Coding NCHS Survey Questions on Disability using the International

Classification of Functioning,Disability, and Health

Gerry E. Hendershot, Ph.D.

Consultant on Disability and

Health Statistics

Overview International Classification of Functioning,

Disability, and Health (ICF) United Nations reporting categories Illustrations of coding NCHS survey questions

to ICF categories Summary of NCHS survey coverage of ICF/UN

categories

The ICF Approved by World

Health Assembly Available in six

official languages Searchable Web and

CD versions www.who.int/icidh

Health Condition Health Condition ((disorder/diseasedisorder/disease))

Environmental Environmental FactorsFactors

Personal Personal FactorsFactors

Body Body function&structure function&structure

(Impairment(Impairment))

ActivitiesActivities(Limitation)(Limitation)

ParticipationParticipation(Restriction)(Restriction)

ClassificationClassification

PartsParts

ComponentsComponents

Domains and Domains and categoriescategories

at different levels at different levels

ICFICF

Part 1:Part 1:Functioning and Functioning and

DisabilityDisability

Part 2:Part 2:Contextual Contextual

FactorsFactors

Body Body Functions Functions

and and StructuresStructures

Activities Activities andand

ParticipationParticipation

Environ-Environ-mental mental Factors Factors

Personal Personal FactorsFactors

(Not covered)(Not covered)

Item Item levels:levels:

11stst 22ndnd

33rdrd

Item Item levels:levels:

11stst 22ndnd

33rdrd

Item Item levels:levels:

11stst 22ndnd

33rdrd

d4500, Walking short distances d450, walking: Moving along a surface on foot, step

by step, so that one foot is always on the ground, such as when strolling, sauntering, walking forwards, backwards, or sideways.

d4500, walking short distances: walking for less than a kilometre, such as walking around rooms or hallways, within a building or for short distances outside.

UN disability categories 1. Seeing, even with glasses

2. Hearing, even with aid 3. Speaking, includes

talking 4. Moving/mobility,

includes walking, climbing, standing

5. Body movement, includes reaching, crouching, kneeling

6. Gripping/holding, includes using fingers to grip objects

7. Learning, including intellectual difficulties, retardation

8. Behavioral, includes psychological, emotional

9. Personal care, includes bathing, dressing, feeding

NHIS on walking

By yourself and without using aids, do you have any difficulty walking a quarter of a mile (that is about 2 or 3 blocks)? [ If yes] How much difficulty do you have, some, a lot, or are you unable to do it?

NHANES on walking

By yourself and without any special equipment, how much difficulty do you have walking for a quarter of a mile [that is about 2 or 3 blocks]? No difficulty, some difficulty, much difficulty, unable to do?

b230, hearing functions Sensory functions relating to sensing the presence of

sounds and discriminating the location, pitch, loudness and quality of sounds.

Inclusions: functions of hearing, auditory discrimination, localization of sound source, lateralization of sound, speech discrimination; impairments such as deafness, hearing impairment and hearing loss

LSOA on hearing

Do you NOW have deafness in both ears? Deafness in one ear? Any other trouble hearing with one or both ears?

NNHS on hearing

Does … have any difficulty in hearing (when wearing a hearing aid)? Is …”s hearing (when wearing a hearing aid) partially, severely, or completely impaired, as defined on this card?

Deaf: “can hear only a few words a person says or loud noises.”

NCHS surveys covered in study

Nat’l Health Interview Survey

Nat’l Health & Nutrition Exam. Survey

Longitudinal Studies of Aging

Nat’l Nursing Home Survey

Nat’l Home & Hospice Care Survey

Nat’l Mortality Followback Survey

NCHS Coverage of ICF/UN Categories

See

Hear

Speak

Move

Body

NCHS Coverage of ICF/UN Categories

Grip

Learn

Behave

Care

All

In conclusion . . .