… the work of the Washington Group on Disability Statistics

Jennifer H. MadansNational Center for Health Statistics, USA

for the Washington Group on Disability Statistics

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June of 2001-- the UN International Seminar on the Measurement of Disability, based on a broad consensus on need for population based measures of disability, recommended the development of principles and standard forms for global indicators of disability to be used in censuses.

The Washington Group, made up of representatives from national statistical offices, has pursued these goals over the past 10 years with recognized success.

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Foster international cooperation in the area of health and disability statistics

Untangle the web of confusing and conflicting disability estimates

Develop a short set of general disability measures Develop extended set/s of items to measure

disability on population surveys Address methodological issues associated with

disability measurement Produce internationally tested measures for use to

monitor status of disabled populations.

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The Definitional Paradox There is no single operational definition of

disability Different operational definitions lead to different

estimates The question you are trying to answer (the

purpose) will determine which definition to use Need to understand the choices that are being

made when choosing a definition

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Health Condition(disorder/disease)

Body Function &Structure (Impairment)

Participation(Restriction)

EnvironmentalFactors

PersonalFactors

Source: World Health Organization, 2001

Locating Risk in the ICF Model

?

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Identify those at greater risk than the general population for limitations in participation

Defined by the ability to carry out basic actions (walking, seeing, remembering, etc) 0

30

60

90

Prop

ortio

n (%

)

Nondisabled Disabled

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% Employed

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Because of a Health problem:1) Do you have difficulty seeing even if wearing glasses?2) Do you have difficulty hearing even if using a hearing

aid?3) Do you have difficulty walking or climbing stairs?4) Do you have difficulty remembering or concentrating?5) Do you have difficulty with (self-care such as) washing

all over or dressing?6) Using your usual (customary) language, do you have

difficulty communicating (for example understanding or being understood by others)?

Response categories: No - no difficulty; Yes - some difficulty; Yes - a lot of difficulty; Cannot do at all

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Core DomainSome

difficultyA lot of

difficultyUnableTo do it

Vision 4.7 2.6 0.5Hearing 3.7 2.3 0.5Mobility 5.1 3.8 0.8Remembering 2.0 1.5 0.3Self-Care 2.0 1.3 0.4Communicating 2.1 1.4 0.5

At least:

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Person with disability has: N %

at least 1 Domain is ‘some difficulty’ 4053 14.5

at least 2 Domains are ‘some difficulty’ 3090 11.0

at least 1 Domain is ‘a lot of difficulty’ 2368 8.5

at least 1 Domain is ‘unable to do it’ 673 2.4

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By standardizing these questions it will be possible to provide comparable data cross-nationally for populations living in a variety of cultures with varying economic resources;

Data can be used to assess a country’s compliance with the UN Convention and, over time, their improvement in meeting the requirements set out under the Convention.

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Year of survey 2006/2008

Follow-up Survey 2012

Country Withdisability

Withoutdisability

Withdisability

Withoutdisability

Mozambique 38 27Uganda 42 16Zambia 23 10Brazil 30 8Tanzania 42 21Vietnam 30 6South Africa 23 6

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RowVision (1) Hearing (1) Mobility Communi-

cationCognition/

rememberingUpper Body

Learning/ understanding Affect Pain Fatigue ADL/

IADL

Getting Along with

People

Life Activities

Participation in Society

Short SetSingle Questions (1) d a d

Extended SetMultiple Questions (1) c c c c

Use of Assistive DevicesMicro-E (2)

Functioning with Assistance, Micro-E (2)

5 Age at Onset

6 Cause

7 Duration

8 Impact ? ? ?

9Meso-Environment

(3)

10Macro-Environment

(4)

ICF Chapter Reference - Activities/Participation ICF-1 ICF-1 ICF-4 ICF-3 ICF-1,2 ICF-4 ICF-1 ICF-2 ICF-5,6 ICF-7 ICF-8 ICF-9

Capacity

Performance

Basic Activity Domains Complex Activity Domains

(5) See Note below

Washington Group/Budapest Initiative/UNESCAP Activities and Workplan

QuestionnaireTopic/Type

To be obtained through other sources, not personal survey data collections

b

Background information, WG Objectives, Summaries of all meetings, including

all papers and presentations are posted on the Washington Group

website:http://www.cdc.gov/nchs/

washington_group.htm

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