General Measure on People with Disabilities in the
European Statistical System (E.S.S.)
FIRST DRAFT REPORT
in progress
Roberta Crialesi, Elena De Palma
ISTAT
In collaboration with M. De
Smedt, J. Bonte, M. de Klein
Washington Group on Disability Statistics
9-10
January 2003
Ottawa
- Canada
Index
Introduction
Part 1: Empirical Questions Matrix
1. Identification
of surveys available
2. Selection
of the General Measures
3. Main
Results
4. Appendices:
Appendix
1 “Inventory of Surveys available”
Appendix
2 “Information on Selected Surveys”
Appendix 3a “Empirical Questions Matrix »
Appendix
3b “Legend of criteria for Empirical Questions Matrix”
Appendix
4 “List of General Measures” selected
Part 2: Minimum European Health Module (MEHM)
1. The
MEHM
2. Selection
of questions
3. Analysis
of the questions and main results
4. Appendices:
Appendix
5a “Overview of use MEHM related questions in the European surveys”
Appendix 5b “Overview of the questions used in the
European surveys”
Appendix
6 “Legend of criteria for analyzing
MEHM questions”
Appendix
7 “Analysis of MEHM question 1”
Appendix
8 “Analysis of MEHM question 2”
Appendix
9 “Analysis of MEHM question 3”
General
Introduction
In
the framework of its activities on Health Statistics, EUROSTAT is assuring the coordination of the efforts of the
European Statistical System (E.S.S.) in relation to the Washington Group
on Disability Statistics (WG).
PG/TNO-NL has supported
this work until 31 August 2002 through the European Disability Measurement
(EDM) Project. A new subvention for the continuation of the coordination can
come into force by March 2003 at the earliest.
ISTAT-Italy had offered to bridge
the gap and to carry out activities required for the preparation of WG interim
meeting which in Ottawa, Canada (January 9 –10, 2003), organized by the
Statistical Institute of Canada (STATCANADA).
The second meeting of the Washington Group will be
held in Europe in recognition of the “European year of persons with disabilities
(2003)”. It was decided to organize an interim meeting in order to make progress in WG work and be able to
report this to the UN Statistical Commission in March 2003.
The main issues
of this meeting are:
-
the question matrix on the purposes of
general disability measures
-
results of methodological testing of
general disability measures.
As result of the first WG
meeting two Matrices were developed for approaching the “Global measure” issue
and the term “Comparable general disability measure” was adopted to reduce
confusion about multiple meanings of the term “global”.
These
two matrix are: a) “Conceptual Matrix” that cross-classifies the
purpose that a general disability measure is supposed to address (i.e., the use
that the data will be put to) with a typology of question characteristics which
address concepts such as ICF domain, severity, etiology and duration; b) “Empirical
Questions Matrix” for evaluating the characteristics of the general
measures currently in use according to the dimensions of the matrix.
These two matrices are
intended to be tools for identifying the gaps that exist in disability
measurement and for directing future work in developing internationally
comparable general measures of disability.
To full contribute on the Ottawa meeting topics and to
enhance the European Countries experience on statistical disability, ISTAT has
focused its activities on the “Empirical Questions Matrix” and furthermore on
the Minimum European Health Module (MEHM) proposed to use in all European surveys as one of the results of the “European
Disability Measurement Project”. The MEHM, can be considered the EU
contribution to the first priority of the Washington Group (to guide
development of a small set of comparable general disability measures for
censuses and national surveys).
This report presents the result of the activities carried
out by ISTAT, in collaboration with M. De Smedt, J. Bonte, M. de Klein, as preparatory work at the European level
for the meeting in Ottawa (9-10 January
2003).
The report is composed of two parts: the first one is
focused on the “Empirical Questions Matrix” and the second one is focused on
“MEHM”.
Part 1
“Empirical Questions Matrix”
1.
