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AMERICANS WITH DISABILITIES: 1997

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Household Economic Studies
Current Population Reports P70-73
Americans With Disabilities: 1997
By Jack McNeil

Introduction

The Americans with Disabilities Act of 1990 (ADA) defines disability as a substantial limitation in a major life activity. The Survey of Income and Program Participation (SIPP) contains questions about the ability to perform a number of activities. If an individual reported having difficulty performing a specific activity, a follow-up question usually determined if the level of difficulty was severe or not. Responses to these and related questions were used to arrive at two overall measures of disability status. The criteria used to classify individuals by disability status are explained in the box on this page.

This report presents information on the number and characteristics of individuals with disabilities and is based on data collected in wave 5 of the 1996 Panel of the SIPP. Wave 5 data were collected from August - November 1997. The SIPP is a household survey, and the estimates in this report exclude the population in institutions. Approximately 32,000 households were interviewed during wave 5 of the 1996 Panel.

(Table A presents the confidence intervals for the estimates cited below.)

• In 1997, 52.6 million people (19.7 percent of the population) had some level of disability and 33.0 million (12.3 percent of the population) had a severe disability.
• About 10.1 million individuals (3.8 percent of the population) needed personal assistance with one or more ADLs or IADLs.
• Among the population 15 years old and over, 2.2 million used a wheelchair. Another 6.4 million used some other ambulatory aid such as a cane, crutches, or a walker.
• About 7.7 million individuals 15 years old and over had difficulty seeing the words and letters in ordinary newspaper print; of them, 1.8 million were unable to see.
• The poverty rate among the population 25 to 64 years old with no disability was 8.3 percent; it was 27.9 percent for those with a severe disability.

Out of a total population of 267.7 million noninstitutional individuals, 52.6 million (or 19.7 percent) had some type of disability. Among those with a disability, 33.0 million (or 12.3 percent of the total population) had a severe disability and 10.1 million (or 3.8 percent of the total population) needed personal assistance with one or more ADLs or IADLs (see Table 1).

The likelihood of having a disability increased with age. Among those 45 to 54 years old, 22.6 percent had some form of disability, 13.9 percent had a severe disability, and 3.6 percent needed personal assistance. For those 65 to 69 years old, the comparable estimates were 44.9 percent, 30.7 percent, and 8.1 percent. For the oldest age group shown in Table 1, 80 years old and over, the estimates were 73.6 percent, 57.6 percent, and 34.9 percent.

Among the population 15 to 24 years old, the prevalence of disability among women (9.8 percent) was lower than the prevalence among men (11.6 percent). The relationship was reversed for older age groups: among those 45 to 54 years old, the proportion with a disability was 24.2 percent for women, and 20.9 percent for men; and among those 55 to 64 years old, the rates were 37.2 for women and 34.0 for men. Overall, women made up the majority of the individuals with disabilities: 28.3 million women compared with 24.3 million men. Among those with a severe disability, 18.2 million were women and 14.8 million were men, and among those who needed personal assistance, 5.9 million were women and 4.1 million were men.

The likelihood of having a disability varies by race and Hispanic origin¹. For all ages, the prevalence of severe disability was 8.5 percent for Asians and Pacific Islanders, 9.7 percent for Hispanics (not statistically different from the rate for Asians and Pacific Islanders) , 12.2 percent for non-Hispanic Whites, and 15.7 percent for Blacks.

Some of the overall differences cited above reflect differences in the age distributions of the populations. For the population 25 to 64 years old, the rates of severe disability were 7.9 percent for Asians and Pacific Islanders, 11.0 percent for non-Hispanic Whites, 11.7 percent for Hispanics (not statistically different from the rate for non-Hispanic Whites), and 19.3 percent for Blacks. For individuals 65 years old and over, non-Hispanic Whites had a considerably lower rate of severe disability than individuals in the other categories: 35.3 percent compared with 49.2 percent for Asians and Pacific Islanders, 47.0 percent for Hispanics and 51.8 percent for Blacks (the rates for Asians and Pacific Islanders, Hispanics, and Blacks are not statistically different).

Table 2 shows the prevalence of specific disabilities for the population 15 years old and over and for three age groups.

The number of individuals with a disability in one or more of the activities of seeing, hearing, or speaking was 14.6 million, or 7.0 percent of the population. A relatively small proportion (2.9 million, or 1.4 percent of the population) had a severe disability². For these activities, individuals were considered to have a disability if they had difficulty seeing the words and letters in ordinary newspaper print, if they had difficulty hearing what was said in a normal conversation with another person (even when wearing a hearing aid), or if they had difficulty having their speech understood. They were considered to have a severe disability if they were unable to see words and letters in ordinary newspaper print, if they were unable to hear what was said in a normal conversation with another person, or if other people were unable to understand their speech.

