Disability Data

Data Source

The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based, random-digit dialed telephone survey of the U.S. civilian noninstitutionalized population 18 years of age or older. The survey is conducted by all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam. With assistance from the Centers for Disease Control and Prevention (CDC), trained interviewers collect comprehensive demographic, health condition, health risk behavior, and preventive health data. A detailed description of the compilation and use of BRFSS data, including questionnaires and codebooks, is available online at www.cdc.gov/brfss/.

Estimates

There are 79 indicators available for Disability Data. Indicators were defined based on recently published literature. For more information on indicator definitions, please see the Demographic Data Guide or Health Topic Data Guide. Estimates were produced independently by two analysts and compared, and differences were reconciled to ensure internal validity.

For each indicator response, data are provided for Disability, No Disability, Total, and Disparity. Disability, No Disability, and Total are expressed as percentages.

Total was calculated only from those respondents who meet the criteria for either Disability or No Disability, and is not an overall population estimate.

Disparity is expressed as a percentage point difference, calculated by subtracting the percentage for No Disability from the percentage for Disability.

Demographic Indicators

Non-socioeconomic demographics (age, sex, race/ethnicity, and veteran status) are reported as the percentage of disability among each selected demographic group. For example, the Demographics :: Age :: 18-44 :: Disability :: 2009 data view shows the percentage of disability among adults 18 through 44 years of age in 2009.

Socioeconomic demographics (education level, marital status, employment status, and income level) are reported as the percentage of the demographic group among the selected disability classification. For example, the Demographics :: Employment Status :: Employed :: Disability :: 2007 data view shows the percentage of adults with a disability who were employed in 2007.

Health Topic Indicators

Health topics are reported as the percentage of the health indicator response among the selected disability classification. For example, Health Risks & Behaviors :: Alcohol :: Drink Alcohol :: Yes :: No Disability :: 2004 shows the percentage of adults without a disability who reported using alcohol during the previous 30 days in 2004.

Statistical Analysis

The estimates presented here were obtained using Statistical Analysis Software (SAS) and SAS-callable SUDAAN to account for the BRFSS complex survey design. All estimates were weighted to account for the probability of selection, the number of adults in a household, the number of telephones in a household, nonresponse, and noncoverage of households without a landline telephone. Estimates were age-adjusted to the 2000 U.S. standard population, with the exception of estimates stratified by age and estimates limited to adults 65 years of age or older.

Data were analyzed in single year and 5 year averages. All 5 year average estimates were calculated by first combining 5 years of data and dividing final weights by 5. Analyses were run on the combined data to produce annualized results.

For Disability, No Disability, and Total, the following estimates were computed: percentage, number of respondents, weighted number of respondents, standard error, and 95% confidence interval. Analyses excluded missing responses or those for which the participant refused to respond or did not know. Estimates were suppressed if the standard error was greater than or equal to 30% of the estimate or if the unweighted total population was less than 50.

Limitations

The estimates presented here are subject to a number of limitations. First, estimates presented are based on self-report and thus, subject to recall bias. Second, the BRFSS does not include people living in institutions or group homes and, because people with a disability are likely to reside in such facilities, the prevalence of disability may be underestimated. Third, BRFSS is conducted only in English and Spanish and is inaccessible to individuals who require electronic telephone devices (TDD/TTY), which might preclude participation by people who speak other languages or who are deaf or hard of hearing. Fourth, BRFSS questions that are used to define disability do not collect information on the type, duration, severity, or permanence of disability.

Top of Page

Psychological Distress Data

Data Source

The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based, random-digit dialed telephone survey of the U.S. civilian noninstitutionalized population 18 years of age or older. The survey is conducted by all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam. With assistance from the Centers for Disease Control and Prevention (CDC), trained interviewers collect comprehensive demographic, health condition, health risk behavior, and preventive health data. A detailed description of the compilation and use of BRFSS data, including questionnaires and codebooks, is available online at www.cdc.gov/brfss/.

Estimates

There are 49 indicators available for Psychological Distress Data. Indicators were defined based on recently published literature. For more information on indicator definitions, please see the Demographic Data Guide or Health Topic Data Guide. Estimates were produced independently by two analysts and compared, and differences were reconciled to ensure internal validity.