Identification of
surveys available
For our purpose it was decided to focus only on
population-based surveys (administrative data sources were not taken into
account). The fully harmonized EU-wide surveys (European Community Household
Panel -ECHP, European Labour Force Survey -LFS, Survey on Income and Living Conditions -SILC) were included and analyzed using the questions given as reference instruments
to the MS.
To have an overview of all surveys carried out in
Europe and related to health/disability issues it was necessary to collect
information by using reference documents (HIS/HES database) and sending a
letter to all Member States (MS) asking
them to submit questions used as general measures to
identify persons with disabilities.
Hungary, an EU Candidate Country, was also included because it is represented
by Eva Gardos at the Ottawa meeting.
As
result was an Inventory was done (see Appendix 1) with a total of n. 86 surveys.
As reference the following documents were
used:
-
“EUROSTAT Disability Project: Survey data
on disability” (1999)[1]
-
“Inventory of survey data on disability
in EU member state” (2002)[2]
-
European Commission’s “European Health
Interviews & Health Examination Surveys” (HIS/HES) database[3]
(version of July and of November2002).
Because
of the large number of surveys available, it was decided to adopt the following
criteria to select surveys for an analysis of the General Measure Questions on
disability:
- Survey typology: all types of survey - census, health interview,
health examination with a self-completed questionnaire component, social
surveys, designated disability surveys - were included if they were
carried out at national level.
- Period of time: from 1998 to 2002. Some exceptions were made for
countries that did not have surveys in the identified period such as
Greece (EL01,1991) or Luxembourg (L01, 1996) or Portugal (P01, 1995; P02,
1994). Switzerland (Ch01,1997).
Following
these criteria a total of 53 surveys
were selected. Details on these surveys, when available, are included in Appendix
2
2. Selection of the
General Measure Questions
The
term of General Measure refers to a general question, or a fort set of
questions, used to identify persons with disabilities.
For
the selected surveys (53), one o more questions considered as General Measure
were identified through the HIS/HES Database (version of July 2002 and version
November 2002) or, in a few cases, from
documents that were sent directly by the Member States.
It
was decided to refer to the most recent survey if the same one was carried out
more than once in the defined period of time (1998-2002), (e.g. CH01-1997 and
CH02- 2002, F08-1999 and F12-2002; I03-2000 and I04-2001; IRL01-1998 and
IRL03-1998; IRL02-2000 and IRL04-2001).
For some surveys general measure questions were not identified for lack
of information available or because it
was clear that a “battery of questions” (such as ADL scale, IADL scale or
similar scale) was used to identify persons with disability.
In other cases, the full wording was not available
(e.g. The Austrian Survey on disability) or the English translation was not
completed (e.g. N02).
Due to the above decisions/situations the number of
surveys included in the “Empirical Matrix Questions” (see
Appendix 3) is less than the total
number of the surveys selected.
In fact, a total of 30 national surveys and 6
census containing general measure question(s) on disability were used for
the analysis, plus the three fully harmonized EU-wide surveys ECHP,
LFS, SILC.
Main
criteria to be used in the “Empirical Matrix Questions” were then identified such as: number of questions used, reference
to ICF domain, specification of duration of disability, response categories,
attribution to health condition, use of neutral terminology, reference to
norms, complexity of the question, age orientation, specific reference to
mental health. (for more information see Appendix 3b).
To better represent the characteristic of the
questions used in the European surveys the original version of the Empirical
Questions Matrix was slightly modified by adding other criteria such as: mix
of concepts, need of help, specific reference to work/job activities.
The
wording of each question selected available was analysed by the above criteria.
3.
Main Results
From the statistical point of view, the disability
issue has a long tradition in surveys carried out in Europe. In fact, almost
all surveys (1998-2002) have questions on health condition related to
disability.
Table 1 shows the distribution of the selected surveys
having a general measure by types of surveys.
The majority of these are Health Interview Surveys
(13) and General Social Surveys (10). There are also 6 Censuses.
