Focus Area 6: Disability and Secondary Conditions: Objectives and Subobjectives

Goal: Promote the health of people with disabilities, prevent secondary conditions, and eliminate disparities between people with and without disabilities in the U.S. population.

As a result of the Healthy People 2010 Midcourse Review, changes were made to the Healthy People 2010 objectives and subobjectives. These changes are specific to the following situations:

Changes in the wording of an objective to more accurately describe what is being measured.
Changes to reflect a different data source or new science.
Changes resulting from the establishment of a baseline and a target (that is, when a formerly developmental objective or subobjective became measurable).
Deletion of an objective or subobjective that lacked a data source.
Correction of errors and omissions in Healthy People 2010.

Revised baselines and targets for measurable objectives and subobjectives do not fall into any of the above categories and, thus, are not considered a midcourse review change.¹

When changes were made to an objective, three sections are displayed:

In the Original Objective section, the objective as published in Healthy People 2010 in 2000 is shown.
In the Objective With Revisions section, strikethrough indicates text deleted, and underlining is used to show new text.
In the Revised Objective section, the objective appears as revised as a result of the midcourse review.

Details of the objectives and subobjectives in this focus area, including any changes made at the midcourse, appear on the following pages.

¹See Technical Appendix for more information on baseline and target revisions.

NO CHANGE IN OBJECTIVE

6-1.

Include in the core of all relevant Healthy People 2010 surveillance instruments a standardized set of questions that identify “people with disabilities.”

Target: 100 percent.

Baseline: No Healthy People 2010 surveillance instruments include a standard set of questions that identify people with disabilities in 1999.

Target setting method: Total coverage.

Data source: CDC, NCBDD.

NO CHANGE IN OBJECTIVE

6-2.

Reduce the proportion of children and adolescents with disabilities who are reported to be sad, unhappy, or depressed.

Target: 17 percent.

Baseline: 31 percent of children and adolescents aged 4 to 11 years with disabilities were reported to be sad, unhappy, or depressed in 1997.

Target setting method: 45 percent improvement (parity with children and adolescents without disabilities in 1997).

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

NO CHANGE IN OBJECTIVE

6-3.

Reduce the proportion of adults with disabilities who report feelings such as sadness, unhappiness, or depression that prevent them from being active.

Target: 7 percent.

Baseline: 28 percent of adults aged 18 years and older with disabilities reported feelings that prevented them from being active in 1997 (age adjusted to the year 2000 standard population).

Target setting method: 75 percent improvement (parity with adults aged 18 years and older without disabilities in 1997).

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
6-4.	Increase the proportion of adults with disabilities who participate in social activities. Target: 100 percent. Baseline: 95.4 percent of adults aged 18 years and older with disabilities participated in social activities in 1997 (age adjusted to the year 2000 standard population). Target setting method: Total participation (parity with adults aged 18 years and older without disabilities in 1997). Data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
6-4.	Increase the proportion of adults with disabilities who participate in social activities. Target: ~~100~~79 percent. Baseline: ~~95.4~~61 percent of adults aged 18 years and older with disabilities participated in social activities such as getting together with friends and family, telephoning friends and family, or going to worship or group events in 2001~~in 1997~~ (age adjusted to the year 2000 standard population). Target setting method: ~~Total participation~~30 percent improvement (parity with adults aged 18 years and older without disabilities in ~~1997~~2001). Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
6-4.	Increase the proportion of adults with disabilities who participate in social activities. Target: 79 percent. Baseline: 61 percent of adults aged 18 years and older with disabilities participated in social activities such as getting together with friends and family, telephoning friends and family, or going to worship or group events in 2001 (age adjusted to the year 2000 standard population). Target setting method: 30 percent improvement (parity with adults aged 18 years and older without disabilities in 2001). Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
6-5.	Increase the proportion of adults with disabilities reporting sufficient emotional support. Target: 79 percent. Baseline: 71 percent of adults aged 18 years and older with disabilities reported sufficient emotional support in 1998 (data from 11 States and the District of Columbia; age adjusted to the year 2000 standard population). Target setting method: 11 percent improvement (parity with adults aged 18 years and older without disabilities in 1998). Data source: Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.
OBJECTIVE WITH REVISIONS
6-5.	Increase the proportion of adults with disabilities reporting sufficient emotional support. Target:7984 percent. Baseline: 71 percent of adults aged 18 years and older with disabilities reported sufficient emotional support in 2001~~1998 (data from 11 States and the District of~~ ~~Columbia;~~ (age adjusted to the year 2000 standard population). Target setting method: 118 percent improvement (parity with adults aged 18 years and older without disabilities in ~~1998~~2001). Data source: ~~Behavioral Risk Factor Surveillance System (BRFSS), CDC,~~ ~~NCCDPHP~~National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
6-5.	Increase the proportion of adults with disabilities reporting sufficient emotional support. Target: 84 percent. Baseline: 71 percent of adults aged 18 years and older with disabilities reported sufficient emotional support in 2001 (age adjusted to the year 2000 standard population). Target setting method: 18 percent improvement (parity with adults aged 18 years and older without disabilities in 2001). Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
6-6.	Increase the proportion of adults with disabilities reporting satisfaction with life. Target: 96 percent. Baseline: 87 percent of adults aged 18 years and older with disabilities reported satisfaction with life in 1998 (data from 11 States and the District of Columbia; age adjusted to the year 2000 standard population). Target setting method: 10 percent improvement (parity with adults without disabilities in 1998). Data source: Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.
OBJECTIVE WITH REVISIONS
6-6.	Increase the proportion of adults with disabilities reporting satisfaction with life. Target: 96 percent. Baseline: ~~87 percent of adults aged 18 years and older with disabilities reported~~ ~~satisfaction with life in 1998 (data from 11 States and the District of Columbia; age~~ ~~adjusted to the year 2000 standard population)~~ 80 percent of adults aged 18 years and older with disabilities reported satisfaction with life in 2001 (age adjusted to the year 2000 standard population). Target setting method: ~~10 percent improvement (parity with adults without~~ ~~disabilities in 1998)~~ 20 percent improvement (parity with adults without disabilities in 2001). Data source: ~~Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP~~ National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
6-6.	Increase the proportion of adults with disabilities reporting satisfaction with life. Target: 96 percent. Baseline: 80 percent of adults aged 18 years and older with disabilities reported satisfaction with life in 2001 (age adjusted to the year 2000 standard population). Target setting method: 20 percent improvement (parity with adults without disabilities in 2001). Data source: National Health Interview Survey (NHIS), CDC, NCHS.