Approximately 25 million individuals 15 years old and over had an ambulatory disability--defined as having difficulty walking a quarter of a mile or up a flight of 10 stairs, or using an ambulatory aid such as a wheelchair, a cane, crutches, or a walker. About 14.7 million people had a severe ambulatory disability, defined as using an ambulatory aid (8.5 million), being unable to walk a quarter of a mile (9.9 million), or being unable to walk up a flight of stairs (5.9 million).³

Eighteen million individuals had difficulty lifting and carrying a ten-pound bag of groceries or grasping small objects, and of these almost 8 million had a severe disability performing either or both of these activities.⁴

The survey asked about the ability to perform six activities of daily living, or ADLs, and six instrumental activities of daily living, or IADLs. In 1997, 8.7 million had a limitation in at least one ADL, and of this total, 4.1 million needed personal assistance. Of those who needed personal assistance with one or more ADLs, 1.5 million needed assistance with one, 0.7 million needed assistance with two, and 1.9 million needed assistance with three or more. In the case of IADLs, 12.9 million had difficulty with at least one, and 9.4 million of this total needed personal assistance.

When both ADLs and IADLs are considered, 9.9 million individuals needed personal assistance to perform one or more of the 12 activities. Of those who needed personal assistance, 0.4 million were 15 to 24 years old, 4.1 million were 25 to 64, and 5.3 million were 65 or older.

The survey asked a number of questions designed to identify individuals with mental disabilities. Questions were asked about four mental conditions (a learning disability; mental retardation; Alzheimer=s, senility, or dementia; or any other mental or emotional condition), and about certain symptoms (frequently depressed or anxious, trouble getting along with others, trouble concentrating, trouble coping with day-to-day stresses). If one or more of the symptoms was reported, a follow-up question asked if the problem seriously interfered with the ability to manage everyday activities. Finally, the IADL question about any difficulty keeping track of money and bills was used as an indicator of mental difficulties. In 1997, 14.3 million had a mental disability; 8.1 million had one or more of the specific conditions; 6.9 million had one or more symptoms that seriously interfered with their ability to manage day-to-day activities; and 4.6 million had difficulty keeping track of money and bills.

In terms of specific mental conditions, 1.4 million individuals had mental retardation, and 1.9 million had Alzheimer=s, senility, or dementia. The number with a learning disability was 3.5 million, and about the same number had some other mental or emotional condition.

Among the 6.9 million individuals with one or more specific mental symptoms that seriously interfered with their day-to-day activities, 5.6 million were frequently depressed or anxious, 4.7 million had trouble coping with stress, 3.8 million had trouble concentrating, and 1.8 million had trouble getting along with others.

Questions about whether a physical, mental, or other health condition prevented or limited the work that could be done at a job or business (that is, had a Awork disability@) were asked in each wave of the 1996 SIPP Panel. In addition to the core questions, the wave 5 disability supplement also asked about the presence of a condition that has made it difficult to remain employed or to find a job. In 1997, 18.5 million individuals 16 to 64 years old were identified as having a work disability by either the core questions or the disability supplement question. The core questions identified 9.7 million individuals as prevented from working and 7.2 million as limited in the kind or amount of work they could do, but not prevented from working. The disability supplement question identified 11.3 million as having a condition that had made it difficult to remain employed or to find a job.

Of the individuals 16 years old and over, 17.6 million were limited in the kind or amount of housework they could do, and of those, 4.4 million were prevented from doing housework.

The final section of shows the number of individuals within three disability domains: communication (seeing, hearing, or speaking), physical (unable to perform a specific physical activity or who had a specific physical condition), and mental as defined above. Individuals may have a disability in more than one domain, and, in some cases, the domain of the disability cannot be identified. The latter situation could occur if an individual has a disability in a general activity such as working at a job and does not report a specific condition as the cause of the disability. In 1997, 28.0 million individuals had a disability in one domain (21.1 million physical, 3.9 million mental, and 2.9 million communication); 13.6 million had a disability in two domains (7.5 million physical and communication, 5.3 million physical and mental, and

0.7 million mental and communication); and 4.3 million had a disability in all three domains. Finally, 2.1 million had a disability whose domain could not be identified.

The survey included a question about the use of a hearing aid, although the use of a hearing aid was not a criterion for determining disability status. The number of individuals who used a hearing aid was 4.0 million; 1.7 million of these individuals reported difficulty hearing what was said in a normal conversation and 2.3 million did not.

Table 3 shows the relationships between disability status and a number of other characteristics for two groups: individuals 25 to 64 years old and 65 and older.

