Trends and differentials in disability: challenges in measurement

ADL and IADL indexes, both of which are self-reported limitations on the daily activities, are limited to differentiate the contextual barriers and intrinsic impairment for of disability status in the elderly population. This study examines four types of disability measurements in the Chinese elderly disability trend analysis: 1) the self-reported difficulty in IADL, 2) the self-reported dependency in ADL, 3) the self-evaluated function performance, and 4) the objective performance in function tests. The data are from three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2002, 2005 and 2008. The results showed contrasting trends under four different measurement schemes. The fact that the trends based on objective performance is reversed in comparison with trends of ADL and IADL suggests that it is likely that the ADL and IADL improvement could be largely due to the changes in the living environment of the elderly instead of the improvement of their body functions. To better understand the source of disability in the elderly population is extremely important for medical interventions, elderly care and public policy development and we call for more attentions to such a measurement problems in the disability trend studies.

The objective of this study is to present the method proposed by Sullivan and to estimate the healthy life expectancy using different measures of state of health, based on information from the World Health Survey carried out in Brazil in 2003. By combining information on mortality and morbidity into a unique indicator, simple to calculate and easy to interpret, the Sullivan method is currently the one most commonly used for estimating healthy life expectancy. The results show higher number of healthy years lost if there is a long-term disease or disability that limits daily activities, regardless of the difficulty in performing such activities or the severity of the functional limitations. The two measures of healthy life expectancy adjusted by the severity of functional limitation show results very similar to estimates based on the perception of state of health, especially in advanced age. It was also observed, for all measures used, that the proportion of healthy years lost increases significantly with age and that, although females have higher life expectancy than males, they live proportionally less years in good health.

This study follows about 500 disabled individuals over life to examine their survival chances in past society and in comparison to a control cohort of non-disabled people. The aim is to detect whether those with disabilities were markedly stigmatized and thus faced difficulties in life, which we in accordance with the labeling theme of secondary deviance assume would be indicated by high levels of mortality. We make use of Sweden’s 19th-century parish registers (digitized by the Demographic Data Base, Umeå University) to identify people who the ministers defined as disabled and to construct the control cohort. Then we employ bi-variate analyses and run multivariate regression models. The statistical results suggest that disability significantly jeopardized the survival of individuals but was not the only key to their mortality, because gender determined the survival of disabled, too. Disability limited men’s life expectancy more evidently than the women’s. Our findings are rare in providing statistical evidence of disabled individuals’ experiences beyond institutional life and because we seek to measure the level of labeling in their life. The death differentials demonstrate that the disabled constituted a disadvantaged but heterogeneous collection of people whose demography and pathways must be further researched.

One group of human rights is to guarantee an adequate standard of living to everyone. This paper narrows the focus to health, particularly with respect visual difficulty. Indonesia is the ninth country who signed the UN Convention of the Rights of Persons with Disabilities in 2007. It took four years for Indonesia to finally ratify the convention, precisely on 18 October 2011. At almost the same time, the Indonesia 2010 population census collected information on visual difficulties. It is the first nationwide data gathering information on this type of disability. It is a self-assessment which takes three options: no difficulty, some difficulty and severe difficulty. Therefore, the paper aims at providing reference statistics, distribution and prevalence, on visual difficulty estimated from the Indonesia 2010 Population Census
We use two types of measurements: distribution and prevalence. It takes into account differential by age, sex and place of residence. This paper also examines the extent Indonesians have the financial ability and accessibility to improve their visual ability; and the laws as well as their enforcement to help improving the visual ability.

In this paper we focus on elderly disability in China using data from the China Health and Retirement Longitudinal Study (CHARLS) national baseline, which was fielded in 2011/12 and defines disability by international standard ADLs and IADLs questions and contains detailed care-giving and family information. We estimate the magnitude of disability among older Chinese and examine resources available for their care, the current pattern of care, and job division between children. Such research has not been possible before due to data limitations. We find that 23% of those 60 and older are disabled and need care; this amounts to about 40 million nationwide. However, only 86% received care. In addition, whether or not care is provided for the disabled elderly is significantly related to the wellbeing of them. Furthermore, spouse is the largest source of care giver, especially for men, followed by children. Finally, in accordance with the Chinese tradition, sons are the dominant care-giver but daughters are increasingly important.

As composite of mortality and morbidity, health expectancy has advantage over single indicators when exploring socioeconomic disparities in health. Although huge income gap between urban and rural residents has been reported in China, little research has been done in discussing the urban-rural disparities in health expectancy and the underlying causes. Based on 2006 China Disability Survey, this study used attribution tool to identify the causes of disability by individual diseases and employed Sullivan method to compute life expectancy lived with disability by diseases. Urban male have 4.08 years (female: 4.95 years) lived with disability while rural male have 4.72 years (female: 5.46 years) lived with disability. Leading diseases of presbycusis, cataract, cerebrovascular disease, osteoarthritis and unclassified injury accounted for different years of disability. Different diseases patterns of disability and health expectancy exist among urban and rural areas. Such an identification provides a support to Chinese policy for fighting against disability among elderly.

Objectives: This study creates a new model to predict the changing tendency of ageing population with disability, and gave some evidences on prevention and reduction of disability risk. Data & Methods: A cross-sectional data of Second China Sample Survey on Disability (2006) is used in this study. This study combines PDE model with the methods of static covariate-direct prediction, static covariate by type prediction and dynamic covariate effect prediction respectively. Results: The future total number and growth rate of older adults with disabilities in China are very striking. Under scenario II, about 1.5 million of older adults increase annually from 2006 to 2040, and more than 2.5 million increase annually from 2040 to 2050. Total number in 2050 is 3.05 times of 2006. And population ageing, sex, place of residence, marital status, education, income, provincial GDP per capita are significantly affect the prevalence of disability among the older adults. Conclusion： Social and economic factors affect the development process of future changes in size of population with disability, but the most far-reaching impact factor is population aging, so the health expectancy of the elderly population is most worthy of attention.