Disability

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Disability Measure Definitions
Population Resident adults aged ≥18 years.
Numerator Respondents were asked to report on the presence of six disability types using a six-item set of standard disability questions.1 See each disability type (hearing, vision, cognition, mobility, self-care, independent living) and any disability for numerator definitions and related survey questions.
Denominator Respondents aged ≥18 years (excluding those who refused to answer, had a missing answer, or answered “don’t know/not sure” for six individual types of disability. For “any disability,” excluding refused, missing, and “don’t know/not sure” for all six questions).
Measure frequency Annual prevalence (crude, age-adjusted)
Time Period of Case Definition Current
Data Source Behavioral Risk Factor Surveillance System (BRFSS)
Summary In 2020, 1 in 4 US adults reported at least one of the following disability types: hearing, vision, cognition, mobility, self-care, and independent living.2 Mobility was the most prevalent disability type reported (11.1%), followed by cognition (10.9%), independent living (6.4%), hearing (5.7%), vision (4.9%), and self-care (3.0%).2 Prevalence of any disability and specific disability types varies by state, demographic characteristics, and presence of general health conditions and chronic conditions.2 National and state estimates of the prevalence of disability in US adults are available at Disability and Health Data System (DHDS)2 and BRFSS Prevalence & Trends Data.3

 

To be healthy, all people with or without disabilities must have opportunities to take part in meaningful daily activities that add to their growth, development, fulfillment, and community contribution. Assessment of disability highlights opportunities and areas for improvement for people with disabilities, including opportunities to fully participate in and benefit from public health activities, receive well-timed interventions and services, interact with their environment without barriers, and participate in everyday life activities.4
Limitations of Indicator The six-item disability standard series of questions represents a minimum standard, and the questions and answer categories cannot be changed.1 The six questions provide a conservative estimate in that they emphasize “serious” difficulty doing functions, thus potentially excluding people with less severe impairments.5 As with all self-reported sample surveys, BRFSS data might be subject to systematic error resulting from noncoverage, nonresponse, or measurement bias. Prevalence estimates of disability have been shown to vary across surveys with differences attributed to several factors, including survey context, assessment, design, and administration.6 County estimates of disability prevalence generated using the PLACES approach were moderately correlated with direct estimates from the American Community Survey, which is typical in small-area estimation validation studies when comparing data from different surveys.7

 

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Hearing Disability Among Adults Aged ≥18 Years
Numerator Respondents aged ≥18 years who answered “yes” to the question “Are you deaf or do you have serious difficulty hearing?”.

 

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Vision Disability Among Adults Aged ≥18 Years
Numerator Respondents aged ≥18 years who answered “yes” to the question “Are you blind or do you have serious difficulty seeing, even when wearing glasses?”.

 

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Cognitive Disability Among Adults Aged ≥18 Years
Numerator Respondents aged ≥18 years who answered “yes” to the question “Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?”.

 

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Mobility Disability Among Adults Aged ≥18 Years
Numerator Respondents aged ≥18 years who answered “yes” to the question “Do you have serious difficulty walking or climbing stairs?”.

 

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Self-care Disability Among Adults Aged ≥18 Years
Numerator Respondents aged ≥18 years who answered “yes” to the question “Do you have difficulty dressing or bathing?”.

 

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Independent Living Disability Among Adults Aged ≥18 Years
Numerator Respondents aged ≥18 years who answered “yes” to the question “Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office or shopping?”.

 

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Any Disability Among Adults Aged ≥18 Years
Numerator Respondents aged ≥18 years who answered “yes” to at least one of six disability questions below:
  • “Are you deaf or do you have serious difficulty hearing?”
  • “Are you blind or do you have serious difficulty seeing, even when wearing glasses?”
  • “Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?”
  • “Do you have serious difficulty walking or climbing stairs?”
  • “Do you have difficulty dressing or bathing?”
  • “Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor´s office or shopping?”

 

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References

  1. Implementation guidance on data collection standards for race, ethnicity, sex, primary language, and disability status. US Department of Health and Human Services; 2011. Accessed March 8, 2023. http://aspe.hhs.gov/datacncl/standards/ACA/4302/index.shtml
  2. Centers for Disease Control and Prevention. Disability and Health Data System (DHDS) Data. Accessed February 7, 2023. https://dhds.cdc.gov/
  3. Centers for Disease Control and Prevention. BRFSS Prevalence & Trends Data. Accessed December 16, 2022. https://www.cdc.gov/brfss/brfssprevalence/
  4. National Center for Health Statistics. Chapter 9: Disability and Health. Healthy People 2020 Midcourse Review; 2016. https://www.cdc.gov/nchs/data/hpdata2020/HP2020MCR-C09-DH.pdf [PDF – 358 KB]
  5. McGuire DO, Watson KB, Carroll DD, Courtney-Long EA, Carlson SA. Using two disability measures to compare physical inactivity among US adults with disabilities. Prev Chronic Dis. 2018;15:E08. doi: 10.5888/pcd15.170261
  6. Lauer EA, Houtenville AJ. Estimates of prevalence, demographic characteristics and social factors among people with disabilities in the USA: a cross-survey comparison. BMJ Open. 2018;8:e017828. doi: 10.1136/bmjopen-2017-017828
  7. Lu H, Wang Y, Liu Y, Holt JB, Okoro CA, Zhang X, et al. County-Level Geographic Disparities in Disabilities Among US Adults, 2018. Prev Chronic Dis 2023;20:230004. doi: http://dx.doi.org/10.5888/pcd20.230004.
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