Table
1 Breakdown by survey type
|
Type Survey |
Number |
Code Survey |
|
HIS |
13 |
A01, B02, CH02, DK02,
E02, EL02, F09, F1999, FIN06, I01, IS02, NL02, H01 |
|
General Social Survey* |
10 |
B03, D02, F12, I04, IRL04, IS03, L02,
N01, S02, UK11 |
|
Census |
6 |
Bc02, EL01, IrlC02, P04, UK15, H02 |
|
HIS/HES |
3 |
FIN03, IRL03, NL03 |
|
Disability |
2 |
F02 |
|
Other |
3 |
UK02, H03, H04 |
Total
|
36 |
|
*
Multipurpose Surveys and Standard of Living Surveys were included under this
category.
The results of the analysis are presented according to the criteria
previous mentioned.
§
Number of questions used to
identify people with disabilities
In the surveys examinated this number
ranges from 1 to 7 questions (Multiresponses
questions have been counted as total number of items such as in IrlC02, IS02,
IS03, NL03).
In the European context 17 out of 36 surveys use only 1 question and 13
surveys use 2 questions, as showed in the below table.
Table
2 Distribution of surveys by the number of question used to identify people
with disabilities
|
Survey code |
Number surveys |
% of total |
|
|
1 |
CH02, D02, E02, EL01, EL02, F02, F12, F1999, FIN03,
I01, I04, IRL03, NL02, S02, UK15, H02, H03 |
17 |
47,1 |
|
2 |
A01, B02, B03, Bc02, DK02, F09, FIN06, IRL04, L02,
P04, UK02, UK11, H01 |
13 |
36,1 |
|
3 |
IS03 – H04 |
2 |
5,6 |
|
4 |
|
0 |
0 |
|
5 |
NL03 |
1 |
2,8 |
|
6 |
IrlC02 - N01 |
2 |
5,6 |
|
7 |
IS02 |
1 |
2,8 |
|
Total Number |
|
36 |
100 |
Table
3 Distribution of surveys by question(s) used as general measure and survey
type
|
N. of questions |
His |
General
Social Survey |
Census |
HIS/HES |
Disability |
Other |
Number of surveys |
|
1 question |
6 |
4 |
3 |
2 |
1 |
1 |
17 |
|
2 |
6 |
4 |
2 |
|
|
1 |
13 |
|
3 |
|
|
|
|
1 |
2 |
|
|
4 |
|
|
|
|
|
|
0 |
|
5 |
|
|
|
1 |
|
|
1 |
|
6 |
|
1 |
1 |
|
|
|
2 |
|
7 questions |
1 |
|
|
|
|
|
1 |
|
Total |
13 |
10 |
6 |
3 |
1 |
3 |
36 |
The above table
shows that:
-
6 out of 13 HIS use only 1 question (CH02, E02, EL02, E1999, I01, NL02), 6
others use 2 questions (A01, B02, DK02, F09, FIN06, H01), and only 1 (IS02)
uses 7 questions;
-
4 out of 10 General Social Surveys utilize 1 question (D02, F12, I04, S02) or 2 questions (B03, IRL04,L02,UK11), 1 (IS03) uses 3 questions and 1 (N01) uses 7
questions;
-
3 out of 6 Censuses use 1 question (EL01, H02, UK15), 2 (Bc02, P04) use 2
questions and 1 (IrlC02) uses 6 questions;
-
2 out of 3 HIS/HES use only 1
question (FIN03, IRL03) and 1 (NL03)
uses 5 questions;
-
the one Disability Survey ( F02) uses 1
question;
-
3 surveys belonging to “other” categories
use respectively 1 (H03), 2 (UK02) and 3 (H04) questions.
§
ICF Domain
The ICF domains most frequently covered
in the European surveys are Activities, Body Structures and Body Function. In fact, these are investigated in all the surveys considered: Activities is included in 32 out of 36
surveys, and Body Structures and Body
Function in 31 surveys.
The Participation domain has also
been taken into consideration in several surveys (17 out of 36) generally by
using 1 question (8 surveys) or two or more (9 surveys).
