Chartbook on Disability in New York State, 1998 - 2000

Chronic Health Conditions

The prevalence of chronic diseases increases with age and is a major cause of disabling conditions. Unlike acute conditions and injuries, chronic diseases often do not have an identifiable point of onset, and they frequently entail gradually progressive declines in functional capacity.1

People with chronic disease are at increased risk of functional limitation and disability, and, absent effective preventive measures, the quality of their lives is also likely to decline.1 Primary prevention efforts are targeted toward health habits such as smoking, obesity, nutrition, and physical activity, and also include immunization for diseases such as influenza and pneumonia. Secondary prevention measures, on the other hand, seek to halt, reverse, or at least retard the progress of a condition, and are thus especially important for people with chronic disease. Secondary prevention efforts include screening for conditions such as hypertension, diabetes, colorectal cancer, breast cancer, and cervical cancer. These efforts also focus on areas such as stroke prevention and prevention of myocardial infarction.

This section highlights the prevalence by disability status of seven chronic conditions that are significant causes of disability across the age spectrum: arthritis, diabetes, asthma, hypertension, high blood cholesterol, history of myocardial infarction (heart attack), and history of stroke. Arthritis has been found to be associated with a broad array of activity limitations. Heart disease, on the other hand, has been associated with difficulties in activities requiring endurance, and stroke has been associated with upper extremity and self-care tasks.18 Diabetes has been found to be a significant cause of mobility impairments.19,20 Hypertension and high blood cholesterol, although chronic conditions in their own right, are more important as risk factors for other health problems such as cardiovascular disease and stroke. Items to assess diabetes prevalence were a part of the BRFSS from 1998 to 2000. Questions on asthma were included in the 1999 and 2000 BRFSS questionnaires. Items on hypertension awareness, cholesterol awareness, and cardiovascular disease were offered only on the 1999 BRFSS survey. An arthritis module was included as an optional module on the 2000 NYS BRFSS administration. Each condition is presented separately on the following pages, although it is recognized that the presence of multiple chronic conditions has a significant impact on disability status, and that many people, especially the elderly, have multiple chronic and potentially disabling conditions.1

Arthritis

Questions: During the past 12 months, have you had pain, aching, stiffness or swelling in or around a joint? [If "yes"] Were these symptoms present on most days for at least one month? Have you ever been told by a doctor that you have arthritis?

Persons with disabilities were far more likely to report arthritis (either physician-diagnosed or chronic joint symptoms) than were those with no disabilities. The prevalence differences were greatest between the subgroup needing assistance and the group without disabilities across all age groups. In the 18-44 years age group, 59.2% of those requiring assistance reported arthritis, compared to 32.9% of those needing no assistance and only 12.9% of those with no disabilities. The comparable arthritis totals for the 45-64 years age group were 80.0%, 66.6%, and 31.8%, respectively. In the oldest age group (65+ years), over 70% of both disability subgroups reported arthritis, compared to 48.4% of those with no disabilities. [Appendix B: Table B-9]

Persons with disabilities, especially those needing assistance, were more likely to report arthritis than were those with no disabilities.

Prevalence of Arthritis among New Yorkers, by Age Group and Disability Status

Diabetes

Question: Have you ever been told by a doctor that you have diabetes?

In all age categories, respondents with disabilities requiring assistance were most likely to report a doctor diagnosis of diabetes, followed in order by those needing no assistance and those with no disabilities. Particularly striking were the results among those aged 45-64 years old, as 25.6% of persons with disabilities requiring assistance reported doctor-diagnosed diabetes, compared to 15.5% of those needing no help, and 6.2% of those with no disabilities. [Appendix B: Table B-9]

Persons with disabilities were more likely to report diabetes than were those with no disabilities.

Prevalence of Diabetes among New Yorkers, by Age Group and Disability Status

Asthma

Questions: Did a doctor ever tell you that you had asthma? [If "yes"] Do you still have asthma?

Asthma prevalence varied by disability status. The greatest range was found in the 45-64 years age group, with 20.8% of those needing assistance reported current doctor-diagnosed asthma, compared to 4.9% prevalence among those with no disabilities. Regardless of age, persons in both disability subgroups were more likely to report asthma than were those without disabilities. [Appendix B: Table B-9]

Persons with disabilities were more likely to report asthma than were those with no disabilities.

Prevalence of Asthma among New Yorkers, by Age Group and Disability Status

Hypertension

Questions: About how long has it been since you last had your blood pressure taken by a doctor, nurse, or other health professional? [If not "never"] Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?

The prevalence of hypertension, considered both a chronic condition as well as a risk factor for other adverse health problems such as stroke, was greater among persons with disabilities compared to those with no disabilities in all three age groups. The greatest range of estimates was in the 18-44 years age group, with 34.0% of those requiring assistance reporting a history of hypertension, compared to 9.7% of those without disabilities. [Appendix B: Table B-10]

Persons with disabilities were more likely to report hypertension than were those with no disabilities.

Prevalence of Hypertension among New Yorkers, by Age Group and Disability Status

High Blood Cholesterol

Questions: Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked? [If "yes"] Have you been told by a doctor or other health professional that your blood cholesterol is high?

Of those who reported ever having their blood cholesterol checked, persons with disabilities generally were more likely than those without disabilities to report being told that their blood cholesterol was high. This was especially apparent in the 45-64 years age group, as 51.2% of those requiring assistance reported being told of a high blood cholesterol level compared to 42.8% of those not needing assistance and 32.5% of those with no disabilities. [Appendix B: Table B-10]

Among respondents who had ever had their blood cholesterol checked, persons with disabilities were more likely than those with no disabilities to report being told of a high blood cholesterol level.

Prevalence of High Blood Cholestrol among New Yorkers Who Ever Had Bllod Cholesterol, by Age Group and Disability Status

Heart Attack

Question: Has a doctor ever told you that you had any of the following? (heart attack or myocardial infarction, angina or coronary heart disease, stroke)

The lifetime prevalence of heart attack varied by disability status. The range was greatest in the oldest age group (65+ years), as 23.8% of those needing assistance reported a history of myocardial infarction, compared to 5.4% of those with no disabilities. [Appendix B: Table B-10]

Persons with disabilities were more likely to report a history of heart attack than were those with no disabilities.

History of Heart Attack among New Yorkers, by Age Group and Disability Status

Stroke

Question: Has a doctor ever told you that you had any of the following? (heart attack or myocardial infarction, angina or coronary heart disease, stroke)

In both age groups, respondents with disabilities reported a history of stroke more frequently than did those with no disabilities. The difference was greatest between those aged 65 and older needing no assistance (15.5%) and those without disabilities (2.0%). [Appendix B: Table B-10]

Persons with disabilities were more likely to report having had a stroke than were those with no disabilities.

Histroy of Stroke among New Yorkers, by Age Group and Disability Status

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