The 130th Annual Meeting of APHA

Abstract #47984

Donald F Austin, MD, MPH¹, Hank Bersani, PhD², Jodi A. Lapidus, PhD³, and Rebecca Rdesinski³. (1) Dept of Public Health and Preventive Medicine, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Mailcode CB669, Portland, OR 97201-3098, 503-494-8257, austind@ohsu.edu, (2) Department of Special Education, Western Oregon University, 345 North Monmouth Avenue, Monmouth, OR 97361, (3) Department of Public Health and Preventive Medicine, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Road, Mail Code CB669, Campus Services Building 669, Portland, OR 97201-3098

In public health research, there is a growing need to define "disability" as an independent variable, similar to gender, race and SES. However, there are competing ways to define "disability" for research purposes. Disability research has used categorical or etiological definitions of disability (i.e. mental retardation, spinal cord injury, etc). WHO and CDC have suggested using functional definitions (i.e. intellectually disabled, mobility impaired). In functional definitions one must consider the collection of functional limitation information. One option is self-report, e.g., from questions as, "Do you consider yourself to have a disability, impairment or handicap?" Functional assessment information may be collected for other purposes, e.g. qualifying assessments for certain Medicaid programs. The definition and collection method of disability information can impact the outcome of an analysis. In researching cancer among the disabled Medicaid population in Oregon, we developed and applied different definitions of disability using Medicaid eligibility and functional assessment criteria. We examined cancer incidence and stage at diagnosis for Oregon Medicaid clients between 1996-98. The age-adjusted cancer incidence was higher for Medicaid participants (465.9/100,000 person years, 95% CI: 446.4 - 485.4) compared to the Oregon population (396.8). For those with "severe" mobility impairments it was higher still (524.9, 95% CI: 384.5 - 665.3). Females with cognitive impairments were significantly more likely to be diagnosed with colorectal cancer at a later stage than their non-disabled counterparts after controlling for age and mobility impairments (OR: 3.28; 95% CI: 1.03 - 10.42). We will discuss results from this project, and also suggest approaches that others may use when undertaking the task of defining disability from secondary data sources.

Learning Objectives:

• At the conclusion of the session participants will be able to
• Identify various approaches to defining "disability" in public health research.
• Discuss the implications of various definitions and definitional approaches.
• Select definitions of disability to include in their future research.

Keywords: Disability, Data/Surveillance

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Oregon Health Sciences University
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.