As an example among the surveys using
more than one questions, Activities and
Participation are investigated in more completed way, in NL03. It takes also
into account the age of the respondent. In fact, if the respondent is under 12
years old (proxy is allowed) is asked if he/she is limited in activities in
schools or in other activities which are normal for a child of his/her age; if
over 12 years old to what degree he/she is limited in daily activities at
home?; and to all respondents is asked to what degree he/she is limited at
school, work, in leisure time activities, sports or traveling.
In Eleven of the 17 surveys using the
Participation domain the wording also include specific reference to work context or to job activities.
(e.g.: DK02, E02, FIN06, H01 (HIS); D02, N01 (General Social Survey); FIN03,
NL03 (HIS/HES); IrlC02, UK15 (Census); H04 (other).
Table
4 shows the distribution of
the surveys by ICF Domain and number of questions used to identify persons with
disabilities.
Many
surveys (15 out of 36) focus on Body Structures, Body Function and
Activities (BS, BF, A) using: 1
question (6 surveys: CH02, EL01, EL02, F12, S02, H03) or 2 questions (9 surveys: A01, B02, B03, Bc02, F09, IRL04, P04,
UK02, UK11).
While all four ICF domains (BS, BF, A, P)
are used in 12 surveys with: 1
question (6 surveys: E02, FIN03, I01,
I04, IRL03, UK15) or 2 questions (3 surveys : DK12, FIN06, H01) or two or more (3 surveys: H04, NL03, IrlC02).
Furthermore, four surveys focus on
Activities and Participation (D02, F1999, IS03, IS02), three surveys focus on
Body Structure and Body Functions (F02,
H02, L02), one focuses on Body Structure, Body Functions and
Participation (N01) and one only
on Activities (NL02).
Table 4 Distribution of
surveys by ICF Domain and number of questions used to identify persons with
disabilities
|
Number of questions |
BS BF A |
BS BF A P |
AP |
BS
BF |
BS
BF P |
A |
Total |
|
1 |
6 |
6 |
2 |
2 |
|
1 |
17 |
|
2 |
9 |
3 |
|
1 |
|
|
13 |
|
3 |
|
1 |
1 |
|
|
|
2 |
|
4 |
|
|
|
|
|
|
0 |
|
5 |
|
1 |
|
|
|
|
1 |
|
6 |
|
1 |
|
|
1 |
|
2 |
|
7 |
|
|
1 |
|
|
|
1 |
|
Total |
15 |
12 |
4 |
3 |
1 |
1 |
36 |
Table 5 shows the distribution of surveys by ICF domain
and type of survey, from what result that:
-
Of the total 13 HIS, 5
surveys (A01, B02, CH02, EL02, F09) refer to BS, BF and A; 5 others (E02, I01,
DK02, FIN06, H01) refer to all 4 ICF Domains; 2 surveys (F1999, IS02) refer to
A and P, and 1 survey (NL02) only to Activity.
-
Of the total 10 General
Social Surveys, 5 (B03, F12, IRL04, S02, UK11) refer to BS,
BF and A; 1 (I04) to all four ICF domains, 2 (D02, IS03) refer to A and P; 1
(L02) refers only to BF and BF, 1 (N01)
only to Activity.
-
Of the total 6 censuses, 3 (Bc02, EL01, P04) refer to BS, BF and A; 2 (IrlC02, UK15)
to all 4 ICF domains and 1 (H02) to only BS and BF.
-
All three HIS/HES (FIN03, IRL03, NL03)
refer to all four ICF domains.
-
The one Disability Survey refers to only
BS and BF.
-
Of the total 3 surveys belonging to
“other” types of surveys, 2 (UK02, H03) refer to BS, BF and A, and 1 (H04) to
all four ICF domains.
