Brief ReportDiscrepancy among Behavioral Risk Factor Surveillance System, Social Security, and functional disability measurement
Section snippets
Methods and materials
This study posed the 2 BRFSS disability questions as part of a 69-item survey mailed in June 2009 to participants in the Kansas Medicaid Buy-In program in order to investigate the sensitivity of the questions among those with SSA-determined disabilities. The survey was sent to 1049 people with a 38% return rate; 31 respondents did not answer the BRFSS questions, resulting in a study sample of 368.
Nationally, participants in Medicaid Buy-Ins must meet the SSA definition of disability and have
Results
Within our sample of working-age adults with SSA-determined disabilities, the BRFSS disability questions had a sensitivity of 80.7%; 19.3% would not have been included in the state’s BRFSS disability prevalence estimate. People within all disability-type categories screened less than 100% on the 2 BRFSS questions (Table 1). A chi-square test demonstrated significant differences in negative response rates by disability type (χ2 = 24.227, df = 7, p < .001). People with physical disabilities and
Discussion
The BRFSS questions are intended to identify and track health and risk behaviors. Survey instruments ideally use methods that are quick, low-cost, and repeatable, yet they must balance efficiency with accuracy to serve their purpose. We expect that such instruments as the BRFSS should meet empirical psychometric qualities of reliability and validity.
The SSA definition of disability is quite restricted in its focus on substantial work limitation and is recognized as applying to people with
Conclusion
Data collected under Section 4302 of the ACA will be used to monitor health disparities and quality of care among people with disabilities. Our findings indicate that BRFSS questions would not fully identify this entire population. Currently, questions from the ACS are proposed as the minimum standard for use under Section 4302 [14]. The ACS, with its focus on functional queries is a good foundation but, as our study indicates, additional questions that specifically address intellectual
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The research was funded by the Kansas Health Policy Authority (#KHPA2007-055) through a grant from the U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services.
The authors have no direct or indirect financial or personal relationships, interests, and affiliations relevant to the subject matter of this manuscript that have occurred over the last two years, or that are expected in the foreseeable future.