operational Definition1. Selection of sample of positive respondents to census filter questions
2. Population with disabilities = YES to filters at census and
YES to filters at PALS orYES to detailed disability screening questions in PALS
NO
YES
Not sampled
Filter Questions (PALS)
YES
In population
NOScreening Questions (PALS)
YES NONot in population
Filter Questions (Census)
Operational Definition
Data Collection
Mostly telephone interviewsPersonal interviews when required because
of activity limitationProxy interviews kept to minimumPaper and pencil questionnairesSeptember 2001 to January 2002
Sample Size
Total sample size = 43,000 35,000 adults 8,000 children
Response rate: 82.5%
Adult Questionnaire Content
Detailed disability screening questions derived variables include type and severity of
disability
Aids and assistive devices required needs and unmet needs information on costs
Help with everyday activities needs and unmet needs information on providers and costs
Adult Questionnaire (cont ’d)Impacts on education
aids and services requiredEmployment status
aids and services required impacts on employment
Social participation transportation, leisure, housing
Economic characteristics sources of income, insurance coverage
Child Questionnaire Content
Detailed disability screening questions derived variables include type and severity of
disability
Aids and assistive devices required needs and unmet needs information on costs
Help with everyday activities including impact on the family
Child Questionnaire (cont ’d)
Child care issuesImpacts of disability on schoolingImpacts on leisure and recreationAccommodations required in the homeTransportation requirementsEconomic characteristics of the family
SEVERITY SCALE
1. Adult Severity Scale1.1 Disability types and variables
10 disability types: hearing, seeing, speech, mobility, agility, pain, learning
or developmental, memory, psychological
Points for each functional limitation within each disability type
ex. difficulty hearing in a conversation with one person, at least 3 persons, telephone conversation
Number of functional limitations and contexts for each disability type
Disability type Functionallimitations
Contexts
1. Hearing2. Seeing
32
GeneralGeneral
3. Speech4. Mobility
25
Fami., friends, serv., othersGeneral
5. Agility6. Pain
71
GeneralHome, work, school, other
7. Learning8. Memory
11
Home, work, school, otherHome, work, school, other
9. Developmental10. Psychological
11
Home, work, school, otherHome, work, school, other
1.2 Scoring MethodOne point for each functional limitation weighted
by the product of the frequency and the intensity frequency: yes sometimes (1 pt), yes often (2 pts) intensity: some difficulty (1 pt), a lot of difficulty (2
pts), completely unable (3 pts) Mean number of points per applicable context 0 to 1 standardised score for each disability type
Combining all applicable functional limitations
Scores for each type added up and divided by 9 global score between 0 and 1
Distribution of Severity Score
0
0,05
0,1
0,15
0,2
0,25
0,3
0,35
0,4
0 10 20 30 40 50 60 70 80 90 100
PERCENTILE
SE
VE
RIT
Y S
CO
RE
1.3 Cut-off points
No natural cut-offs in global score distributionNeed simple method, easy to eplainFirst cut-off where score curve accelerates
Cut-off very close to 1/9 (max #pts for one type only)
Subdivision of the 2 groups into 4 groups Mild score < 1/18 Moderate (1/18 score < 1/9) Severe (1/9 score < 2/9) Very severe score 2/9
2. Children Severity ScaleSame principles as adult scaleOne scale for 0-4 years old
4 disability types : hearing, seeing, developmental delay, chronic condition
2 severity groups only
One scale for the 5-14 years old 9 disability types: hearing, seeing, speech, walking,
dexterity, learning or developmental disability, psychological, chronic condition
4 severity groups as for the adults
RESULTS
2001 Census
2001 PALS
Disability Rates by Age Group, Census and PALS, 2001(Population in households)
Age GroupsCensus PALS
All Ages 16.0 12.40-14 5.0 3.315 + 18.6 14.615-64 13.0 9.965+ 49.6 40.5
Percentage of “YES to Census Respondents” Indicating aDisability in PALS, by Filter Question, 2001
Filter Question All Ages 0-14 15+ 15-64 65+
Do you have anydifficulty …
81.9 74.2 82.3 80.9 83.9
Limitation athome
85.2 84.2 85.3 85.1 85.5
Limitation atwork / school
76.0 73.1 76.4 75.8 82.1
Limitation inother activities
83.2 75.9 83.6 82.4 85.3
Any filterquestion
77.6 65.3 78.4 76.2 81.5
4.0 3.86.6
15.9
30.2
52.1
2.5 4.07.5
17.5
32.0
54.1
0
10
20
30
40
50
60
0-14 15-24 25-44 45-64 65-74 75+
Males
Females
Chart 1
Disability rate by age and sex, Canada, 2001¹
Percentage
Age groups
¹ The Canada total excludes the Yukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding.
Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.
4.7
10.3
15.513.0
21.9
32.8
34.6
46.6
68.9
67.262.3
58.0
37.6
26.9
24.8
17.6
13.8
12.6
8.9
2.3
0 10 20 30 40 50 60 70 80
Unknown
Seeing
Hearing
Mobility
Dexterity
Developmental
Psychological
Speech
Learning
Chronic
Males
Females
Chart 2
Types of disabilities among children with disabilities aged 5 to 14 years, by sex, Canada, 2001¹
Percentage
¹ The Canada total excludes the Yukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding.
Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.
NEXT STEPS
Further analysis of disability rates from filter questions in surveys
development of severity scale for filter questions
analysis of characteristics of disabled population identified in various surveys