NO CHANGE IN OBJECTIVE

6-7.

Reduce the number of people with disabilities in congregate care facilities, consistent with permanency planning principles.

Target and baseline:

Objective	Reduction in People With Disabilities in Congregate Care Facilities	1997 Baseline Number of Persons	2010 Target Number of Persons
6-7a.	Persons aged 22 years and older in 16 or more bed congregate facilities	93,362	46,681
6-7b.	Persons aged 21 years and under in congregate care facilities	24,300	0

Target setting method: 50 percent improvement for 6-7a; total elimination for 6-7b.

Data source: Survey of State Developmental Disabilities Directors, University of Minnesota.

ORIGINAL OBJECTIVE
6-8.	Eliminate disparities in employment rates between working-aged adults with and without disabilities. Target: 82 percent. Baseline: 52 percent of adults aged 21 through 64 years with disabilities were employed in 1994–95. Target setting method: 58 percent improvement (parity with adults without disabilities in 1994–97). Data source: Survey of Income and Program Participation (SIPP), U.S. Department of Commerce, Bureau of the Census.
OBJECTIVE WITH REVISIONS
6-8.	Eliminate disparities in employment rates between working-aged adults with and without disabilities. Target: ~~82 percent~~ 80 percent. Baseline: ~~52 percent of adults aged 21 through 64 years with disabilities were~~ ~~employed in 1994–95~~ 43 percent of adults aged 18 through 64 years with disabilities were employed in 1997. Target setting method: ~~58 percent improvement (parity with adults without~~ ~~disabilities in 1994–97~~ 86 percent improvement (parity with adults without disabilities in 1997). Data source: ~~Survey of Income and Program Participation (SIPP), U.S. Department~~ ~~of Commerce, Bureau of the Census~~ National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
6-8.	Eliminate disparities in employment rates between working-aged adults with and without disabilities. Target: 80 percent. Baseline: 43 percent of adults aged 18 through 64 years with disabilities were employed in 1997. Target setting method: 86 percent improvement (parity with adults without disabilities in 1997). Data source: National Health Interview Survey (NHIS), CDC, NCHS.

NO CHANGE IN OBJECTIVE

6-9.

Increase the proportion of children and youth with disabilities who spend at least 80 percent of their time in regular education programs.

Target: 60 percent.

Baseline: 45 percent of children and youth aged 6 to 21 years with disabilities spent at least 80 percent of their time in regular education programs in the 1995–96 school year.

Target setting method: 33 percent improvement. (Better than the best will be used when data are available.)

Data source: Data Analysis System (DANS), U.S. Department of Education, Office of Special Education.

ORIGINAL OBJECTIVE
6-10.	(Developmental) Increase the proportion of health and wellness and treatment programs and facilities that provide full access for people with disabilities. Potential data source: National Independent Living Centers Network.
OBJECTIVE WITH REVISIONS
6-10.	~~(Developmental)~~ Increase the proportion of people with disabilities who report having access to health and wellness ~~and treatment~~ programs ~~and facilities that~~ ~~provide full access for people with disabilities.~~ Target: 63 percent. Baseline: 48 percent of people aged 18 years and older with disabilities reported having access to a health and wellness program in 2002. Target setting method: 31 percent improvement (parity between adults aged 18 years and older with and without disabilities). ~~Potential d~~Data source: National ~~Independent Living Centers Network~~Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
6-10.	Increase the proportion of people with disabilities who report having access to health and wellness programs. Target: 63 percent. Baseline: 48 percent of people aged 18 years and older with disabilities reported having access to a health and wellness program in 2002. Target setting method: 31 percent improvement (parity between adults aged 18 years and older with and without disabilities). Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE
6-11.	(Developmental) Reduce the proportion of people with disabilities who report not having the assistive devices and technology needed. Potential data source: National Health Interview Survey (NHIS), CDC, NCHS.
OBJECTIVE WITH REVISIONS
6-11.	~~(Developmental)~~ Reduce the proportion of people with disabilities who report not having the assistive devices and technology needed. Target: 7 percent. Baseline: 10 percent of people aged 18 years and older with disabilities reported not having assistive devices in 2002. Target setting method: Better than the best. ~~Potential d~~Data source: National Health Interview Survey (NHIS), CDC, NCHS.
REVISED OBJECTIVE
6-11.	Reduce the proportion of people with disabilities who report not having the assistive devices and technology needed. Target: 7 percent. Baseline: 10 percent of people aged 18 years and older with disabilities reported not having assistive devices in 2002. Target setting method: Better than the best Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE

