Chartbook on Disability in New York State, 1998 - 2000
This chartbook represents results from three years of administration of the BRFSS in New York State and includes detailed information on the prevalence of disability in the state. Due to certain inherent features of the BRFSS, however, it is likely that the true prevalence of disability may be underreported in the target population. For example, in a telephone survey, it is more likely that persons with hearing limitations may have difficulties in responding. Moreover, persons with mobility impairments may have difficulty in getting to a phone to participate in an interview. Given that the BRFSS only targets the adult, noninstitutionalized population, the survey cannot assess disability among the population under 18 years of age, nor can it measure disability among the institutionalized population, which carries a substantial burden of activity limitation. With these caveats in mind, the major findings from the analysis of three years of BRFSS data are summarized as follows:
- Compared to the general population, persons with disabilities were more likely to have reported lower educational attainment and more likely to be in a lower income bracket. They were far more likely to be unemployed, primarily because their disability prevented them from working.
- The prevalence of disability among adult New Yorkers was found to vary directly by age and inversely by levels of education and household income. The association of disability with racial and ethnic groups was not as clear-cut, but some evidence was found for a greater impact among non-Hispanic blacks. Gender differences were evident primarily among women who reported needing assistance in everyday activities.
- The primary identifiable causes of limitation among younger individuals with disabilities were back and neck problems. Among the older age groups, arthritis was the predominant activity-limiting impairment.
- In general, persons with disabilities reported similar levels of health insurance coverage as the general population, although that coverage was more likely to be under public programs, particularly Medicare. They also tended to get regular routine medical checkups on a more frequent basis than the general population. However, even when insured they were more likely to report at least one recent incident in which cost prevented them from making a needed visit to the doctor. Persons with disabilities were at least as likely as, if not more likely than, the rest of the population to have had recommended colorectal cancer screening procedures, recent blood cholesterol checks, and recommended immunizations. Moreover, women with disabilities were at least as likely as the rest of the population to have had timely mammograms, clinical breast exams, and Pap smears. Compared to persons without disabilities, however, those with disabilities were less likely to have had a recent dental visit.
- Quality of life measures showed substantial differences by disability status. When compared to the general population, respondents with disabilities were more likely to rate their health status as fair or poor, were more dissatisfied with life, and less likely to get needed social or emotional support. Furthermore, individuals with disabilities reported more recent impaired health days across all measures, but especially for physical, mental, activity limitation, pain, depression, and low vitality.
- Persons with disabilities reported more chronic health conditions such as arthritis, diabetes, asthma, hypertension, high blood cholesterol, myocardial infarction, and stroke. They were somewhat more likely to be current smokers. They were also more likely to be overweight or obese and less likely to get regular exercise. They were just as likely as the rest of the population to consume at least five servings of fruits and vegetables daily.
Disability is a major health burden across the entire age spectrum. Historically, it has been equated with inferior health status, with the health needs of persons with disabilities considered only in relation to their particular limitations. Often the management of the primary disabling condition has been the overriding concern, with less attention paid to the generally recommended standards of health screening and disease prevention.
One of the two overarching goals stated in Healthy People 2010 is to increase the quality and years of healthy life.3 Given the aging of the population and the accompanying increase in the risk of chronic disease, efforts toward identifying and intervening on factors that link disability, depression, and quality of life must continue.23 Life with a chronically limiting condition can have substantial negative effect on perceived quality of life, but this effect is neither inevitable nor immutable.23 As we continue progress toward meeting the objectives of Healthy People 2010, the measurement and surveillance of disability indicators will be critical to monitoring the effectiveness of programs designed to reduce secondary conditions, promote better health behaviors, and improve quality of life among persons with disabilities. Any approach to monitoring the status of the population of individuals with disabilities must include a broad range of measures. Although the NYSDOH Disability and Health Program has focused its public health interventions primarily on persons with mobility impairments, it will continue to monitor all aspects of the disability issue under its guiding document, the New York State Strategic Plan for Health Promotion for Persons with Disabilities.