A comparison of data from 3 surveillance systems using select socio-economic status and health indicators under various definitions of disability: A GIS analysis

The lack of a standard disability definition across major surveillance systems in the US leads to conflicting statistics on prevalence rates of individuals with a disability and their associated socio-economic (SES) and health indicators. The Behavioral Risk Factor Surveillance System (BRFSS) uses a broad disability definition based on activity limitations and equipment use. The National Health Interview Survey on Disability (NHIS) and the American Community Survey (ACS) define six categories of disability: difficulties in hearing, vision, cognitive, ambulatory, self-care, or independent living. Even between surveys that utilize the same disability screening questions, prevalence rates vary drastically. For instance, the NHIS (2009) reports 32.0% of non-institutionalized adults report difficulty or limitation in at least one type of basic action or complex activity; the 2010 BRFSS statistics indicate 22.0% of the adult population ages 18 and older have a disability; and the ACS (2010) reports a disability prevalence rate of 14.5% for adults. This affects subsequent analyses of SES and health characteristics, disparity rates and the resulting policy issues on the population of individuals with a disability, because the prevalence rates define the size of the population under analysis. The objective of this study is to illustrate the effect of the varying disability definitions across three major surveillance systems on population characteristics such as employment status, obesity and educational attainment. GIS mapping of results will allow easy comparisons between states and regions on selected SES and health indicators.