Research Paper
An evaluation of the American Community Survey indicators of disability

An earlier version of some of the data was presented by the first author with co-author Julie Weeks at a State of the Science Meeting in Washington DC, in April, 2012.
https://doi.org/10.1016/j.dhjo.2017.03.002Get rights and content

Abstract

Background

Collection of data in the Census for implementing disability legislation has been continuous since 1970 although the questions used have changed several times. Concerns have been raised about the ability of the newest question set developed for the American Community Survey (ACS) to adequately represent the population with disabilities because it does not capture all those eligible for certain benefit programs.

Objective

Using national data, we examine how the addition of questions on the receipt of SSI/SSDI changes the composition of the population identified by the ACS measures. In ancillary materials we also examine the addition of a work limitation question to the population identified by ACS measures.

Methods

Using descriptive secondary analysis of 2011 NHIS data we compare the characteristics of those identified by the ACS questions to those identified by the ACS questions and receipt of SSI/SSDI and those only receiving SSI/SSDI. The comparison is based on conditions, specific functional limitations and severity of limitation.

Results

The results provide evidence ACS questions identify a population representing persons at risk for participation difficulties including those who receive SSI/SSDI. The ACS population has higher proportions with mental health and development disabilities than comparison population. The ancillary data demonstrates the work limitation question does not make a significant difference in identifying recipients of SSI/SSDI.

Conclusion

The analysis demonstrates that the disability measures developed for the ACS produce an unbiased picture of the population with disabilities by including persons with all conditions, more severe disability or selected types of functional limitations.

Section snippets

Methodology/analysis

NHIS data from 2011 were used for this analysis. NHIS collects information about the health and health care of the civilian noninstitutionalized population of the United States from a representative sample of households across the country, and is conducted continuously throughout the year by NCHS. Persons excluded from the NHIS include patients in long-term care institutions, correctional facilities and U.S. nationals living in foreign countries. Interviews are conducted in the respondents'

Results

Agreement between the ACS question set and receipt of SSI/SSDI – Table 2 describes the relationship between the populations identified by the ACS and SSI/SSDI questions. Population counts and the percent distribution of the total adult population ages 18–64 categorized by responses to the ACS and the SSI/SSDI questions is provided. In addition, the percentage distribution of the population defined by a positive response to any of the ACS questions and the percentage distribution of the

Discussion

We used data from the 2011 NHIS to investigate the relationship of the ACS disability questions and the questions on receipt of SSI/SSDI benefits. We describe the conditions and functional limitations of those identified as having a disability by the ACS question set; those receiving SSI/SSDI who are also identified by the ACS questions; and those who receive SSI/SSDI but are not captured by the ACS questions. The results demonstrate that the ACS questions alone can be used to inform policy

Conclusion

There are many purposes for identifying a population with disabilities and the questions used to define the relevant populations will depend on the purpose for which the data are being collected. To monitor the Americans with Disabilities Act (ADA) it is necessary to track the status of a broadly defined group to determine if persons with a disability are fully included in society. The context of the 1990 Americans with Disabilities Act extends civil rights and equalization of opportunity to a

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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    Further, Altman et al. (2017) finds concordance in disability characteristics between the population endorsing the six-question set and those receiving benefits. The concordance reported by Altman et al. (2017) may actually be greater if their analyses controlled for transitory and enduring disabilities because there may be some people who answer the ACS questions due to acute (e.g., transitory) limitations and, thus, may not be receiving benefits. More work is needed to develop measures that distinguish individuals who experience a long-term disability from those with transitory disability.

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