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PubMed1999

Media reports on disability: a binational comparison of types and causes of disability as reported in major newspapers.

PURPOSE: The study aimed to examine the way in which newspapers in two countries relate to problems of disability and people with disabilities. In particular, we looked at the way the extent, type and focus of newspaper articles in both countries varied with the type and cause of the disability under discussion. METHOD: A content analysis of over 400 newspaper articles collected over a 3 month period in Canada and Israel was carried out. RESULTS: The findings show that physical disabilities received the most media attention and positive treatment in both countries, followed by psychiatric disabilities and then developmental disabilities. Likewise, disabilities stemming from congenital problems were treated more positively. The Canadian press was somewhat more progressive than the Israeli press at naming individuals with disability, using appropriate labelling and focusing on somewhat more progressive issues. On the other hand, people with developmental disabilities received more favourable treatment in the Israeli press. CONCLUSIONS: The press has an important role in reflecting and shaping public attitudes. In many ways media coverage reinforces negative attitudes towards people with disabilities, particularly those with psychiatric and developmental disabilities. While there were some differences between the two countries, overall the results suggest that these tendencies, which have been observed in other countries as well, are not limited by national boundaries.

Attitude to Health↗

PubMed1978

Work and disability at the age of 30 years. A sociomedical study of a birth-cohort from Bergen. II. Frequency of disability.

An attempt is made here to quantify occupational disability at the age of 30 years. The term disability is used in a broader sense than defined in the National Insurance Scheme, and covers all permanent occupational disability irrespective of cause. Disability is evaluated in terms of earned income and in accordance with the definition used under the National Insurance Scheme. The study is based on a cohort of 1570 persons, all live births in 1940 of mothers then residing in Bergen. Relevant information on earned incomes and on disability pensions was extracted from the files of the National Insurance Institution for 1331 persons of the cohort residing in Norway on 1st June 1971. Among the 30-year-old men residing in Norway the frequency of disability irrespective of cause was 3.1%, whereas the proportion receiving disability pension was 1.8%. The difference of 1.3% is explained mainly by the fact that alcoholism in itself is not accepted as grounds for a disability pension. Of the women, 88.3% were married. Among these, 0.7% were receiving disability pension. Of the unmarried women in the cohort, 20% (10 persons) were found to be disabled, irrespective of cause. They were all receiving disability pension.

Adult↗

PubMed1997

Disability in activities of daily living: patterns of change and a hierarchy of disability.

OBJECTIVES: This paper examines longitudinal data over 6 years to evaluate incidence rates of disability and the pattern of dependency in activities of daily living. METHODS: The Longitudinal Study of Aging (n = 5151) was used to evaluate incidence of disability in activities of daily living; biennial interview data from 1984 through 1990 were used. The median age to disability onset for individual activities was estimated from survival analysis. A prevalent ordering of incident disability was identified from patterns of disability onset within individuals. RESULTS: The progression of incident disability among the elderly supported by longitudinal data, based on both the ordering of median ages to disability onset and patterns of incident disability, was as follows: walking, bathing, transferring, dressing, toileting, feeding. Gender differences were found in disability incidence rates. CONCLUSIONS: This study provides a mathematical picture of physical functioning as people age. These findings, based on longitudinal data, indicate a different hierarchical structure of disability than found in previous reports using cross-sectional data. Furthermore, the study documents gender differences in incident impairment, which indicate that although women outlive men, they spend more time in a disabled state.

Activities of Daily Living↗

PubMed1985

Ocular anomalies: a comparison of learning disabled and nonlearning disabled elementary school children.

This study compared descriptive data, obtained via retinal reflex photography, concerning ocular anomalies of 439 learning disabled elementary school children, 1657 kindergarten and Grade 1 nonlearning disabled children, and 724 nonlearning disabled children in Grades 2 to 6. Ocular factors included refractive and nonametropic errors as well as severity of the problem. The learning disabled sample had a significantly higher incidence of refractive error than the normal samples in Kindergarten and Grade 1 but lower incidence than the normal sample in Grades 2 to 6. The learning disabled group had a significantly higher incidence of myopia in one or both eyes than did the kindergarten and first grade normal group. No such difference for myopia existed between the learning disabled and the normal sample in Grades 2 to 6. Incidence of hyperopia in both eyes was significantly lower in the learning disabled than in the kindergarten-first grade sample; however, hyperopia in one eye only was greater for the learning disabled than for the older normals. Significant differences between the younger and older normals existed for all types of refractive error except hyperopia in only one eye. Severity of the problem differed significantly between the learning disabled and the kindergarten-first grade sample in the classes of severe and minimal, not at all when comparing learning disabled and older normals, and in all classes when comparing younger and older normals. The learning disabled also had a significantly higher incidence of nonametropic anomalies than did the normal group. Implications relating refractive error and near environment were discussed.

