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Introduction
The Cornell StatsRRTC seeks to bridge the divide between the sources of disability data and the users of disability statistics. One product of this effort is a set of User Guides to national survey data that collect information on the disability population.
The User Guides provide disability data users with:
- An easily accessible guide to the disability information available in the major nationally representative surveys;
- A set of estimates on persons with disabilities from the dataset, including estimates on the size of the population, the prevalence rate, the employment rate and measures of economic well-being;
- A description of the unique features of the survey; and
- A set of estimates that highlight the unique features of the survey.
This User Guide contains information on the National Health Interview Survey — Disability supplement (NHIS-D) that was fielded in 1994 and 1995. Other guides contain information on the American Community Survey (ACS), Census 2000, 2004 Current Population Survey (CPS), 2002 National Health Interview Survey (NHIS), 2001 Survey of Income and Program Participation, and the 2001 Panel Survey of Income Dynamics (PSID).
The NHIS-D was a supplement to the National Health Interview Survey (NHIS) in 1994 and 1995 and is one of the more comprehensive data sources regarding people with disabilities in the United States. In addition to the broader disability questions used in the NHIS, the supplement contains additional questions that can help identify disability including questions about health conditions (both physical and mental), service receipt and program participation (e.g. SSI), activity limitations, and participation restrictions. The supplement also contains extensive information about the different facets of the lives of people with disabilities including the types of services people with disabilities receive, transportation issues facing working age adults with disabilities, social activities of people with disabilities, vocational rehabilitation services, and disability accommodations.
The highlight of the NHIS-D is its breadth of information about disability. All individuals in the NHIS are asked many detailed questions that can be useful in defining various populations of people with disabilities. Questions include those that identify activity limitations, mental health issues, and particular conditions.
Data from the two years the supplement was fielded can be combined in order to produce larger sample sizes of people with disabilities. This can aid in studying subpopulations of interest or typically low-prevalence populations. The data can also be linked to data in the Core NHIS for the respective years and other supplements — for example, the Family Resource Supplement which collects information about a family's access to care, health insurance and detailed income information.
The timing of the NHIS-D makes it an excellent data source to understand disability in a post- Americans with Disabilities Act (ADA) environment. This is not to say that all changes that occurred as a reaction to the ADA are reflected in survey respondent's answers to the survey. It is likely that some reactions to the ADA could take many years to implement, in which case the NHIS-D information might only reflect initial responses. For example, structural building changes such as accessible elevators may have not had time to fully be incorporated prior to the survey being fielded. And indeed, Loprest and Maag (2001) use the NHIS-D to document that worksite features (accessible parking or transportation stop, elevators, or specially designed work stations) are the most common type of accommodation people with disabilities report that they need. Worksite features are also the most likely accommodations to be reported as an unmet need. Over time, we might expect that more worksites will become fully accessible, which would make the information from the NHIS-D an overestimate of the current level of unmet need for these accommodations.
The primary limitation of the NHIS-D is that it is now over 10 years old. The supplement was last included in the NHIS in 1994 and 1995. Many potentially significant policy changes have occurred since this time, responses of which obviously cannot be studied using these data. For example, data in the NHIS-D do not indicate how people with disabilities responded to the Social Security Administration's (SSA) Ticket to Work and Work Incentives Improvement Act enacted in 1999.
Another limitation to the NHIS-D is that Phase 2 of the survey (the Disability Followback Survey or DFS) collects information germane to the entire population (such as detailed employment information) only for people identified in Phase 1 as having a disability. This limits the user's ability to make comparisons of people with disabilities to those without disabilities on a variety of dimensions. In contrast, information in Phase 1 is collected for people with disabilities as well as those without disabilities.
Similar to other household surveys, the NHIS-D surveys only the noninstitutionalized population of the United States. Members of the active duty military service, people living in prison, and those in nursing homes or long-term care facilities are the primary groups of people not included in the survey. The latter may be of particular importance to some disability related questions. However, interviewers did attempt to interview individuals who met the criteria for being included in the DFS, even if they had moved into an institution between the time of the initial survey and the time the DFS was conducted.
Note: This report is available in its entirety in the Portable Document Format (PDF).
The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders.
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