Table 5 Distribution of
surveys by ICF Domain and type of survey
|
Type of Survey |
BS BF A |
BS
BF A P |
A P |
BS
BF |
BS
BF P |
A |
Total of surveys
|
|
HIS |
5 |
5 |
2 |
|
|
1 |
13 |
|
General Social Survey |
5 |
1 |
2 |
1 |
1 |
|
10 |
|
Census |
3 |
2 |
|
1 |
|
|
6 |
|
HIS/HES |
|
3 |
|
|
|
|
3 |
|
Disability |
|
|
|
1 |
|
|
1 |
|
Others |
2 |
1 |
|
|
|
|
2 |
|
Total |
15 |
12 |
4 |
3 |
1 |
1 |
36 |
Taking into consideration the number of questions and the type of ICF
domains that they refer to, it seems that when only 1 question is used
there is much of variability in the wording of the instrument. Despite of this
variability 15 surveys out of 17 refer to Activity Limitations and only 2 (F02,
H02) refer to BS and BF.
Generally the variability in the wording is due to the introduction of
more specified information, e.g. on health conditions, cause of illness, etc.
When activity and participation limitations are investigated, other concepts
are added, such as need of help or limitation due to health
conditions/disabilities/handicaps.
The following examples of wording give an idea of this variability.
-
Limitation of activities,
(A) e.g.:
“What
about your day-to-day activities? - I have no difficulties in my day-to-day
activities/ I have some difficulties in my day-to-day activities/I am unable to
carry out my day-to-day activities.” (NL02).
-
Activities
limitation and participation (A, P) e.g.:
“Is
he/she restricted in the kind or amount of exercise he/she can do? (at home,
work, or school or any other occupation of his/her age such as travelling,
games, sports, leisure activities?” (F1999)
“Apart
from short illness: does your state of health prevent you from carrying out
your day to day activities, for example, in the home, at work or in your
training? - Not at all/ A little/ Considerably.” (D02);
-
Long
standing illness/disability that limits Activities and Participation, (BS, BF, A, P).
e.g:
“Do
you have some permanent or chronic illness or some defect, trouble or injury,
which diminishes your working capacity or functional ability? – Yes/ No”
(FIN03);
“Do
you have any long-term illness, health problems or disability which limits your
daily activities or work that you ca do? -Yes/ No” (UK15)
-
Activities
and participation limitations due to health condition/disability and needs for help, (BS,BF, A, P)
e.g.:
“Does
some of people of the household need some type of special dedication for the
fact of suffering a handicap or some limitation to carry out with normality the
activities of the family, social and labour life? – Yes/ No” (E02);
“Are
you affected by longstanding illness or a permanent disability that reduces
your personal freedom till requiring help from other people for daily needs
inside and outside the home? -No/ Yes
occasionally for some needs/ Yes continuously or for important needs” (I01, I04).
When 2 questions are used to identify people with disability there
is more homogeneity in fact the first enquires about chronic illness and the
second one about activities or activities and participation limitations. Again
the variability is due to the introduction of more
specified information on health
conditions (disability/handicap/mental health illness…), examples of activities
and contexts or type of answer categories.
The following examples of wording give the general idea of this
variability.
-
The
first question refers to “suffering of chronic disease/disability/handicaps”
(BS/BF) and the second one refers to “activities limitation due to health condition” (A).
e.g.:
(B02,
B03, Bc02,)
1.
“Do you suffer from one or more longstanding illnesses, chronic conditions or
handicaps?-Yes/ No”;
2. “Are you restricted in your daily activities
due to this (these) illness(es), chronic condition(s) or handicaps? –
Continually/ At intervals/ Not or seldom”.
(IRL04)
1. “Do
you have any chronic, physical or mental problem, illness or disability? –Yes/
No”
2. “Are
you hampered in your daily activities by this physical or mental health
problem, illness or disability?- Yes severely/ Yes to some extent/ No” .
(UK02,
UK11)
1. “Do
you have any long-standing illness,
disability or infirmity? – Yes/ No”
2. “Does this illness or disability limit your
activities in any way? – Yes/ No”
(F09)
1. “Do
you suffer from a chronic disease or health problems? – Yes/ No”
2. “During at least six months, have you been
limited in activities which people normally carry out due to a health problem?