Child↗

PubMed1977

Employment and work adjustments of the disabled: 1972 survey of disabled and nondisabled adults.

Of the 15.6 million individuals in the United States who were currently disabled in 1972, 8 out of 10 were employed as the disability began. For these persons, several aspects of work adjustments after the onset of disability are examined here, with the measures of adjustment based on self-reports of the disabled. Women were less likely to be employed after onset than men. Those employed full time before they were disabled were more likely to work after onset than those who had been part-time workers. The relationship between duration of disability and employment varied with severity of disability. Among the severely disabled, those with a long-term disability were more likely not to work than were the recently disabled. Keeping the pre-onset work status varied with type of employment. For the severely and occupationally disabled, industries staffed by craftsmen and operatives had lower rates of retention than did other sectors. Most of those who returned to work after onset did so within 6 months. Men who returned to work did so more quickly than did women. Doctor's advice and family responsibility were the primary reasons for not returning to work.

Adult↗

PubMed2004

Disabled children and their families in Ukraine: health and mental health issues for families caring for their disabled child at home.

In the Eastern European countries included in the communist system of the USSR, parents of disabled children were encouraged to commit their disabled child to institutional care. There were strict legal regulations excluding them from schools. Medical assessments were used for care decisions. Nevertheless many parents decided to care for their disabled child at home within the family. Ukraine became an independent country in 1991, when communism was replaced by liberal democracy within a free market system. Western solutions have been sought for many social problems existing, but 'hidden,' under the old regime. For more of the parents of disabled children, this has meant embracing ideas of caring for their disabled children in the community, and providing for their social, educational, and medical needs, which have previously been denied. The issue of disability is a serious one for Ukraine where the nuclear disaster at Chernobyl in 1986 caused extensive radiation poisoning. This almost certainly led to an increase in the number of disabled children being born and an increase in the incidence of various forms of cancer. This paper is based on a series of observation visits to some of the many self-help groups established by parents, usually mothers, for their disabled children. It draws attention to the emotional stress experienced both by parents and their disabled children in the process of attempting to come to terms with the disabling conditions, and the denial of the normal rights of childhood resulting from prejudice, poor resources, ignorance, and restrictive legislation. Attempts have been made to identify the possible role and tasks of professional social workers within this context. International comparisons show that many parents and their children do not benefit from the medical model of disability, and that serious consequences include the development of depressive illness among those who find that little help is available from public services.

Caregivers↗

PubMed1985

Framingham Disability Study: relationship of disability to cardiovascular risk factors among persons free of diagnosed cardiovascular disease.

The relationship between physical disability and cardiovascular risk factors among persons free of diagnosed cardiovascular disease was examined. Between 1948 and 1951, a cohort of adult, Framingham, Massachusetts, residents was assembled for a longitudinal examination of cardiovascular disease. Twenty-seven years after the participants' initial examination (between 1976 and 1978), members of the cohort who were still participating in the Framingham Heart Study were interviewed to ascertain their self-assessed ability to perform various physical activities. A score on the cumulative disability index was assigned to 2,021 persons free of diagnosed cardiovascular disease. Analyses controlled for noncardiovascular health conditions which were identified as related to disability. Among women, both long-term and current hypertension and body mass index, as well as diabetes, were associated with disability. Among men, long-term hypertension was related to disability. Age-specific analyses indicated that, for women, current hypertension was statistically significantly related to disability in the middle and oldest age groups; long-term hypertension was related to disability in the middle age group. Both long-term and current measures of diabetes in the oldest age group and long-term measure of cigarette use in the middle age group of women were also related to disability. Age-specific analyses among men indicated that the only statistically significant risk factor was long-term hypertension in the youngest age group. Cholesterol was not related to disability. Results suggest that certain cardiovascular risk factors should be considered in efforts to understand further the development of disability.

Age Factors↗

PubMed2004

Family well-being and disabled children: a psychosocial model of disability-related child behaviour problems.