Individuals with a severe disability are much less likely than individuals with no disability to be a householder or a spouse of a householder in a married-couple family, and they were much more likely to live as an unrelated individual. In 1997, 46.1 percent of individuals 25 to 64 years old with a severe disability were householders or spouses of householders, and 33.4 percent lived as unrelated individuals. For those in the same age group but with no disability, the comparable figures were 66.3 percent and 20.0 percent.

For individuals 65 years old and over, 42.0 percent of those with a severe disability were householders or spouses compared with 60.1 percent among those with no disability in the same age category. In addition, 44.8 percent of those with a severe disability lived as unrelated individuals, compared with 32.5 percent for those with no disability.

There is a strong relationship between disability status and perceived health status.
Among those 25 to 64 years old with a severe disability, 14.5 percent reported very good or excellent health and 58.9 percent fair or poor, compared with 75.1 percent and 2.6 percent of those in the same age group with no disability. Among those 65 years old and over with a severe disability, 8.8 percent reported very good or excellent health, and 68.0 percent fair or poor. Among those 65 years old and over with no disability, 50.7 percent reported good or excellent health, and 10.5 percent fair or poor.

Individuals with a severe disability are less likely to be covered by private health insurance. Among the population 25 to 64 years old with a severe disability, 47.5 percent were covered by private health insurance compared to 82.3 percent of those with no disability. Among people 65 years old and over with a severe disability, 67.0 percent were covered by private health insurance, compared with 79.7 percent of those with no disability. Among those 25 to 64 years old, 17.2 percent of those with a severe disability and 15.4 percent of those with no disability lacked any form of health insurance.

Disability status is associated with sharp differences in levels of educational attainment. For individuals 25 to 64 years old with a severe disability, 32.6 percent had not finished high school compared with 10.7 percent of those with no disability. In 1997, 9.4 percent of those with a severe disability had graduated from college compared with 28.5 percent of those with no disability. Among those 65 years old and over with a severe disability, 46.2 percent had not finished high school compared to 25.9 percent with no disability .

The presence of a severe disability is associated with an increased likelihood of receiving welfare benefits, of having low levels of income, and being more likely to live in poverty.

Among individuals 25 to 64 years old with a severe disability:

• 20.3 percent received Supplemental Security Income (SSI);
• 5.8 percent received some other form of cash assistance;
• 16.2 percent received food stamps; and
• 9.2 percent lived in public or subsidized housing.

For those in the same age group with no disability:

• 1.2 percent received cash assistance;
• 2.1 percent received food stamps; and
• 1.9 percent lived in public or subsidized housing.⁵

The proportion of individuals 25 to 64 years old with an annual personal income less than $20,000 was 80.2 percent for those with a severe disability compared with 43.7 percent for those with no disability. When the income measure was household income, 41.8 percent of those with a severe disability, and 13.9 percent of those with no disability, lived in a household with an annual income below $20,000. In 1997, 27.9 percent of those with a severe disability and 8.3 percent of those with no disability in this age group lived in poverty.

Income differentials by disability status also existed for individuals 65 years old and over. Among those with a severe disability, the proportion with an annual personal income less than $20,000 was 83.5 percent, the proportion living in a household with an annual income below $20,000 was 52.6 percent, and the proportion in poverty was 16.6 percent. The comparable figures for those in the same age group with no disability were 68.4 percent, 34.1 percent, and 6.9 percent, respectively.

Table 4 shows the employment rate and median and average annual earnings for individuals 21 to 64 years old by overall disability status and by specific disability categories. Individuals with a severe disability had an employment rate of 31.4 percent and median earnings of $13,272, compared with 82.0 percent and $20,457 for those with a nonsevere disability, and 84.4 percent and $23,654 for those with no disability.

The first section of Table 4 shows selected data on the relationship between disability status and program participation status. One reason for examining this arrangement of the data is to examine whether individuals with a disability who participate in a major program such as Medicare, SSI, or Social Security, or who are identified in the survey as having a condition that prevents them from working, have a reduced availability for employment. Of the 17.4 million individuals aged 21 to 64 with a severe disability, 6.9 million were either covered by Medicare or received SSI payments, and an additional 1.2 million received Social Security benefits. In other words, 8.1 million individuals with a severe disability participated in one or more of these three programs. Of the 9.3 million individuals with a severe disability who did not participate in one or more of the three programs , 3.3 million reported that they were prevented from working and 6.0 million did not.

These three categories of severely disabled individuals (participated in one or more major programs, did not participate but who had a disability that prevented them from working, and did not participate and were not prevented from working) might prove useful when examining their employment situation. If individuals with a severe disability who were not employed are to become employed, the 8.1 million who participated in a major program may need special transition assistance, and the 3.3 million who did not may need to be convinced that changes to the physical and social environment can make employment feasible. Many (73.5 percent) of the 6.0 million individuals in the third category were already employed.

