Transcript A Review of Disability Data for the Institutional Population

A Review of Disability Data for the
Institutional Population of Working Age
Peiyun She
David C. Stapleton
Cornell Institute for Policy Research
Presented to participants of the
Cornell StatsRRTC Conference on:
The Future of Disability Statistics:
What We Know and Need to Know
October 5, 2006
Washington, DC
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www.cuipr.cornell.edu
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Motivation
• Limited disability data and research for the institutional
population versus the non-institutional population, especially
for working-age people.
• Impact of trends in institutionalization on trends of disability
prevalence in the non-institutional population and the
distributions of their socio-demographic characteristics.
• Difficulty in assessing the effects of policy efforts in
promoting people with disabilities to live in the community.
• Possible effects of trends in institutionalization on persistent
declines in employment among non-institutional working-age
people with disabilities.
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Group Quarters (GQ)
• Non-institutional GQ
– Military quarters
– College dormitories
– Other non-institutional GQ (e.g., group homes, shelters,
etc.)
• Institutional GQ
– Correctional institutions
– Nursing homes
– Other institutions (e.g., mental hospitals, juvenile
institutions, etc.)
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Data Sources
• 1990 and 2000 Census
• Population estimates from the Bureau of the Census
• BJS surveys
– Survey of Inmates of Local Jails
– Survey of Inmates of State and Federal Correctional
Facilities
• National Nursing Home Survey
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Outline
•
•
•
•
•
The size and distribution of the institutional
population.
The size, distribution, and characteristics of the
institutional population with disabilities.
Disability prevalence for people living in
correctional institutions and nursing homes.
Rate of institutionalization over time.
Gaps in coverage, timing, and disability definitions.
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Size and Proportion of the Institutional Populations,
1990 and 2000
1990
Number in millions
2000
4.50
4.00
3.50
3.00
2.50
2.00
1.50
1.00
0.50
0.00
4.06
(1.4%)
3.33
(1.3%)
1.98
1.77
1.72
(0.70%)
(0.71%) (0.61%)
1.12
(0.45%)
0.45 0.36
(0.18%)(0.13%)
All
Institutions
Nursing
Homes
Source: Census 1990 and 2000.
Correctional
Institutions
Other
Institutions
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Distribution of the Institutional Population
by Institution Type, 1990 and 2000
1990
2000
60
Percent
50
53
49
42
40
33
30
20
13
10
9
0
Nursing homes
Correctional
institutions
Source: Census 1990 and 2000.
Other institutions
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Institutional Population of Working Age
(18-64), 1990 and 2000
1990
2.26
(1.3%)
(56%)
Number in millions
2.50
2.00
1.50
2000
1.52
(0.98%)
(45%)
1.00
0.50
0.00
All Institutions
Source: Census 1990 and 2000.
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Age Distribution of the Institutional
Population by Institution Type, 2000
100%
1
19
90%
80%
70%
60%
44
91
98
50%
40%
30%
20%
38
10%
0%
9
0
Nursing Homes
1
Correctional Insitutions
Under 18
Source: Census 2000
18-64
Other Institutions
65+
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Distribution of People in Various Age Groups
by Institution Type, 2000
100%
7
4
1
90%
80%
70%
60%
87
50%
86
95
40%
30%
20%
10%
0%
13
0
7
Under 18
18-64
Nursing Homes
Source: Census 2000
Correctional Insitutions
65+
Other Institutions
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Census 2000 Disability Measures
•
•
•
•
•
Self-care (bathing, dressing, or getting around inside the home)
Mental (learning, remembering, or concentration)
Physical (walking, climbing stairs, reaching, lifting, or carrying)
Sensory (blindness, deafness, or a severe vision or hearing impairment)
[Go outside home] (going outside the home alone to shop or visit a
doctor’s office)
• [Employment] (working at a job or business)
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Disability Prevalence by Living Quarters, 2000
60
54
50
Percent
40
30
22
20
12
11
All
Housing units
10
0
Source: Census 2000
Non-institutional GQs
Institutional GQs
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Distribution of People with Disabilities
by Living Quarters, 2000
Institutional GQs,
6.4%
2 million
Non-institutional
GQs, 2.3%
0.8 million
Housing units,
91.3%
31 million
Source: Census 2000
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Working-age People with Disabilities Living in
Institutions, by Gender and Race, 2000
• The share of males is much larger than the share of
females (7.7% versus 1.7%).
• They are also disproportionately African American
(38.6% of those ages 18-49 and 22.4% of those ages
50-64).
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BJS Surveys Disability Measures, 1996 - 97
•
•
•
•
•
Physical disability
Sensory disability (vision, hearing, speech)
Learning disability (such as dyslexia or attention deficit disorder)
Mental disability (mental or emotional condition)
Work disability (limitation in the kind or amount of work one can
do)
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Disability Prevalence in the Incarcerated Population,
1996 - 1997
40
35
37
31
Percent
30
23
25
20
15
10
12 11
10
10 10
9 10
5
5
Mental
Learning
5
0
Any disability
Jail
Source: BJS Surveys
Physical
State prison
Federal prison
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Changes in Incarceration Rate
by Age and Sex, 1989 - 91 to 1996 - 97
1800
1,690
Incarceration rate (per 100,000)
1600
1,474
1400
1,262
1,113
1200
1,242
1,110
926
1000
800
600
669
638
472
476
400
297
200
66 97
66 87
0
All ages
18 - 24
25 -34
35 - 44
1989/91
Source: Authors’ calculations.
45 - 54
55+
Male
Female
1996/7
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Percent
Disability Prevalence in the Nursing Home Population, 1999
100
90
80
70
60
50
40
30
20
10
0
95
88
85
77
66
Bathing
Dressing
Under 65
Source: NNHS
76
Three or more
ADLs
65+
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Changes in Nursing Home Residence Rate by Age, 1977 to 1999
Nursing home residence rate (per 100,000)
30000
24,219
25000
20000
18,250
15000
10000
6,595
4,297
5000
87
66
1,473
1,080
0
Under 65
65 - 74
75 - 84
1977
Source: Authors’ calculations.
85+
1999
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Gaps in Survey Coverage
• Institutional GQ: Nursing home and incarcerated
populations are covered in periodic surveys, but
not residents of other institutions.
• Non-institutional GQ: Limited information for the
homeless and military populations.
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Infrequent Collection
• Census long form survey: once per decade.
• BJS surveys: roughly every six years (1989-91,
1996-97, and 2002-04).
• NNHS: biennially from 1995 to 1999, and the
most recent one five years later, in 2004.
• Some major national household surveys: annually.
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Disability Definitions
Disability
Census
2000
BJS Surveys
1996-97
NNHS
1999
Sensory limitations
×
×
×
Functional limitations
×
×
×
Mental disability
×
×
×
Activities of Daily Living
×
×
Instrumental Activities of
Daily Living
×
×
Work disability
×
Learning disability
×
×
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Discussion
• Change in the size and composition of the institutional
population.
• Relatively high disability prevalence in the incarcerated
population and the growth in incarceration.
• Decline in the nursing home residence rate.
• The inclusion of the GQ population in the ACS from 2006
forward.
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