A disability or restrictive long-term health condition exists if a limitation, restriction, impairment, disease or disorder has lasted, or is expected to last for six months or more, which restricts everyday activities.
A disability or restrictive long-term health condition is classified by whether or not a person has a specific limitation or restriction. The specific limitation or restriction is further classified by whether the limitation or restriction is a limitation in core activities, or a schooling/employment restriction only.
There are five levels of activity limitation (profound, severe, moderate, mild and school/employment restriction only). These are based on whether, and how often, a person needs help, has difficulty, or uses aids or equipment with any core activities (self-care, mobility or communication). A person's overall level of core activity limitation is determined by their highest level of limitation in any of these activities.
Information was obtained from all persons in the NHS.
Respondents were asked about any conditions that they may have that have lasted, or are expected to last, six months or more:
- shortness of breath, or difficulty breathing
- chronic or recurring pain
- a nervous or emotional condition
- long-term effects as a result of a head injury, stroke or other brain damage
- any other long-term condition that requires treatment or medication
- any other long-term condition such as arthritis, asthma, heart disease, Alzheimer's disease or dementia.
More than one response was allowed.
Respondents were then asked whether they were restricted in everyday activities because of these conditions.
Respondents were then asked if they had any of the following conditions which had lasted, or were likely to last for six months or more:
- sight problems not corrected by glasses or contact lenses
- hearing problems
- speech problems
- blackouts, fits or loss of consciousness
- difficulty learning or understanding things
- limited use of arms or fingers
- difficulty gripping things
- limited use of legs or feet
- any condition that restricts physical activity or physical work (e.g. back problems, migraines)
- any disfigurement or deformity
- any mental illness for which help or supervision is required.
Respondents who identified a condition were then asked about the levels of help or supervision that they may require with any of the following tasks.
1. Self-care such as:
- going to the toilet
- bladder/bowel control.
2. Mobility such as:
- moving around away from home
- moving around at home
- getting in or out of bed or chair.
3. Communication in own language such as:
- understanding/being understood by strangers, friends or family, including use of sign language/lip reading.
Respondents who identified requiring help or supervision for these tasks were asked whether they always needed help with any of these tasks. Respondents who did not require help or supervision were asked if they ever had any difficulty with the tasks. Respondents who did not have any difficulty were then asked if they used any aids to assist with those tasks. Based on their responses they were classified as follows:
- those who answered yes to always needing help, were classified as having a 'profound core activity limitation'
- those who don't always need help, but may require help at times, were classified as having a 'severe core activity limitation'
- those who had difficulty with the tasks were classified as having a 'moderate core activity limitation'
- those who simply required aids to undertake the task were classified as having a 'mild core activity limitation'.
Respondents aged 5 years and over who did not require aids or assistance to undertake the levels of care tasks, were asked whether they could do all of the following:
- easily walk 200 meters
- walk up and down stairs without a handrail
- easily bend to pick up an object from the floor
- use public transport without difficulty, help or supervision.
Those who answered no to any of these were also classified as having a: 'mild core activity limitation'.
Respondents who were identified as being at school or currently studying were asked whether any of the following applied:
- not attending school/further study due to condition
- need time off school/study
- attend special classes/school
- other related difficulties.
Respondents aged 15 years or older were asked whether they had any difficulties with employment such as these:
- type of job could do
- finding suitable work
- needing time off work
- permanently unable to work.
Respondents who identified as having a difficulty with school/study or work, and had not already been classified previously, were classified as having a 'school/employment restriction only'. Those who indicated that they had no difficulties with school/study or work, or had not identified any conditions in the initial questions, were identified as having 'no limitation or restriction'.
The data items and related output categories for this topic are available in Excel spreadsheet format from the Downloads
page of this product.
Points to be considered in interpreting data for this topic include the following:
Comparability with 2007-08
- Conditions are 'as reported' by respondents and do not necessarily represent conditions as medically diagnosed. However, as the data relate to conditions which had lasted, or were expected to last, for six months or more, there is considered to be a reasonable likelihood that medical diagnoses would have been made in most cases. The degree to which conditions have been medically diagnosed is likely to differ across condition types.
- Interviewers were advised that conditions reported in this module were also reported in the other modules where appropriate. However, respondents did not always report conditions again, so types of disabilities reported in this module may not be reflected in the ICD-10 conditions and as such any comparisons should be undertaken with caution.
- 'Restricted in everyday activities' means less able, or unable, to engage in the everyday activities that a healthy individual of the same age would be able to. Respondents can perceive themselves to be restricted in everyday activities by causes other than the specific conditions listed.
- Aids needed for any condition lasting less than six months (i.e. broken leg) were not included. Examples of aids are hearing aids, wheelchairs for long-term use, special cutlery and changes to floors/steps/paths.
- Difficulties with education relate to situations such as being unable to attend a particular educational institution, needing time off from regular classes, or requiring special tuition. Only current difficulties with education were collected. Any difficulties a respondent may have previously experienced with education were excluded.
- Difficulties with employment relate to respondents who could not work or were restricted in the type of work they could do, regularly needed time off work, were restricted in the number of hours they could work, or required an employer to make special arrangements for them. Only current difficulties with employment were collected. Any difficulties a respondent may have previously experienced with employment were excluded.
In determining whether a person has a mild core activity limitation, questions about the four additional mobility tasks were added to the 2011-12 survey. This allowed respondents an additional way to be classified as having a mild disability and hence more people were identified as having a mild disability in 2011-12 than in 2007-08. It also had the effect of classifying respondents as having a mild disability as opposed to having a school/study or work disability only.
In addition, the ordering of types of conditions has been modified between 2011-12 and 2007-08 and also a more focused question regarding condition set 1, being restricted in everyday activities has been added, whereas in 2007-08 this was part of the question. As a result, some reduction in response to certain disability types is expected and may have a small impact on disability rates.
These changes should be noted when comparing data from the 2011-12 and the 2007-08 surveys.
Comparability with Survey of Disability, Ageing and Carers (SDAC)
Disability status has been included in the NHS to allow for comparisons in service use, risk factors and health outcome comparisons between those with disabilities and those without, not to serve as a disability prevalence measure.
It is difficult to capture the full complexity of the disability experience and accurately assess the full range of disability severity in a small number of questions, such as used in the NHS. The SDAC uses 125 questions to establish Disability Status and is considered the more reliable and robust measure of Disability Status. Therefore, users who are looking for measures of disability prevalence are advised to refer to the Disability, Ageing and Carers, Australia: Summary of Findings, 2009 (cat. no. 4430.0)