– Yes/ No”
-
the first question refers to suffering of
chronic disease/disabilities/handicaps” (BS/BF) and the second one refers to A
and P. e.g.:
(DK02)
1. “Do
you suffer from any long standing illness, long standing after effect from
injury, any disability or other long-standing condition? – Yes/ No”
2. “Are you restricted by this illness in your
work/usual activities? - Yes, very much/ Yes a little/ No”.
§
Duration specification
on disability
11 surveys do not include a specific time
reference in the wording. In these cases the verb is used in Present tense.
25 surveys refer to specific time as follows:
Long standing: 17 (B02, B03, Bc02, DK02, EL01, EL02, I01, I04,
IRL03, IrlC02, N01, NL03, S02, UK02, UK11, UK15, H03); Apart from short/not
short period: 2 (D02, H01); At least three months/or more: 2 (FIN03,
H04); More than one year: 1 (Ch02); Past/6 months: 1 (F09); Specific
date: 1 (L02); Future: 1 (F12).
§
Reference Norms
In
the European surveys a reference norm to compare with something or someone,
such as “compared
with persons of your own age…” is never used.
§
Attribution to
health conditions
There are 25 (out of 36 survey) that
include a specific reference to health problems or disability as the cause of
restriction in activities and participation, while 6 surveys have no such reference (EL01, F12, F1999,
IS02, NL02, S02). For 5 surveys the
criterion is not applicable (EL02, L02, P04, H02, H03).
§
Answer categories
The answer
categories as criteria were: dichotomous, multiple and their combination.
As Table 6
shows, the Dichotomous answer category is more used (16 surveys: Ch02,
E02, EL01, EL02, F02, F12, F09, F1999, Fin03, IrlC02, IS03, S02, UK02, UK11,
UK15,H03).
Eleven out of
36 surveys use both categories (B02, B03,Bc02, Dk02, Fin06, IRL04, L02, N01,
NL03, P04, H01), and only 9 surveys use Multiple answer category (A01,
D02, I01, I04, IRL03, ISO2, NL02, H02, H04).
If we analyse
the types of answer category used by number of questions the result are as it
follow.
The surveys with one question (17) can be split up in:
-
dichotomous
answer category: 12 surveys (Ch02, E02 EL01, EL02, F02, F12, F1999, FIN03,
IRL03, S02, UK15, H03) and
-
multiple answer
category: 5 surveys (D02, I01, I04, NL02, H02).
The surveys
using two questions (13) are split up in:
-
dichotomous
answer category: 3 surveys (F09, UK02, UK11)
-
multiple answer
category: 1 survey (A01)
-
both answer
categories: 9 surveys (B02, B03, Bc02, DK02, FIN06, IRL04, L02, P04, H01).
Surveys using 3
questions (IS03 and H04) use respectively Dichotomous and Multiple category.
Surveys using 5
questions (IrlC02 and NL03) use respectively Dichotomous and Dichotomous
followed by Multiple answer category.
The survey N01,
using 6 questions, utilizes Dichotomous for the first one and Multiple for the
others.
The survey
IS02, using 7 questions, utilizes Multiple answer category for all questions.
Table 6 Survey
distribution by answer categories and by number of questions
|
N. of questions |
Dichotomous |
Multiple |
Dic and Multiple |
Number of surveys |
|
1 |
12 |
5 |
|
17 |
|
2 |
3 |
1 |
9 |
13 |
|
3 |
1 |
1 |
|
2 |
|
4 |
|
|
|
- |
|
5 |
1 |
|
1 |
2 |
|
6 |
|
|
1 |
1 |
|
7 |
|
1 |
|
1 |
|
Total surveys |
17 |
8 |
11 |
36 |
§
Use of neutral
terminology
The ICF as conceptual framework force to
use a neutral terminology as result also to the cultural change in definition
of people with disabilities. In the European context the word “handicap”
and “disability” were considered with a
negative connotation. As result of using this criteria only 12 out of 36
surveys use neutral terminology (1/3
of the total).
