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Disabil Health J. 2018 Jul;11(3):447-450. doi: 10.1016/j.dhjo.2017.11.005. Epub 2017 Nov 29.

Underrepresentation of adolescents with respiratory, mental health, and developmental disabilities using American Community Survey (ACS) questions.

Author information

1
University of Montana, Rural Institute for Inclusive Communities, 52 Corbin Hall, Missoula, MT 59812, United States. Electronic address: Catherine.ipsen@mso.umt.edu.
2
University of Utah, Kem C. Gardner Policy Institute, Salt Lake City, UT 84111, United States.
3
University of Kansas, Institute for Health and Disability Policy Studies, Lawrence, KS 66045, United States.
4
University of Montana, Rural Institute for Inclusive Communities, 52 Corbin Hall, Missoula, MT 59812, United States.
5
University of Kansas Medical Center, Department of Health Policy and Management, Kansas City, KS 66160, United States.

Abstract

BACKGROUND:

Disability prevalence estimates are used to identify populations, establish priorities and allocate funding for a broad range of federal, state, and local initiatives. Increasingly, these estimates are based on a set of six questions developed and tested for use in the American Community Survey (ACS). A key assumption about the ACS disability screeners is that they sufficiently capture the entire population of people with disabilities, but some studies indicate that certain disability groups are underrepresented.

OBJECTIVES:

The objective of this study is to explore potential underrepresentation of certain disability groups identified by the ACS disability questions.

METHODS:

We compared disability prevalence rates from two data sources for adolescents with disabilities, aged 14 to 16, who receive Supplemental Security Income (SSI, n = 2051). The Social Security Administration (SSA) provided disability determination data for each adolescent, and adolescents (or proxy-rater) provided baseline self-report data about functional limitation based on the six ACS disability questions.

RESULTS:

Approximately 17% of the sample did not endorse any ACS questions. Excluding SSA categories with cell counts less than 10, the top five conditions not captured by ACS questions included respiratory conditions (38%), mood disorders (28%), other mental disorders (27%), schizophrenic and other psychotic disorders (27%) and developmental disorders (20%).

CONCLUSIONS:

Our findings suggest that people with mental health and developmental disabilities and those with respiratory conditions are among those groups under-represented by the ACS disability questions. Changes or additions to ACS questions should be considered to ensure that all disability groups are addressed in public health planning.

KEYWORDS:

Disability; Measurement; Prevalence; Surveillance; Transition

PMID:
29233622
DOI:
10.1016/j.dhjo.2017.11.005
[Indexed for MEDLINE]

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