Measuring Disability Prevalence in Healthcare: A Study Comparing Two Disability Measures

Authors

• Kristen L. Milefchik, Disability Rights MichiganFollow
• Rhonda K. Dailey, Wayne State University, DetroitFollow
• Sharon Milberger, Michigan Developmental Disabilities InstituteFollow

Abstract

People with disabilities experience significant health disparities and interventions are needed to address them. Measuring disability prevalence is an essential aspect of designing effective, data-driven healthcare strategies. Accurately measuring disability prevalence is challenging given disability is a complex phenomenon, with biological, social, environmental, and cultural components. Previous studies have compared a variety of disability status measurements and found that measurements were incongruent with each other. This study examines the concordance between disability status using two different measures: the nationally recognized American Community Survey (ACS-6) functional difficulty questions and one disability identity question. We used data from 3,621 adult patients participating in a COVID-19 vaccination intervention designed to reach people with disabilities. The results of this study indicate that older patients (age 65+) were less likely to self-identify as disabled or having a disability, even when having one or more impairment-related functional difficulties. Conversely, a higher prevalence of adults under the age of 65 (ages 18-64) answered yes to the identity question, despite answering no to all the ACS-6 functional difficulty questions. These findings suggest that disability prevalence may be more accurately measured using a combination of disability measurements that includes a self-identifying measurement and a more standardized measurement that aligns with a biomedical definition of disability.

Plain Language Summary

People with disabilities face serious health challenges. We must act to improve their situation. Measuring disability rates is key to creating successful healthcare methods. It is not easy to track how often disabilities occur. Disability is complex. It includes biological, social, environmental, and cultural factors. Previous studies compared several disability status measurements. They showed that the measurements did not match up with each other. This study looks at how two measures of disability match up. It compares questions about real-world difficulties to one question about disability identity. The real-world difficulty questions come from the American Community Survey, or ACS-6. We gathered data from 3,621 adult patients. They participated in a COVID-19 vaccination program. The focus was on assisting people with disabilities to get their vaccines. This study shows that older patients (age 65+) often do not see themselves as disabled. They might face one or more real-life challenges, but they do not see themselves as disabled. More adults under 65 (ages 18-64) said yes to the identity question but no to all the difficulty questions. These findings show that we can measure disability rates with greater accuracy. We can get clearer results by using both self-identification and standardized measures. This combination aligns well with both the social and medical definitions of disability.

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Recommended Citation

Milefchik, Kristen L.; Dailey, Rhonda K.; and Milberger, Sharon (2026) "Measuring Disability Prevalence in Healthcare: A Study Comparing Two Disability Measures," Developmental Disabilities Network Journal: Vol. 5: Iss. 2, Article 14.
DOI: 10.59620/2694-1104.1140
Available at: https://digitalcommons.usu.edu/ddnj/vol5/iss2/14