ASPE Research Notes INFORMATION FOR DECISION MAKERS

Introduction

In 1990, 4,536,300 American children under 18 were reported as having a disability, defined as difficulty with certain functions or abilities (e.g., playing or going to school), due to a physical or mental health impairment. (1990 SIPP, 1990 Decennial Census, Lakin, CMHS.) This includes 4,444,500 children living in the community and 91,800 in institutions. Altogether, 7% of all children and 6.8% in the community have disabilities. All children with disabilities are included in this figure regardless of the severity of their disability or their need for disability-related services.

Comparisons with Other Data

Few data sources exist on children with disabilities and estimates vary by how disability is defined. According to the 1989 National Health Interview Survey (NHIS), 5.7% of children in the community were limited in their usual activities for health reasons. (Adams.) Special Education services were provided in 1989 to 4,271,200 children aged 3-17 or 8.1% of children that age. (Census.) In December 1992, 548,700 children under 18 received SSI, which provides cash assistance to certain low-income children with disabilities. (SSA.)

Sources of Data

Data on children in the community are from the 1990 Survey of Income and Program Participation (SIPP), a nationally representative survey of the civilian non-institutionalized population. Children residing in facilities for people with disabilities were included in institutional totals. Institutional data came from the 1990 Census, the Center for Mental Health Statistics in DHHS, and the University of Minnesota.

Prevalence

Of the 4,536,300 children with disabilities, 4,444,500 (98%) lived in the community and 91,800 (2%) in institutions. (See Table 1.) According to the 1990 Census, 1,200 children lived in nursing homes and 1,100 in homes for the physically handicapped (i.e., homes and schools for the blind, the deaf, or those with physical disabilities). Another 29,500 were in facilities for the mentally ill and 60,000 in facilities for the mentally retarded. (CMHS, Lakin.) Facilities for the mentally ill include state and county mental hospitals, private psychiatric hospitals, residential treatment centers for emotionally disturbed children, multi-service mental health organizations, and other residential organizations. Facilities for the mentally retarded include group homes, board and care homes, foster care homes, and Medicaid certified intermediate care facilities for the mentally retarded (ICF-MRs). The 148,000 children in correctional facilities or in Group Quarters not associated with disability (i.e., emergency shelters, rooming and boarding houses) were not included, as data on disability was unavailable. (1990 Census.)

Characteristics

Socio-demographic characteristics of children with disabilities pertain only to those living in the community and are derived from the 1990 SIPP. (See Table 2.)

Disabling Conditions. Leading causes of disability include learning disabilities (1,372,200), speech disorders (1,096,000), mental retardation and other developmental disabilities (720,500), mental illness (462,800), and respiratory conditions (362,200), such as asthma.

Age/Gender. Disability increases with age for children--5.2% are under 3, 14.1% are 3-5, and 80.7% are 6-17. Most children with disabilities are boys (62.6%), whereas most adults with disabilities are women (56%).

Race/Ethnicity. 76.9% of children with disabilities were White non-Hispanic (76.9%), 11.8% Black, 7.7% Hispanic, and 3.6% were "Other" (i.e., American Indian or Asian-American). Disability rates varied by race: 7.5% for White non-Hispanics, 5.6% for Blacks, and 4.6% for Hispanics.

Economic Status. In 1990, 957,600 children with disabilities lived in poverty. Poverty rates were 21.8% for children with disabilities and 20.7% for children without disabilities. The proportion of children on AFDC was similar for children with (9.8%) and without (9.5%) disabilities. Most AFDC families, along with other low-income families are eligible for Food Stamps. Participation in Food Stamps was higher for children with (15.4%) than for those without disabilities (13.5%).

Health Insurance. Although 782,400 children with and 9,847,000 children without disabilities are uninsured, there is little difference proportionately: 17.6% of uninsured children have disabilities compared to 16.3% who do not. A lower proportion of children with disabilities have private insurance only (69.5% with and 61.9% without disabilities), whereas a higher proportion of children with disabilities are on Medicaid (by itself or in conjunction with private insurance): 20.5% of those with and 14.2% without disabilities. Medicaid, which pays for the health care of low-income individuals, covers children who are on AFDC, most on SSI, and those who qualify for certain optional State programs covering ill or disabled persons.

Sources

Adams, P.F., and V. Benson, "Current Estimates from the National Health Interview Survey, 1989," National Center for Health Statistics. Vital Health Statistics 10(176), 1990.

*Adler, M., "The Disabled: Their Health Care and Health Insurance," Proceedings of the American Statistical Association, 1990. [http://aspe.hhs.gov/daltcp/reports/disabled.htm]

Census Bureau, Unpublished tabulations from the 1990 Decennial Census.

Census Bureau, "Statistical Abstract of the United States, 1993," (113th edition), Washington, D.C., 1993.

Center for Mental Health Statistics, Substance Abuse and Mental Health Services Administration, DHHS, unpublished, 1990.

Lakin, C., University of Minnesota (unpublished tabulations).

*Mathematica Policy Research, "Task I: Population Profile of Disability," ASPE Report, DHHS, Washington, D.C., 1989. [http://aspe.hhs.gov/daltcp/reports/task1.htm]

*Mathematica Policy Research, "Task II: Federal Programs for Persons with Disabilities," ASPE Report, DHHS, Washington, D.C., 1990. [http://aspe.hhs.gov/daltcp/reports/task2.htm]

Social Security Administration, "Annual Statistical Supplement to the Social Security Bulletin, 1993," DHHS, August 1993.

Unpublished tabulations from the 1990 SIPP.

AUTHOR: Michele Adler, Office of Disability, Aging, and Long-Term Care Policy

ASPE Research Notes is circulated periodically to the Department of Health and Human Services by the Office of the Assistant Secretary for Planning and Evaluation. This paper reflects only the views of its author and does not necessarily represent the position of the U.S. Department of Health and Human Services. For further information on long-term care or disability issues, call Mary Harahan, Office of Disability, Aging and Long-Term Care Policy at 202-690-6613. To obtain asterisked reports referenced, contact Brenda Veazey, DHHS/OS/ASPE/DALTCP, Room 424E, HHH Building, 200 Independence Avenue, S.W., Washington, DC 20201.