BACKGROUND: When parents receive a diagnosis that their child is disabled, many families adjust to this healthily and cope well, but others do not. Feelings of hopelessness, social isolation of the family within the community and child behaviour problems have all been reported. While utilization of social support systems is well documented in the literature as being a significant factor in family coping and adjustment to the child's disability, less attention has been focused on the role of psychological factors. OBJECTIVE: This theoretical study aims to address this inbalance by integrating perspectives from a social model of disability with psychological research on the role of cognitive change in families' coping and adjustment to having a disabled child, and thus to produce a new psychosocial model of disability-related child behaviour problems. METHOD: Negative societal attitudes to disability identified by a social model of disability are interpreted with respect to how they might translate to parent views of their disabled child within the family. Resultant parenting beliefs and their possible implications for family interaction, child behaviour and family health and well-being are explored within this new framework. CONCLUSIONS: The psychosocial model of disability-related child behaviour problems provides a useful conceptual framework that has both clinical and research implications for professionals working with families with disabled children.

Child↗

PubMed1994

Disability transitions in an area-based system of long-term care for the elderly and disabled.

OBJECTIVE: To describe patterns of individual disability development and mortality in an area-based system for long-term care of the elderly and disabled. DATA SOURCES AND STUDY SETTING: Yearly surveys according to the ASIM system from 1985 to 1991 of all citizens of Solna, Sweden, receiving long-term care services from the municipality and/or the county council. STUDY DESIGN: Linkage of individual assessments concerning disability and level of care from one survey to the next, using national registration numbers. DATA COLLECTION: Registrations according to the ASIM system concerning services actually provided, assessed need of services, social environment and disability were collected by the staff responsible for the services provided. PRINCIPAL FINDINGS: Mortality was shown to be strongly connected to disability. Disability transitions occurred in both directions for all age groups, but the average rate of disability increase rose with advancing age. Rapid disability development was shown in a multivariate analysis to be connected to institutional care and change in the level of care between surveys. CONCLUSIONS: Data describing disability development can be used for planning purposes, either directly or with the help of a simulation model. More research seems to be needed with regard to the influence of the level of care and of transfers on disability development.

Aged↗

PubMed1999

Disability fingerprints: patterns of disability in spinal cord injury and multiple sclerosis differ.

BACKGROUND: Models for causation of functional disability differ as to whether different diseases lead to common expressions of disability versus producing unique "disability fingerprints." Multiple sclerosis (MS) and Spinal Cord Injury (SCI) both affect the spinal cord; however, their pathophysiologies differ (progressive vs. nonprogressive; multifocal vs. unifocal). METHODS: Patterns of disability were compared among veterans who reported in a national survey that they had MS (n = 1789) or SCI (n = 6361) as the sole cause of their spinal cord dysfunction. The study used self-reported information on disease duration, physical impairments, and self-care skills to compare the two samples for differences in disability overall and after stratification according to (a) disease duration, and (b) specific physical impairments. RESULTS: Patterns of disability differed significantly among persons with MS compared to SCI (p = .001). Differences in level of disability between the two samples remained statistically significant after stratification on disease duration. There were substantial, statistically significant differences between the two samples in the amount and kinds of physical impairment. However, differences in level of disability between the two conditions remained highly significant after stratifying on number of affected limbs (p = .003), amount of useful movement (p = .001), overall motor impairment (p = .003), amount of sensation (p = .001), impairment in memory and thinking (p = .001), and visual impairment (p = .001). CONCLUSIONS: This study shows differing diseases indeed have unique disability fingerprints, which remain unique after controlling for disease duration and for population-specific differences in physical impairment. These findings point out the need to explain the disablement process more fully.

Activities of Daily Living↗

PubMed2005

Racial disparities in disability: recent evidence from self-reported and performance-based disability measures in a population-based study of older adults.

OBJECTIVE: Although disability levels have been declining in older adults, there is little current information on racial differences in disability. METHODS: Our data came from a longitudinal, population-based study of 6,158 Black and White adults aged 65 and older from the south side of Chicago. Data were collected during three face-to-face interviews between 1993 and 2002. We ascertained disability using three self-report measures and a performance-based measure of physical function. Using longitudinal data analysis, we examined overall racial differences in disability and the degree to which they varied by age and gender. RESULTS: After an average of 6 years of follow-up, Blacks reported significantly higher disability levels than Whites after adjustment for age and sex. There was a significant increase in disability during follow-up on all four measures. Racial differences in disability did not vary consistently by age at baseline or over time but were greater among women. Findings were largely similar for self-reported and performance-based measures of disability. Adjustment for socioeconomic status substantially reduced racial differences in disability, although some of the differences remained significant, especially among women. CONCLUSION: Racial disparities in disability have not been eliminated, are greater among women, and have their origins earlier in adulthood.