The remainder of Table 4 shows data by type of disability. For example, individuals with a limitation in seeing had an employment rate of 41.5 percent and median earnings of $16,791. Those with a mental disability had an employment rate of 37.0 percent and median earnings of $13,534. And those who had experienced difficulty finding a job or remaining employed had an employment rate of 21.1 percent and median earnings of $7,975.

For additional information on employment and earnings, see the materials referenced below in the section on ARelated material@.

The survey asked two questions about the disability status of children under 3 years old and two questions about the disability status of children 3 to 5 years old. Two percent of children under 3 had a disability with either a developmental delay or a condition that limited the ability to use arms or legs. In 1997, 3.4 percent of children 3 to 5 had a disability with either a developmental delay or a condition that limited the activities of walking, running, or playing.

A longer set of disability questions were asked for children 6 to 14 years old: 11.2 percent had some disability and 4.8 percent had a severe disability. Children in this age category were considered to have a severe disability if they met any of the following criteria: (1) they had mental retardation or some other developmental disability, (2) they had some other developmental condition for which they had received therapy or diagnostic services, (3) they used an ambulatory aid, (4) they had a severe limitation in the ability to see, hear, or speak, or (5) they needed personal assistance for an activity of daily living.

In terms of specific disabilities, 6.8 percent of children 6 to 14 years old had difficulty doing regular schoolwork, 5.2 percent had a learning disability, 1.5 percent had a developmental disability (including mental retardation, autism, or cerebral palsy), and 3.7 percent had some other developmental condition for which they had received therapy or diagnostic services. The proportion who used an ambulatory aid (wheelchair, cane, crutches, or a walker) was 0.3 percent.

In 1997, 0.7 percent of children 6 to 14 had difficulty seeing, the same percentage as those who had difficulty hearing, and 2.1 percent had difficulty speaking, the same percentage as those who had difficulty walking, running, or taking part in sports and games.

This report updates estimates shown in AAmericans with Disabilities: 1991-92", Series P-70-33, and AAmericans with Disabilities: 1994-95", Series P70-61. The latter report can be found on the U. S. Census Bureau=s disability web site: http://www.census.gov/hhes/www/disability/disability.html.

The Census Bureau=s disability web site also contains additional tables about disability in 1997, as well as AEmployment, Earnings, and Disability@, a paper by John McNeil that was presented at the 75th Annual Conference of the Western Economic Association International, June 29 - July 3, 2000.

Statistics from surveys are subject to sampling and nonsampling error. All comparisons presented in this report have taken sampling error into account and meet the U.S. Census Bureau=s standards for statistical significance. Nonsampling errors in surveys may be attributed to a variety of sources, such as how the survey was designed, how respondents interpret questions, how able and willing respondents are to provide correct answers, and how accurately the answers are coded and classified. The Census Bureau employs quality control procedures throughout the production process - including the overall design of surveys, the wording of questions, review of the work of interviewers and coders, and statistical review of reports.

The Survey of Income and Program Participation employs ratio estimation, whereby sample estimates are adjusted to independent estimates of the national population by age, race, sex, and Hispanic origin. This weighting partially corrects for bias due to undercoverage, but how it affects different variables in the survey is not precisely known. Moreover, biases may also be present when people who are missed in the survey differ from those interviewed in ways other than the categories used in weighting (age, race, sex, and Hispanic origin). All of these considerations affect comparisons across different surveys or data sources.

1/ Hispanics may be of any race.
2/ Totals for individuals with selected disabilities in 1997 were (numbers in parentheses are those with a severe disability in that category): sight -- 7.7 million (1.8 million severe); hearing -- 8.0 million (0.8 million severe); speech -- 2.3 million (0.5 million severe). The number of individuals with a sight disability was not statistically different from the number with a hearing disability.
3/ 19.5 million had difficulty walking a quarter of a mile; 19.8 million had difficulty walking up a flight of stairs (not statistically different from the number that had difficulty walking a quarter of a mile); 2.2 million used a wheelchair; and 6.4 million did not use a wheelchair, but used some other ambulatory aid such as a cane, crutches, or a walker.
4/ 15.2 million had difficulty lifting and carrying a bag of groceries (of those, 7.7 million could not lift and carry a bag of groceries); 6.8 million had difficulty using their hands and fingers to pick up objects such as a glass or pencil (of those, 0.6 million could not use their hands and fingers to pick up a glass or pencil).
5/ For individuals with no disability, the percent living in public or subsidized housing is not statistically different from the percent receiving food stamps.

For further information on statistical standards and the computation and use of standard errors, contact Sam Sae-Ung, Demographic Statistical Methods Division, at 301-457-4221 or on the internet at Smanchai.Sae.Ung@census.gov.

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