Health Services/Policy
Prevalence estimates of disability, overall and by functional disability domains, among adults and children in national population-based surveys in US Qi Cheng* Qi Cheng Yan Wang Allison Boda Seman Joseph Holbrook Catherine E. Rice
Background: The six standardized disability questions developed by the Census Bureau and used in the American Community Survey are population-level measures of functional disability in 6 domains (ACS-6: hearing, vision, mobility, cognition, self-care, and independent living). This analysis examined the range of disability prevalence estimates in adults and children from national population-based surveys using ACS-6.
Methods: Using 2017 or/and2018 data from ACS, BRFSS, CPS, NHANES, NHIS, and SIPP, we calculated disability prevalence for adults aged ≥ 18 years and children aged 5-17 years by survey accounting for their complex survey design. Z-tests assessed statistically significant differences (p<.05) between survey estimates.
Results: Among adults, disability prevalence ranged from 27.2% (CI: 26.9-27.5) in BRFSS to 12.1% (11.7-12.5) in CPS (p<.05). Variation in prevalence existed across functional domains of disability, with mobility disability consistently having the highest prevalence (Figure 1a). Disability prevalence for children also varied across surveys, from 15.1% (13.1-17.6) in NHANES to 5.4% (5.4, 5.5) in ACS (p<.05). Variation in prevalence across domains of disability also existed, with cognition disability consistently having the highest prevalence across all surveys (Figure 1b).
Conclusion: Given the variation in disability prevalence across surveys using the ACS-6 question set, cautious interpretation of estimates from a single survey may be needed. Understanding how survey purpose, sampling design, response rate, and statistical weighting influence disability prevalence across national surveys may help stakeholders interpret and use estimates.