Black or African American↗

PubMed1994

Occupational disability due to low back pain: a new interdisciplinary classification based on a phase model of disability.

STUDY DESIGN: This study critically reviewed current conceptualizations of occupational disability resulting from low back pain (LBP). It proposes a new classification system for back pain built on a phase-model of disability. OBJECTIVES: The goal was to develop a classification system that overcomes the shortcomings of existing classification schemes and is useful for interdisciplinary research, prevention, treatment, and rehabilitation. SUMMARY OF BACKGROUND DATA: Attempts to study and prevent disability resulting from LBP have been hampered by the use of inadequate classifications of LBP. METHODS: Current classifications of LBP were critically reviewed, and criteria for a useful classification system are described. The disabling process is organized in eight consecutive phases determined by the presence and duration of work disability. RESULTS: The proposed eight-phase classification is based primarily on the presence and duration of work-disability rather than on clinical categories. It takes into account the developmental and social character of disability. The simplicity, reliability, and expandability of the model allow for its interdisciplinary use in research and intervention. CONCLUSIONS: The prevention of disabling back pain requires an interdisciplinary approach. For this purpose, other than purely biomedical classifications of LBP are needed. The authors propose an eight-phase classification system primarily based on the duration of work disability and that takes into account other biomedical, developmental, and social characteristics of work-disability resulting from LBP.

Adult↗

PubMed2000

Bias in proxies' reports of disability: data from the National Health Interview Survey on disability.

OBJECTIVES: These studies examined whether differences between self-reports and proxy reports of disabilities reflect proxy response biases or only respondent selection factors. METHODS: The data were from the National Health Interview Survey on Disability (1994-1995, phases 1 and 2). In study 1, reports of disabilities were regressed on respondent status, self vs proxy, and demographic factors. In study 2, the ratios of the proportions of self-reports and proxy reports of disabilities were regressed on independent lay ratings of observability of these disabilities and their "interactional" nature. In study 3, the disability reports for people who differed in respondent status in one phase but self-reported the same disability in the other phase were compared. RESULTS: In study 1, proxies under-reported disabilities for people aged 18 to 64 years but overreported for people 65 years or older. In study 2, the observability and interactional scores accounted for more than 60% of the variance of self and proxy differences in an inverse relationship, study 3 confirmed the basic findings of study 1. CONCLUSIONS: Use of proxies in representative surveys on disability introduces systematic biases, affecting national disability estimates.

Activities of Daily Living↗

PubMed2002

Impact of disability on quality of life of rural disabled people in Bangladesh.

This study examined the impact of disability on the quality of life of disabled people in rural Bangladesh. A primary healthcare specialist conducted a door-to-door survey in two villages in Bangladesh to collect socioeconomic and demographic information on the villagers and for identification of disabled people. Information on disability and how it affected their life was also obtained either from the disabled people or from their caregivers by interviewing them. The study revealed that disability had a devastating effect on the quality of life of the disabled people with a particularly negative effect on their marriage, educational attainment, employment, and emotional state. Disability also jeopardized their personal, family and social life. More than half of the disabled people were looked at negatively by society. Disabled women and girl children suffered more from negative attitudes than their male counterparts, resulting in critical adverse effects on their psychological and social health. A combination of educational, economic and intensive rehabilitative measures should be implemented urgently to make them self-reliant. Collaborative communication between professionals and parents, behavioural counselling, formation of a self-help group, and comprehensive support to families will reduce their suffering.

Affective Symptoms↗

PubMed2005

Stigma as a barrier to employment: mental disability and the Americans with Disabilities Act.

