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Milbank Q. 1991;69 Suppl 1-2:55-77.

The demographics of disability.


In this article, I have attempted to clarify some of the disparate estimates and ways of measuring disability that have been used in different surveys. The definitional issue has implications for the size of the population that will be covered by the ADA. I have reviewed several perspectives, including that of researchers, disability advocates, and individual self-perceptions, which need to be considered in understanding the meaning of disability. Disability involves limitations in actions and activities because of mental and physical impairments. Comparison of these different perspectives reveals that the differences lie in the range of activities that are considered. At least 36 million persons, over 14 percent of the U.S. population, are limited in selected activities. Depending on what are considered to be major life activities, the population covered by the ADA could vastly exceed that figure. Little information is available about the extent to which persons with disabilities, however defined, are affected by discrimination and unequal treatment. Limited data are available from one survey conducted by the International Center for the Disabled, which indicate that as many as 66 percent of persons with activity limitations who are not working would like a job. On the other hand, many persons with activity limitations indicate that their limitations are an important cause of their unemployment. About a quarter of persons with activity limitations due to impairments have experienced discrimination in some form. The impact of the ADA will likely vary by impairment. Because the prevalence of chronic diseases is far greater than the prevalence of physical and sensory impairments, chronic diseases are more frequently the cause of disability. The risk of disability is highest for impairments with low prevalence. Because states and local areas differ in the prevalence of disability, the impact of the ADA will also be likely to vary by geographic area. For some states, the rate of work disability is more than twice the rate of other states. Yet, research indicates that much of the variation is due to socioeconomic characteristics of areas. This reflects, at the macroeconomic level, that persons with disabilities are more likely to be poor and less educated than persons without disabilities. Because of differences in understanding what disability is and insufficient knowledge about the extent of the problem of discrimination toward persons with disabilities, assessment of the potential impact of the ADA is challenging.(ABSTRACT TRUNCATED AT 400 WORDS)

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