The population of people with disabilities inhabit a distinct position in the U.S. economy, both for their contributions to the marketplace and roles in government policies and programs. People with disabilities bring unique sets of skills to the workplace, enhancing the strength and diversity of the U.S. labor market.1 In addition, they make up a significant market of consumers, representing more than $200 billion in discretionary spending and spurring technological innovation and entrepreneurship.2 People with disabilities also often rely on various government interventions to maintain their participation in the community. Federal programs like Social Security and Medicare and more than 60 smaller federal and state programs provide a wide array of income, health care, and other support services to individuals with disabilities across the United States. In 2008, the federal government spent an estimated $357 billion dollars on programs for working-age people with disabilities, representing 12 percent of total federal outlays.3 While there is little doubt about the large economic impact of people with disabilities, estimates of the size and characteristics of this population depend much on the definitions used to classify what it means to be disabled.
Because health professionals, advocates, and other individuals use the same term in different contexts, disability does not often refer to a single definition. Medical models view disability as an extension of a physiological condition requiring treatment or therapy. In contrast, social ;models view disability as the result of societal forces on impairment, and suggest that changes to social norms and practices would reduce restrictions.4 As a demographic category, disability is an attribute with which individuals may broadly identify, similar to race or gender. In contrast, certain federal programs narrowly define disability as the impairment or limitation that leads to the need for the program’s benefit—such as the Social Security Disability Insurance program’s income support for individuals who are not able “to engage in any substantial gainful activity.”5 The agencies and organizations that provide benefits to, advocate for, or study these populations, each refer to their targeted group as people with disabilities; but because of the differences in definitions, an individual may be considered to have a disability under one set of criteria but not by another.
The International Classification of Functioning, Disability, and Health (ICF) attempts to bridge many of these definitions by considering disability as an umbrella term for impairments, activity limitations, and participation restrictions.6 Rather than a dichotomous concept, disability is a gradient on which every person functions at different levels due to personal and environmental factors. While the ICF provides a common language for discussion of the concepts associated with disability, operationalizing this framework for survey questionnaires is not a simple task. Surveys must contain questions about a finite set of activities and set thresholds for demarking levels of functioning. While the U.S. Census Bureau is always looking towards ways to improve on how it measures topics like disability, having a consistent definition allows for comparisons of the population over time. This report is an update of “Americans With Disabilities: 2005,” which presented similar estimates of disability status and type as the ones presented here.7 Readers should take care when comparing the estimates from this report to other disability estimates from other data sources because of differences in the criteria used to define disability.
In its supplemental questionnaires on adult and child functional limitations, the Survey of Income and Program Participation (SIPP) contains questions about whether respondents had difficulty performing a specific set of functional and participatory activities. For many activities, if a respondent reported difficulty, a follow-up question was asked to determine the severity of the limitation. Using these responses and others to questions about specific conditions and symptoms, this report presents disability as severe and nonsevere, defined in Figure 1. These two measures combine to provide an overall estimate of disability prevalence.
The data used in this report were collected from May through August 2010 during the sixth interview of the 2008 SIPP. The estimates in this report are representative of the civilian noninstitutionalized population living in the United States. The population living in institutional group quarters, such as correctional facilities and nursing homes, and those living in military barracks are not included in the estimates presented here because the SIPP does not survey these populations. Estimates from the American Community Survey suggest that over half of the population living in institutional group quarters had a disability in 2010.8 Were this population included in the SIPP, the magnitude of the disability estimates presented in this report would likely be larger.
1 U.S. Department of Labor, “Building an Inclusive Workforce: A Four-Step Reference Guide to Recruiting, Hiring, & Retaining Employees With Disabilities.”
2 U.S. Department of Labor, “Diverse Perspectives: People With Disabilities Fulfilling Your Business Goals.”
3 See Livermore, Stapleton, and O’Toole (2011)
4 See Altman (2001).
5 Definition of disability from the Social Security Act, 42 U.S.C. §423(d)(1).
6 See WHO (2001).
7 See Brault (2008)
8 S2601A. Characteristics of the Group Quarters Population in the United States, <factfinder.census.gov/bkmk/table/1.0/en /ACS/10_1YR/S2601A>.