In a controversial expansion of workplace civil rights, the 1990 Americans with Disability Act (ADA) extended anti-discrimination protection to individuals with "mental impairments." One of the most critical barriers to the employment of individuals with mental disabilities is the degree of social stigma such disabilities incur, and there is compelling evidence that employers have stigmatizing attitudes and have discriminated against those with mental disabilities. This study examines the role played by stigma in employers' response to the 1990 Americans with Disability Act (ADA). A stratified sample of one hundred ninety employers were surveyed in 1996-1997 in a major Southern metropolitan area. Telephone interviews were completed with one hundred seventeen employers (response rate of 61.6%). The article describes employers' experiences with employees with mental disabilities and accommodations, specific employment practices, and attitudes towards those with mental disabilities. Stigma played an important role in conformity to the ADA (operationalized as either hiring or having specific recruiting policies for hiring individuals with mental disabilities). Furthermore, employers expressing coercive (fear of a lawsuit) as opposed to normative (belief that it is the right thing to do) rationales for compliance were more likely to hold stigmatized attitudes. Employers' beliefs about mental disability form a crucial foundation for truly supportive work environments (those that value difference and diversity), and further research is needed to determine if over time the ADA is successful in changing attitudes as well as behavior.

Commerce↗

PubMed2000

Older workers' progression from private disability benefits to Social Security disability benefits.

People with medical conditions that limit their ability to work tend to receive short-term disability benefits initially and may then move to long-term and eventually to permanent disability benefits. The progression of older workers (those aged 55 to 64) along that continuum of benefits is documented here with data from a large disability insurance company. The data show that older workers who receive short-term medical disability benefits are three times as likely as younger workers to progress to receipt of Social Security Disability Insurance (SSDI) benefits, although a slight reversal of that trend occurs as workers pass age 62. Musculoskeletal conditions are the most frequent basis of short-term disability claims among older workers, with circulatory conditions running a close second. Furthermore, although all medical conditions are more likely to lead to SSDI benefits among older workers, circulatory conditions do so most frequently. This article discusses industry standards for the management of disability claims at each level of severity. It also addresses common and emerging disability management practices that may reduce the likelihood of impaired workers developing long-term or permanent financial dependence on disability benefits programs.

Adolescent↗

PubMed1978

1972 Survey of disabled and nondisabled adults: chronic disease, injury, and work disability.

The Social Security Administration 1972 Survey of Disabled and Nondisabled Adults showed that an estimated 15.6 million adults aged 20--64, or 15 percent of the total noninstitutionalized population of those ages, were disabled as a result of some chronic condition or impairment. Yet more than three times as many persons (51.8 million) reported that they suffered from one or more chronic health conditions. The diseases reported most frequently by the adult population of working age were cardiovascular and musculoskeletal disorders, each with prevalence rates of 200 persons per 1,000 population. The prevalence rate for neurological disorders was only 7 persons per 1,000; their disabling potential, however, was much greater than that for the diseases with the highest prevalence rates: 80 percent of those suffering from neurological disorders were also currently disabled. For almost every disease group, older persons were more likely to suffer from a chronic condition or impairment and more likely to be disabled as a result. Women were more likely than men to report a chronic disease or impairment and more likely to be severely disabled as a result. White persons were somehwat more likely than blacks and members of other races to report one or more chronic conditions but less likely to be disabled as a result and even less likely to be severely disabled. Among the nondisabled, less than one-tenth reported a condition caused by accident or injury but close to one-fourth of the disabled reported a disease or impairment of accidental origin.

Accidents↗

PubMed2004

The contribution of social disability to the evaluation of mental disability among PTSD veterans.

BACKGROUND: Israeli veterans who claim for recognition of their mental disability and compensation undergo multi-professional assessments including a detailed psychosocial evaluation. OBJECTIVES: To conduct a systematic evaluation of the social disabilities of veterans with PTSD; to examine the relationships between the various aspects of their social disability and their PTSD symptom severity, on the one hand, and the ratings they receive from psychiatrists determining their overall disability, on the other hand. METHOD: The study was conducted on 120 veterans with PTSD, all filing for compensation. Data was collected by means of semi-structured interviews that were carried out by social workers in ajoint meeting with the veterans and their spouses and that covered marital, parental and social functioning; from the self-report PTSD questionnaire that the veterans filled out; and from the final disability ratings in the veterans' files. RESULTS: Findings showed a disturbing picture of impaired marital, parental and social functioning of veterans with PTSD. In addition, they indicate that both PTSD severity and the psychiatrists' disability ratings were correlated with only a quarter or so of the veterans' specific social disabilities in the areas studied. DISCUSSION: Several explanations for the pattern of correlations between these two assessments are offered. In addition, we highlight the importance of a sensitive and detailed evaluation of social disability as well as recommending the development of practical guidelines for the determination of disability.

Adaptation, Psychological↗