§
Complexity
A wording were
considered “complex” not only for the syntax
but also for the format used to submit the question(s). It was excluded, as criteria for complexity,
the mix of concepts that was analysed separately. 19 out of 36 surveys use
“no complex wording” while 17 use a complex one.
§
Mix of concepts
This stresses if in the wording there is a mix of
concepts such as long-standing
illness, disability, health problems or/and activities and participation with
reference to environment too. The most common mix of
concepts is related with longstanding illness/chronic conditions and disability
or handicap.
§
Age oriented
The question(s)
was considered age oriented when it refers to specific target population. In
only 4 surveys it happens (A01, FIN06, IrlC02, NL03) by selecting a question on
the age of the respondent (A01, NL03, IrlC02), or referring to example of
activities or context that are related with specific age of the population
surveys (e.g.: FIN06).
It must be
underline that in almost all the other surveys when the question is related
with activity limitation refers to activity in general (B02, B03, Bc02, CH02,
F02, F09, F1999, I01, I04, IRL04, NL02, UK02, UK11) so that can be use for all
type of population survey.
§
Need of Help
This concept is
included in only 6 surveys. The breakdown for number of questions used is: one question (E02, I01, I04),
two questions (A01, H01) and three questions (IS03).
Examples of wording:
I01 “Are you affected by a
longstanding illness or a permanent disability that reduces your personal
freedom till requiring help from other people for daily needs inside and
outside the home?
NO
YES, intermittently, for some needs
YES, continuously, or for important
needs”;
E02
“Does some of people of the household need some type of special dedication for
the fact of suffering a handicap or some limitation (not being able to be alone
at nights, to need help to go out in the street, personal hygiene, etc.) to
carry out with normality the activities of the family, social and labour
life?
Yes
No”
§
Specific reference to mental health functioning
Only 9 surveys
refers to Mental Health: 8 refers to Psychological functioning (Ch02, IRL04,
IrlC02, L02, P04, H01, H04) and 1 to Psychological and Cognitive functioning
(F02).
Special Questions
In Four surveys, not
included in the above presentation on results, a special general measure was
found. These in fact, have a general question
that aims only to identify people who have an official recognition of
disability or who have a disability pension.
The
surveys are:
D01 Germany - Microcensus, 1999 (HIS)
114. Is your handicap established by an
official notice, or
have you made an appropriate application?
D05 German National Health Examination and
Interview Survey 1998 (HIS)
25. Do you have
a disability which has been officially
acknowledged by the appropriate
body/pension office?
E04 Spain – Impairment, Disabilities and Health
Status Survey, 1999 (Disability survey).
19. Does any
person in the household have a handicap
certificate issued by the National
Social Services Institute
or the respective Autonomous Community
body as a
result of suffering from a disability,
problem or disease?
FIN07 Finland – The
National FinRisk, 2002) (HIS/HES)
21. Do you receive disability pension for
a disease or inability?
no
yes, partial disability pension
yes, temporary disability pension
yes, permanent disability pension
Several others surveys include this kind
of question but they have also
questions as general measure (e.g. D02,
FIN06, P04).
Fully harmonized EU-wide surveys and
general measure
The
three fully harmonized EU-wide
surveys are:
European Community Household Panel -ECHP,
European Labour Force Survey -LFS,
Survey on Income and Living Conditions –SILC.
In the ECHP
(1994-2001) is used a general measure composed by two questions:
“Do you have any chronic physical or mental health
problem, illness or disability?- Yes/No” followed by “Are you hampered in your
daily activities by this physical or mental health problem, illness or
disability?” – Yes severely/ Yes to some extent/ No”.
The first one investigate the health/disability
condition (BS, BF) and the second one the limitations of the activities. As we
can see the main characteristics of this general measure are: to refer to BS,
BF e A domains, no specification of duration of the chronic condition or
disability, no age orientation, no use of neutral terminology (if “disability”
is considered as no neutral), no complexity in the syntax but mix of concepts
in the wording, specific reference to mental health problem (Psychological and
Cognitive) is included.
