Institute on Disability

Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License


Objective: A national priority for disability research in the USA is the standardised identification of people with disabilities in surveillance efforts. Mandated by federal statute, six dichotomous difficulty-focused questions were implemented in national surveys to identify people with disabilities. The aim of this study was to assess the prevalence, demographic characteristics and social factors among people with disabilities based on these six questions using multiple national surveys in the USA.

Setting: American Community Survey (ACS), Current Population Survey Annual Social and Economic Supplement (CPS-ASEC), National Health Interview Survey (NHIS) and the Survey of Income and Program Participation (SIPP).

Participants: Civilian, non-institutionalised US residents aged 18 and over from the 2009 to 2014 ACS, 2009 to 2014 CPS-ASEC, 2009 to 2014 NHIS and 2008 SIPP waves 3, 7 and 10.

Primary and secondary outcome measures: Disability was assessed using six standardised questions asking people about hearing, vision, cognition, ambulatory, self-care and independent living disabilities. Social factors were assessed with questions asking people to report their education, employment status, family size, health and marital status, health insurance and income.

Results: Risk ratios and demographic distributions for people with disabilities were consistent across survey. People with disabilities were at decreased risk of having college education, employment, families with three or more people, excellent or very good self-reported health and a spouse. People with disabilities were also consistently at greater risk of having health insurance and living below the poverty line. Estimates of disability prevalence varied between surveys from 2009 to 2014 (range 11.76%–17.08%).

Conclusion: Replicating the existing literature, we found the estimation of disparities and inequity people with disabilities experience to be consistent across survey. Although there was a range of prevalence estimates, demographic factors for people with disabilities were consistent across surveys. Variations in prevalence estimates can be explained by survey context effects.

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British Medical Journal- Open


BMJ Publishing

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© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.


This is an article published by BMJ Publishing in British Medical Journal- Open in 2018, available online: