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 . . .