Independent Living Difficulty
Percentage of adults who report difficulty doing errands alone because of a physical, mental, or emotional condition.
Why do we measure independent living difficulty as a type of disability?
In the U.S. Census Bureau’s American Community Survey, adult respondents are asked to report if they have difficulty with hearing, vision, cognition, ambulation, self-care, and independent living. Almost 13% of U.S. adults report having one of these six types of functional disability, including approximately 1/3 of older adults.1 One of these types, independent living difficulty, defined as difficulty doing errands alone, such as visiting a doctor’s office or shopping, because of a physical, mental, or emotional problem, is experienced by almost 6% of U.S. adults.2-3 The physical, mental, and emotional problems that result in independent living difficulty can be a result of conditions identified at birth or in young adulthood, be related to an injury, or reflect some other chronic, progressive, or enduring condition.4 The types of support needed by those who identify as having difficulty living independently can vary significantly.5
The Dashboard team chose to focus on independent living difficulty (from among the six types of functional disability) because it is particularly amenable to improvements in community-level programs and services.
Adults with disabilities face health and health-related challenges to maintain their health and wellbeing, including accessing preventative services and care for chronic conditions, and obtaining education and employment opportunities.6-10 Compared to the general population, people with disabilities experience significant health disparities for chronic diseases, such as obesity, heart disease, diabetes, and have lower life expectancy.9-13 In 2023, the National Institutes of Health designated people with disabilities as a population with health disparities, signaling new investment of resources into research to improve health outcomes and equity for people with disabilities.13 Additional efforts to support people with disabilities include establishing policies and programs to facilitate fuller participation in the community, in keeping with a framework of disability inclusion.14-17
How do we measure independent living difficulty?
This metric includes anyone who reported difficulty living independently among U.S. adults.
The rate of independent living difficulty may differ depending on whether a survey includes individuals living in institutional settings such nursing homes, adult care facilities, prisons, or supported living care settings.17 The version we use in the Dashboard does not include persons who live in institutional settings, focusing instead on the population living in the general community.
Strengths and Limitations
Strengths of Metric | Limitations of Metric |
• While the U.S. Census Bureau defines and measures rates of six functional disability types among the U.S. adult population, this metric sheds light on one type—independent living difficulty—which can be readily amenable to improvements in community-level programs and services. • Monitoring independent living difficulty may allow city officials to understand the various system-level needs for this population, such as investment in accessible housing, home care, and transportation programs for people with disabilities. | • This metric is self-reported and depends on the perspective of the person surveyed. • The data do not capture the range of experiences among those with difficulty living independently. • The data only capture independent living difficulty among respondents aged 18 and older. • This metric is measured in the civilian non-institutional population. |
Calculation
Independent living difficulty is calculated by the following formula:
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For more information on the calculation, please refer to the City Health Dashboard Technical Document.
Data Source
Estimates for this metric are from American Community Survey data using the S1810 table(s). Multi-year data are available for this metric. For more information, please refer to Using Multi-Year Data: Tips and Cautions.
Years of Collection
Calculated by the Dashboard Team from 2022, 5 year estimate.
References
U.S. Census Bureau. (n.d.) Why We Ask Questions About... Disability https://www.census.gov/acs/www/about/why-we-ask-each-question/disability/
U.S. Census Bureau. (2021, November 21) How Disability Data are Collected from The American Community Survey https://www.census.gov/topics/health/disability/guidance/data-collection-acs.html;
U.S. Census Bureau. (2023) 2018-2022 American Community Survey 5-year Estimates. [Obtained via API]. Retrieved from https://api.census.gov/data/2022/acs/acs5/subject/groups/S1810.html
Center for Disease Control and Prevention. (2024, April, 3) Disability and Health Overview https://www.cdc.gov/ncbddd/disabilityandhealth/disability.html
Center for Disease Control and Prevention. (2020, September 16) Disability and Health Information for People with Disabilities https://www.cdc.gov/ncbddd/disabilityandhealth/people.html
Okoro CA, Hollis ND, Cyrus AC, Griffin-Blake S. Prevalence of Disabilities and Health Care Access by Disability Status and Type Among Adults — United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67:882–887. DOI: http://dx.doi.org/10.15585/mmwr.mm6732a3
Armour BS, Thierry JM, Wolf LA. State-level differences in breast and cervical cancer screening by disability status: United States, 2008. Womens Health Issues. 2009 Nov-Dec;19(6):406-14. doi: 10.1016/j.whi.2009.08.006. PMID: 19879454.
Loeb M, Madans J, Weeks J, Miller K, Dahlhamer J, Golden C. Disability and participation: assessing employment and education outcomes in the National Health Interview Survey (2010). In: Barnartt SN, Altman BM, eds. Research in social science and disability, vol. 7: disability and intersecting statuses. Bingley, UK: Emerald Group Publishing Limited, 2013:171–88.
Krahn GL, Walker DK, Correa-De-Araujo R. Persons with disabilities as an unrecognized health disparity population. Am J Public Health. 2015 Apr;105 Suppl 2(Suppl 2):S198-206. doi: 10.2105/AJPH.2014.302182. Epub 2015 Feb 17. PMID: 25689212; PMCID: PMC4355692.
Pharr JR, Bungum T. Health disparities experienced by people with disabilities in the United States: a Behavioral Risk Factor Surveillance System study. Glob J Health Sci 2012;4:99–108.
Center for Disease Control and Prevention. (2024, May 15) Disability Impacts All of Us. https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
Altman B, Bernstein A. Disability and health in the United States, 2001–2005. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2008. https://www.cdc.gov/nchs/data/misc/disability2001-2005.pdf
National Institutes of Health. (2023, September 26) News Release: NIH designates people with disabilities as a population with health disparities, U.S. Department of Health and Human Services, National Institutes of Health. Retrieved July 16, 2024, from https://www.nih.gov/news-events/news-releases/nih-designates-people-disabilities-population-health-disparities
Cegarra, B., Cattaneo, G., Ribes, A., Solana-Sánchez, J., & Saurí, J. (2023). Independent living, emotional well-being, and quality of life in people with disabilities: the mediator role of self-determination and satisfaction with participation. Frontiers in psychology, 14, 1279014. https://doi.org/10.3389/fpsyg.2023.1279014
Center for Disease Control and Prevention. (2020, September, 15). Disability and Health Inclusion Strategies. https://www.cdc.gov/ncbddd/disabilityandhealth/disability-strategies.html
Center for Disease Control and Prevention. (2020, September 16) Disability Inclusion. https://www.cdc.gov/ncbddd/disabilityandhealth/disability-inclusion.htmlholli
Brault, M., Stern, S., & Raglin, D. (2007, January 3) Evaluation Report Covering Disability. 2006 American Community Survey Content Test Report P.4 U.S. Census Bureau. https://www.census.gov/content/dam/Census/library/working-papers/2007/acs/2007_Brault_01.pdf
Last Updated: July 17, 2024