Exploring the Impact of Assistive Device Use on Disability Measurement Jennifer Madans Beth Rasch Barbara Altman 1/13/2019 National Center for Health Statistics, CDC

What is Being Measured? Disability Prevalence 1/13/2019 National Center for Health Statistics, CDC

What is being Measured? Disability as a Demographic 1/13/2019 National Center for Health Statistics, CDC

Exploring Use of Assistive Devices as a Partial Measure of Disability This analysis examines how assistive device use can effect how a global measure of disability is developed. The issues raised also apply to other measurement of participation or environment. 1/13/2019 National Center for Health Statistics, CDC

Choices of Basis of Measurement Questions can be structured to capture: Body/structure impairments Activity limitations Limitations in participation Environmental factors Includes device use How do these types of measures combine to influence the two uses of measures? 1/13/2019 National Center for Health Statistics, CDC

National Center for Health Statistics, CDC Data Source The data used in this analysis come from the National Health Interview Survey – Disability Supplement collected in the U.S. in 1994-95. Sample includes adults, aged 18 and over 1/13/2019 National Center for Health Statistics, CDC

Variety of Question Format – Mobility Devices and Braces Questions asked of or about everyone: Example: Does anyone in the family now use any of these aids to get around? (a cane, crutches, walker, medically prescribed shoes, a wheelchair, or a scooter?) Which aids does –use? Has – used or is – expected to use (aid identified) for 12 months or longer? 1/13/2019 National Center for Health Statistics, CDC

Types of Equipment Use Reported 1/13/2019 National Center for Health Statistics, CDC

Duration of Equipment Use Among Equipment Users 1/13/2019 National Center for Health Statistics, CDC

National Center for Health Statistics, CDC Report of No Limitation in Mobility Functions Among Mobility Device Users 1/13/2019 National Center for Health Statistics, CDC

Report of No Mobility Limitations Among Persons with Brace Use 1/13/2019 National Center for Health Statistics, CDC

Variety of Question Formats – Hearing Devices (or Vision) Does anyone in the family now use a hearing aid? Asked of everyone. (Besides a hearing aid), Does – now use an amplifier for the telephone, a TDD, TTY or teletype, closed caption TV, assistive listening or signaling devices, an interpreter, or any other equipment for people with hearing impairments? ASKED ONLY OF PERSONS WHO REPORTED HAVING TROUBLE HEARING AND EXPECTING TO HAVE IT FOR AT LEAST 12 MONTHS 1/13/2019 National Center for Health Statistics, CDC

Report of Hearing Limitations Among Persons with Hearing Aid Use 1/13/2019 National Center for Health Statistics, CDC

National Center for Health Statistics, CDC Report of Hearing Limitations among Persons with Other Hearing Equipment Use 1/13/2019 National Center for Health Statistics, CDC

National Center for Health Statistics, CDC Report of ADL Difficulty or Need for Help Among Persons with ADL Device Use 1/13/2019 National Center for Health Statistics, CDC

Report of Limitations in Major Activities by Persons with Device Use 1/13/2019 National Center for Health Statistics, CDC

National Center for Health Statistics, CDC Do Persons Who Use Devices Report Any Type of Activity Limitation? (Sensory Devices and Limitations Omitted) 1/13/2019 National Center for Health Statistics, CDC

National Center for Health Statistics, CDC Influence of Self Identity as Disabled on Reporting No Limitations Among Users of Devices (Sensory Data Omitted) 1/13/2019 National Center for Health Statistics, CDC

National Center for Health Statistics, CDC General Characteristics of Persons Using Assistive Devices, but Reporting No Limitations (Sensory Devices and Limitations Omitted) 25.8% of persons aged 18 to 44 who are long term users of assistive devices report no limitations. Among those 45 to 64, 10.1%, and among those 65+, 5.7% 14.4% of men with long term device use indicate no limitations compared to 8.9% of women. 1/13/2019 National Center for Health Statistics, CDC

National Center for Health Statistics, CDC General Characteristics of Persons Using Assistive Devices, but Reporting No Limitations (Sensory Devices and Limitations Omitted)(continued) 18.5% of college graduates with long term device use report no limitations while only 5.4% of persons with less than 12 years of education report no limitations. 23.3% of persons using devices with greater than $50,000 family income report no limitations. Proportion lower among lower incomes. 1/13/2019 National Center for Health Statistics, CDC

National Center for Health Statistics, CDC Several Questions Arise with Prospect of Increasing Availability and Use of Assistive Devices Is device use enough to include person in count of population with disability? If not, where do these people fit into the picture? 1/13/2019 National Center for Health Statistics, CDC

Where do Device Users Fit in Prevalence Data? 1/13/2019 National Center for Health Statistics, CDC

National Center for Health Statistics, CDC How do Device Users Fit into Disability Measures Used as a Demographic? 1/13/2019 National Center for Health Statistics, CDC

Combining Device Use with Disability Indicator 1/13/2019 National Center for Health Statistics, CDC