6-12.

(Developmental) Reduce the proportion of people with disabilities reporting environmental barriers to participation in home, school, work, or community activities.

Potential data source: Behavioral Risk Factor Surveillance System (BRFSS), CDC, NCCDPHP.

OBJECTIVE WITH REVISIONS

6-12.

~~(Developmental)~~ Reduce the proportion of people with disabilities reporting environmental barriers to participation in home, school, work, or community activities.

Target and baseline:

Objective	Reduction in People Aged 18 Years and Older With Disabilities Who Report Encountering Barriers to Participation in Activities	2002 Baseline Percent	2010 Target Percent
6-12a.	At home	10	9
6-12b.	At school	6.1	5.7
6-12c.	In workplace	7.7	7.0
6-12d.	In community	11	7

Target setting method: Better than the best.

~~Potential d~~Data source: ~~Behavioral Risk Factor Surveillance System (BRFSS), CDC,~~ ~~NCCDPHP~~National Health Interview Survey (NHIS), CDC, NCHS.

REVISED OBJECTIVE

6-12.

Reduce the proportion of people with disabilities reporting environmental barriers to participation in home, school, work, or community activities.

Target and baseline:

Objective	Reduction in People Aged 18 Years and Older With Disabilities Who Report Encountering Barriers to Participation in Activities	2002 Baseline Percent	2010 Target Percent
6-12a.	At home	10	9
6-12b.	At school	6.1	5.7
6-12c.	In workplace	7.7	7.0
6-12d.	In community	11	7

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE

6-13.

Increase the number of Tribes, States, and the District of Columbia that have public health surveillance and health promotion programs for people with disabilities and caregivers.

Target and baseline:

Objective	Increase in Public Health Surveillance and Health Promotion Programs for People With Disabilities and Caregivers	1999 Baseline Number	2010 Target Number
6-13a.	States and the District of Columbia	14	51
6-13b.	Tribes	Developmental	Developmental

Target setting method: Total coverage.

Data sources: Tribal, State, and District of Columbia reports; Office on Disability and Health, CDC.

OBJECTIVE WITH REVISIONS

6-13.

Objective	Increase in Public Health Surveillance and Health Promotion Programs for People With Disabilities and Caregivers	1999 Baseline Number	2010 Target Number
6-13a.	States and the District of Columbia—Surveillance for people with disabilities	14	50 States and DC
6-13b.	Tribes—Surveillance for people with disabilities	Developmental	Developmental
6-13c.	States and the District of Columbia—Health promotion programs for people with disabilities	14	50 States and DC
6-13d.	Tribes—Health promotion programs for people with disabilities	Developmental	Developmental
6-13e.	States and the District of Columbia—Surveillance for caregivers	0	50 States and DC
6-13f.	Tribes—Surveillance for caregivers	Developmental	Developmental
6-13g.	States and the District of Columbia—Health promotion programs for caregivers	0	50 States and DC
6-13h.	Tribes—Health promotion programs for caregivers	Developmental	Developmental

Target setting method: Total coverage.

Data sources: Tribal, State, and District of Columbia reports; CDC, Office on Disability and Health, ~~CDC~~.

REVISED OBJECTIVE

6-13.

Objective	Increase in Public Health Surveillance and Health Promotion Programs for People With Disabilities and Caregivers	1999 Baseline Number	2010 Target Number
6-13a.	States and the District of Columbia—Surveillance for people with disabilities	14	50 States and DC
6-13b.	Tribes—Surveillance for people with disabilities	Developmental	Developmental
6-13c.	States and the District of Columbia—Health promotion programs for people with disabilities	14	50 States and DC
6-13d.	Tribes—Health promotion programs for people with disabilities	Developmental	Developmental
6-13e.	States and the District of Columbia—Surveillance for caregivers	0	50 States and DC
6-13f.	Tribes—Surveillance for caregivers	Developmental	Developmental
6-13g.	States and the District of Columbia—Health promotion programs for caregivers	0	50 States and DC
6-13h.	Tribes—Health promotion programs for caregivers	Developmental	Developmental

Target setting method: Total coverage.

Data sources: Tribal, State, and District of Columbia reports; CDC, Office on Disability and Health.

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