cornell university institute for policy research a review of disability data for the institutional...
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Cornell University
Institute for Policy Research
www.cuipr.cornell.edu
A Review of Disability Data for the Institutional Population of Working Age
Peiyun SheDavid 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, 2006Washington, DC
Cornell University
Institute for Policy Research
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.
Cornell University
Institute for Policy Research
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.)
Cornell University
Institute for Policy Research
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
Cornell University
Institute for Policy Research
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.
Cornell University
Institute for Policy Research
Size and Proportion of the Institutional Populations,1990 and 2000
Source: Census 1990 and 2000.
3.33(1.3%)
1.77(0.71%) 1.12
(0.45%) 0.45(0.18%)
4.06(1.4%)
1.72(0.61%)
1.98(0.70%)
0.36(0.13%)
0.000.501.001.502.002.503.003.504.004.50
AllInstitutions
NursingHomes
CorrectionalInstitutions
OtherInstitutions
Nu
mb
er i
n m
illi
on
s
1990
2000
Cornell University
Institute for Policy Research
Distribution of the Institutional Population by Institution Type, 1990 and 2000
Source: Census 1990 and 2000.
53
33
13
4249
9
0
10
20
30
40
50
60
Nursing homes Correctionalinstitutions
Other institutions
Per
cen
t1990
2000
Cornell University
Institute for Policy Research
Institutional Population of Working Age (18-64), 1990 and 2000
Source: Census 1990 and 2000.
1.52(0.98%)(45%)
2.26(1.3%)(56%)
0.00
0.50
1.00
1.50
2.00
2.50
All Institutions
Nu
mb
er i
n m
illi
on
s
1990
2000
Cornell University
Institute for Policy Research
Age Distribution of the Institutional Population by Institution Type, 2000
Source: Census 2000
0 1
38
9
98
4491
1
19
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Nursing Homes Correctional Insitutions Other Institutions
Under 18 18-64 65+
Cornell University
Institute for Policy Research
Distribution of People in Various Age Groups by Institution Type, 2000
Source: Census 2000
07
95
13
86
1
87
7 4
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Under 18 18-64 65+
Nursing Homes Correctional Insitutions Other Institutions
Cornell University
Institute for Policy Research
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)
Cornell University
Institute for Policy Research
Disability Prevalence by Living Quarters, 2000
Source: Census 2000
12 11
22
54
0
10
20
30
40
50
60
All Housing units Non-institutional GQs Institutional GQs
Per
cen
t
Cornell University
Institute for Policy Research
Distribution of People with Disabilities by Living Quarters, 2000
Source: Census 2000
Institutional GQs, 6.4%
2 million
Housing units, 91.3%
31 million
Non-institutional GQs, 2.3%0.8 million
Cornell University
Institute for Policy Research
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).
Cornell University
Institute for Policy Research
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)
Cornell University
Institute for Policy Research
Disability Prevalence in the Incarcerated Population,1996 - 1997
Source: BJS Surveys
37
10 10 9
31
1210 10
23
11
5 5
0
5
10
15
20
25
30
35
40
Any disability Physical Mental Learning
Per
cen
t
Jail State prison Federal prison
Cornell University
Institute for Policy Research
Changes in Incarceration Rate by Age and Sex, 1989 - 91 to 1996 - 97
Source: Authors’ calculations.
297
66 66
638
1,474
1,690
1,110
476
87
1,242
97
472
1,113
1,262
926
669
0
200
400
600
800
1000
1200
1400
1600
1800
All ages 18 - 24 25 -34 35 - 44 45 - 54 55+ Male Female
Inca
rcer
atio
n r
ate
(per
100
,000
)
1989/91 1996/7
Cornell University
Institute for Policy Research
Disability Prevalence in the Nursing Home Population, 1999
Source: NNHS
8577
66
9588
76
0102030405060708090
100
Bathing Dressing Three or moreADLs
Per
cen
t
Under 65 65+
Cornell University
Institute for Policy Research
Changes in Nursing Home Residence Rate by Age, 1977 to 1999
Source: Authors’ calculations.
6,595
24,219
661,080
4,297
18,250
1,47387
0
5000
10000
15000
20000
25000
30000
Under 65 65 - 74 75 - 84 85+
Nu
rsin
g h
om
e re
sid
ence
rat
e (p
er 1
00,0
00)
1977 1999
Cornell University
Institute for Policy Research
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.
Cornell University
Institute for Policy Research
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.
Cornell University
Institute for Policy Research
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 ×
Cornell University
Institute for Policy Research
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.