1. Coding NCHS Survey Questions on Disability using the International Classification of Functioning, Disability, and Health Gerry E. Hendershot, Ph.D. Consultant on Disability and Health Statistics

2. Overview International Classification of Functioning, Disability, and Health (ICF) United Nations reporting categories Illustrations of coding NCHS survey questions to ICF categories Summary of NCHS survey coverage of ICF/UN categories

3. The ICF Approved by World Health Assembly Available in six official languages Searchable Web and CD versions www.who.int/icidh

4. Health Condition ( disorder/disease ) Environmental Factors Personal Factors Body function&structure (Impairment) Activities(Limitation)Participation(Restriction)

5. Classification Parts Components Domains and categories at different levels at different levels ICF Part 1: Functioning and Disability Part 2: Contextual Factors Body Functions and Structures ActivitiesandParticipation Environ- mental FactorsPersonalFactors (Not covered) Item levels: 1 st 2 nd 3 rd Item levels: 1 st 2 nd 3 rd Item levels: 1 st 2 nd 3 rd

6. d4500, Walking short distances d450, walking: Moving along a surface on foot, step by step, so that one foot is always on the ground, such as when strolling, sauntering, walking forwards, backwards, or sideways. d4500, walking short distances: walking for less than a kilometre, such as walking around rooms or hallways, within a building or for short distances outside.

7. UN disability categories 1. Seeing, even with glasses 2. Hearing, even with aid 3. Speaking, includes talking 4. Moving/mobility, includes walking, climbing, standing 5. Body movement, includes reaching, crouching, kneeling 6. Gripping/holding, includes using fingers to grip objects 7. Learning, including intellectual difficulties, retardation 8. Behavioral, includes psychological, emotional 9. Personal care, includes bathing, dressing, feeding

8. NHIS on walking By yourself and without using aids, do you have any difficulty walking a quarter of a mile (that is about 2 or 3 blocks)? [ If yes] How much difficulty do you have, some, a lot, or are you unable to do it?

9. NHANES on walking By yourself and without any special equipment, how much difficulty do you have walking for a quarter of a mile [that is about 2 or 3 blocks]? No difficulty, some difficulty, much difficulty, unable to do?

10. b230, hearing functions Sensory functions relating to sensing the presence of sounds and discriminating the location, pitch, loudness and quality of sounds. Inclusions: functions of hearing, auditory discrimination, localization of sound source, lateralization of sound, speech discrimination; impairments such as deafness, hearing impairment and hearing loss

11. LSOA on hearing Do you NOW have deafness in both ears? Deafness in one ear? Any other trouble hearing with one or both ears?

12. NNHS on hearing Does … have any difficulty in hearing (when wearing a hearing aid)? Is …”s hearing (when wearing a hearing aid) partially, severely, or completely impaired, as defined on this card? Deaf: “can hear only a few words a person says or loud noises.”

13. NCHS surveys covered in study Nat’l Health Interview Survey Nat’l Health & Nutrition Exam. Survey Longitudinal Studies of Aging Nat’l Nursing Home Survey Nat’l Home & Hospice Care Survey Nat’l Mortality Followback Survey

14. NCHS Coverage of ICF/UN Categories See Hear Speak Move Body

15. NCHS Coverage of ICF/ UN Categories Grip Learn Behave Care All

16. In conclusion...