1. … the work of the Washington Group on Disability Statistics Jennifer H. Madans National Center for Health Statistics, USA for the Washington Group on Disability Statistics 1/21/2016 1

2.  June of 2001-- the UN International Seminar on the Measurement of Disability, based on a broad consensus on need for population based measures of disability, recommended the development of principles and standard forms for global indicators of disability to be used in censuses.  The Washington Group, made up of representatives from national statistical offices, has pursued these goals over the past 10 years with recognized success. 1/21/2016 2

3.  Foster international cooperation in the area of health and disability statistics  Untangle the web of confusing and conflicting disability estimates  Develop a short set of general disability measures  Develop extended set/s of items to measure disability on population surveys  Address methodological issues associated with disability measurement  Produce internationally tested measures for use to monitor status of disabled populations. 1/21/2016 3

4. The Definitional Paradox  There is no single operational definition of disability  Different operational definitions lead to different estimates  The question you are trying to answer (the purpose) will determine which definition to use  Need to understand the choices that are being made when choosing a definition 1/21/2016 4

5. Health Condition (disorder/disease) Body Function & Structure (Impairment) Participation (Restriction) Environmental Factors Personal Factors Source: World Health Organization, 2001 Locating Risk in the ICF Model ? 5

6.  Identify those at greater risk than the general population for limitations in participation  Defined by the ability to carry out basic actions (walking, seeing, remembering, etc) 1/21/2016 % Employed 6

7. Because of a Health problem: 1) Do you have difficulty seeing even if wearing glasses? 2) Do you have difficulty hearing even if using a hearing aid? 3) Do you have difficulty walking or climbing stairs? 4) Do you have difficulty remembering or concentrating? 5) Do you have difficulty with (self-care such as) washing all over or dressing? 6) Using your usual (customary) language, do you have difficulty communicating (for example understanding or being understood by others)? Response categories: No - no difficulty; Yes - some difficulty; Yes - a lot of difficulty; Cannot do at all 1/21/2016 7

8. Core Domain Some difficulty A lot of difficulty Unable To do it Vision4.72.60.5 Hearing3.72.30.5 Mobility5.13.80.8 Remembering2.01.50.3 Self-Care2.01.30.4 Communicating2.11.40.5 At least: 8

9. 1/21/2016 Person with disability has:N% at least 1 Domain is ‘some difficulty’405314.5 at least 2 Domains are ‘some difficulty’309011.0 at least 1 Domain is ‘a lot of difficulty’23688.5 at least 1 Domain is ‘unable to do it’6732.4 9

10.  By standardizing these questions it will be possible to provide comparable data cross- nationally for populations living in a variety of cultures with varying economic resources;  Data can be used to assess a country’s compliance with the UN Convention and, over time, their improvement in meeting the requirements set out under the Convention. 1/21/2016 10

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12. Year of survey 2006/2008 Follow-up Survey 2012 Country With disability Without disability With disability Without disability Mozambique3827 Uganda4216 Zambia2310 Brazil308 Tanzania4221 Vietnam306 South Africa236 1/21/2016 12

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14.  Background information,  WG Objectives,  Summaries of all meetings, including all papers and presentations are posted on the Washington Group website: http://www.cdc.gov/nchs/washington_ group.htm 1/21/2016 14