The activity limitations are investigated by referring
to health condition and without using reference norms (“in your daily
activities) or to work contest/job activities. Need for help is not included.
The answer categories
are dichotomous (in the first one) and multiple (in the second one).
The two questions are
introduced by a Self-perceived health question “How is your health in
general?”. All three questions are a
first version of the Minimum European Health Module (MEHM).
This module, that will be describe in the second part
of the report, will be used in the Survey on Income and Living Conditions –SILC
(2004).
In the European Labour Force Survey 2002 it is used
only one question as general measure for screening the respondents for the
module on “employment of disable people”. The question is “Do you have any
longstanding health problem or disability? – Yes/ No”. This question is also part of the MEHM.
The main characteristics of the question are: it
refers to BS BF domains, with no neutral terminology (disability) and mix of
concepts but not complex wording; there
is not reference to mental health functioning or work/job activity, or to need
for help. The question is not age oriented and not use any reference to norms.
The duration of health problem is
specified (longstanding).
Appendix
1 (file Annex1)
Inventory
surveys available
Appendix
2 (cfr file Annex 2)
Information
on selected surveys
Appendix
3a (cfr file Annex 3)
Empirical Questions Matrix
Appendix
3b
Legend of criteria for the
Empirical Matrix
Survey-Code Number
used in the HIS/HES database. When the survey is not in the database it is
underline but an unofficial code is
given.
Country Country
Year Year in which the survey was done
Title
Survey Title
of the Survey
General
Measure: answer categories: Yes, No. General measure
refers to questions (one or more) that are used to identify persons with
disabilities.
ICF
Domain: Description of
ICF domain that are addressed by the general measure. Answer categories: BS (Body Structure), BF (Body Function), A (Activities), P (Participation).
It refers to the type of ICF domain used to identify persons with disabilities.
When the wording includes words like handicap/disability it is considered
linked to BF - BS and A as ICF domain.
Mixture
of concepts:
This stresses if in the wording there is a mix of
concepts such as long-standing
illness, disability, health problems or/and activities and participation with
reference to environment too. Answer categories: Yes, No.
Duration
specified: Answer
categories: It is reported the expression used in the wording or in the
instruction, if not specified it is reported “Not specified”.
Response
categories: Description of
the type of response categories used: Dichotomous,
Multiple, Open
Attribution
to a health condition: This address the issue
of whether the general measure enclosed a specific reference to health problem
or disability as cause of restriction in activities and participation.
Answer
categories: Yes (when there is a specific reference to health problem,
disability…in the wording), No.
Use
of neutral terminology in question: It stresses the type of terminology used in the
wording. Answer categories: Yes, No. Yes when neutral or
biased words are used, and No when words such as handicaps or disability are
used.
Reference/Norms:
answer
categories: Yes, No. Yes when there is a reference to something or someone ,such as “compared with persons
of your own age…”.
Complexity:
It refers to cognitive complexity of the
general measure such as syntax used. Answer
categories: yes (if the wording is complex for the syntax used), no (if the
syntax is simply).
Age-oriented: answer categories: Yes (if the
wording refer to specific target population), No
Specific reference to Mental health
functioning: It refers to if and how the general measure address
mental functioning. Answer categories: Yes, (cognitive, if in the list there is specific
reference to intellectual or cognitive problems, psychological, when it
used “mental health” or emotional
problems), No.
Specific reference to work activities:
Answer categories: Yes, when there is specific reference to work or working
activities, No.
Need of help: This address the issue whether in the wording it is enclosed the concept
of need of help in daily life. Answer categories: yes (if there is specific
reference to need of help for carrying out activities)
Number of questions used to identify
persons with disabilities: It refers with the number used for selected. The multiresponses have been
counted as total number of items.
Appendix
4 (cfr file Annex 4)
List
of general measure questions selected from the MS survey and census.