Disability
Definition
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 schooling/employment restriction only).The first four are based on whether a person needs help, has difficulty or uses aids or equipment with any core activities (mobility, self-care and communication). A person's overall level of core activity limitation is determined by their highest level of limitation in any of these activities. The fifth level 'schooling/employment restriction only' refers to people who reported no limitations with any of the core activities but reported having difficulty with schooling/employment activities.
Population
Information was obtained from all persons in the NHS.
Methodology
Disability Type
Respondents were asked whether they had any conditions that have lasted, or are likely to last, for six months or more (shown on a prompt card) including:
- 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, dementia etc.
More than one response was allowed.
They were then asked whether they were restricted in everyday activities because of the condition(s) and, is so, which condition(s).
Respondents were then asked if they had any of the following conditions that have lasted, or are likely to last, for six months or more (shown on a prompt card) including:
- 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.
More than one response was allowed.
Respondents who identified more than one condition in the above questions were asked which causes them the most problems.
Disability Status
Respondents were then asked about the levels of help or supervision that they may require with any of the following tasks because of their condition(s) (shown on a prompt card):
Self-care
For example:
- Bathing/showering
- Dressing/undressing
- Eating/feeding
- Going to the toilet
- Bladder/bowel control.
Mobility
For example:
- Moving around away from home
- Moving around at home
- Getting in or out of bed or chair.
Communication in own language
For example:
- Understanding / being understood by strangers, friends or family, including use of sign language / lip reading.
Respondents who identified requiring help or supervision with these tasks were asked whether they always needed help with any of these tasks.
Those who did not require help or supervision were asked if they ever had any difficulty with the tasks.
Those who did not have any difficulty were asked if they used any aids to assist with the tasks.
Respondents aged 5 years and over, who did not require assistance to undertake the tasks, were asked whether they could do all of the following additional mobility tasks:
- Easily walk 200 metres
- 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.
Respondents aged 5 years and over with a disability
were asked whether they had any difficulties with education such as the following (shown on a prompt card) because of their condition(s):
- Not attending school / further study due to condition
- Need time off school/study
- Attend special classes/school
- Other related difficulties.
More than one response was allowed.
Respondents aged 15 years and over with a disability
were asked whether they had any difficulties with employment such as the following (shown on a prompt card) because of their condition(s):
- Type of job could do
- Number of hours that can be worked
- Finding suitable work
- Needing time off work
- Permanently unable to work.
More than one response was allowed.
Classification of Disability Status
Based on their responses, respondents were classified as follows:
- Those who always need help with self care, mobility and communication tasks were classified as having a 'profound core activity limitation'
- Those who don't always need help with self care, mobility and communication tasks, but may require help at times, were classified as having a 'severe core activity limitation'
- Those who had difficulty with the self care, mobility and communication tasks were classified as having a 'moderate core activity limitation'
- Those who simply required aids to undertake self care, mobility and communication tasks, or who were unable to do any of the additional mobility tasks (e.g. easily walk 200 metres, walk up and down stairs without a handrail etc.) were classified as having a 'mild core activity limitation'
- Those who identified as having a difficulty with school/study or work, and had not already been classified previously, were classified as having a 'schooling/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 specific restriction'.
Data Items
The questionnaire, data items and related output categories for this topic are available in pdf / Excel spreadsheet format from the Downloads page of this product.
Interpretation
Points to be considered in interpreting data for this topic include the following:
- 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.
- '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. crutches for a broken leg) were excluded. 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 situations such as being unable to work, restricted in the type of work they could do, regularly needing time off work, 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.
Comparability with 2014-15
The population who were asked the schooling and employment restrictions questions changed in NHS 2017-18. While in NHS 2014-15, the schooling restriction questions were limited to those aged 5 to 20 years, for the 2017-18 cycle these questions were asked of all people aged 5 years and over, recognising that an education restriction can exist outside of school years and be life long. Similarly, the population asked the employment restrictions questions changed from people aged 15 to 64 years (in 2014-15) to all people aged 15 years and over. With the exception of these changes, the disability items are consistent with previous NHS cycles.
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