Coding NCHS Survey Questions on Disability using the International Classification of Functioning,Disability, and Health Gerry E. Hendershot, Ph.D. Consultant on Disability and Health Statistics
Overview • International Classification of Functioning, Disability, and Health (ICF) • United Nations reporting categories • Illustrations of coding NCHS survey questions to ICF categories • Summary of NCHS survey coverage of ICF/UN categories
The ICF • Approved by World Health Assembly • Available in six official languages • Searchable Web and CD versions • www.who.int/icidh
Body function&structure (Impairment) Activities (Limitation) Participation (Restriction) Environmental Factors Personal Factors Health Condition (disorder/disease)
ICF Classification Part 1: Functioning and Disability Part 2: Contextual Factors Parts Activities and Participation Body Functions and Structures Environ-mental Factors Personal Factors (Not covered) Components Item levels: 1st 2nd 3rd Item levels: 1st 2nd 3rd Item levels: 1st 2nd 3rd Domains and categories at different levels
d4500, Walking short distances • d450, walking: Moving along a surface on foot, step by step, so that one foot is always on the ground, such as when strolling, sauntering, walking forwards, backwards, or sideways. • d4500, walking short distances: walking for less than a kilometre, such as walking around rooms or hallways, within a building or for short distances outside.
1. Seeing, even with glasses 2. Hearing, even with aid 3. Speaking, includes talking 4. Moving/mobility, includes walking, climbing, standing 5. Body movement, includes reaching, crouching, kneeling 6. Gripping/holding, includes using fingers to grip objects 7.Learning, including intellectual difficulties, retardation 8. Behavioral, includes psychological, emotional 9. Personal care, includes bathing, dressing, feeding UN disability categories
NHIS on walking • By yourself and without using aids, do you have any difficulty walking a quarter of a mile (that is about 2 or 3 blocks)? [ If yes] How much difficulty do you have, some, a lot, or are you unable to do it?
NHANES on walking • By yourself and without anyspecial equipment, how much difficulty do you have walking for a quarter of a mile [that is about 2 or 3 blocks]? No difficulty, some difficulty, much difficulty, unable to do?
b230, hearing functions • Sensory functions relating to sensing the presence of sounds and discriminating the location, pitch, loudness and quality of sounds. Inclusions: functions of hearing, auditory discrimination, localization of sound source, lateralization of sound, speech discrimination; impairments such as deafness, hearing impairment and hearing loss
LSOA on hearing • Do you NOW have deafness in both ears? Deafness in one ear? Any other trouble hearing with one or both ears?
NNHS on hearing • Does … have any difficulty in hearing (when wearing a hearing aid)? Is …”s hearing (when wearing a hearing aid) partially, severely, or completely impaired, as defined on this card? Deaf: “can hear only a few words a person says or loud noises.”