For each indicator response, data are provided for Serious Psychological Distress, Mild to Moderate Psychological Distress, No Psychological Distress, Total, Disparity – Serious Psychological Distress, and Disparity – Mild to Moderate Psychological Distress. Serious Psychological Distress, Mild to Moderate Psychological Distress, No Psychological Distress, and Total are expressed as percentages.

Total was calculated only from those respondents who meet the criteria for Serious Psychological Distress, Mild to Moderate Psychological Distress, or No Psychological Distress, and is not an overall population estimate.

Disparity estimates are expressed as a percentage point difference. Disparity – Serious Psychological Distress is calculated by subtracting the percentage for No Psychological Distress from the percentage for Serious Psychological Distress. Disparity – Mild to Moderate Psychological Distress is calculated by subtracting the percentage for No Psychological Distress from the percentage for Mild to Moderate Psychological Distress.

Demographic Indicators

Nonsocioeconomic demographics (age, sex, race/ethnicity, and veteran status) are reported as the percentage of psychological distress among each selected demographic group. For example, the Demographics :: Age :: 18-44 :: Mild to Moderate Psychological Distress :: 2007 data view shows the percentage of mild to moderate psychological distress among adults 18 through 44 years of age in 2007.

Socioeconomic demographics (education level, marital status, employment status, and income level) were reported as the percentage of the demographic group among the selected psychological distress classification. For example, the Demographics :: Employment Status :: Employed :: Serious Psychological Distress :: 2007 data view shows the percentage of adults with serious psychological distress who were employed in 2007.

Health Topic Indicators

Health topics were reported as the percentage of the health indicator response among the selected psychological distress classification. For example, Health Risks & Behaviors :: Alcohol :: Drink Alcohol :: Yes :: No Psychological Distress :: 2007 shows the percentage of adults without psychological distress who reported using alcohol during the previous 30 days in 2007.

Statistical Analysis

The estimates presented here were obtained using SAS and SAS-callable SUDAAN to account for the BRFSS complex survey design. All estimates were weighted to account for the probability of selection, the number of adults in a household, the number of telephones in a household, nonresponse, and noncoverage of households without a landline telephone. Estimates were age-adjusted to the 2000 U.S. standard population, with the exception of estimates stratified by age and estimates limited to adults 65 years of age or older.

For Serious Psychological Distress, Mild to Moderate Psychological Distress, No Psychological Distress, and Total, the following estimates were computed: percentage, number of respondents, weighted number of respondents, standard error, and 95% confidence interval. Analyses excluded missing responses or those for which the participant refused to respond or did not know. Estimates were suppressed if the standard error was greater than or equal to 30% of the estimate or if the unweighted total population was less than 50.

Limitations

The estimates presented here are subject to a number of limitations. First, estimates presented are based on self-report and, thus, subject to recall bias. Second, because the BRFSS does not include people living in institutions or group homes or those without telephones, the prevalence of psychological distress might be underestimated. Third, the BRFSS is conducted only in English and Spanish and is inaccessible to individuals who require electronic telephone devices (TDD/TTY), which might preclude participation by people who speak other languages or who are deaf or hard of hearing. Fourth, BRFSS questions that are used to define psychological distress do not collect information on a lifetime diagnosis of specific mental disorders.

Top of Page

Expenditures

Disability-Associated Health Care Expenditures (DAHE) are the additional health care costs related to injuries, diseases, and chronic conditions associated with disability and exclusive of those costs not related to disability.

There are two sections of DAHE―mean expenditures and expenditures by the type of payer. Mean DAHE are presented as per capita estimates. Per capita is the state-level mean DAHE per member of that state, regardless of whether he or she has a disability. DAHE by the type of payer is presented for the following categories: Total Expenditures, Medicare, Medicaid, and Nonpublic Sources. All DAHE are in 2006 Dollars.

For more information, please see:
Anderson WL, Armour BS, Finkelstein EA, Wiener JM. Estimates of state-level health-care expenditures associated with disability. Public Health Rep. 2010;125:44–51.

Top of Page