This project studies multiplicity of disabilities and scope of accommodations among US adults with arthritis disability. The conceptual framework for the analyses is the disablement process, which relates person and environment factors to disability and participation outcomes. The data source is the National Health Interview Survey Disability Supplement (NHIS-D) conducted in 1994-95 for the US community-dwelling population. Both the NHIS-D baseline interview (Phase I-all household members) and follow-up interview (Phase II: persons with disability) are used. Arthritis disability is defined as having one or more disabilities attributed to arthritis. Two spans of ICS codes for arthritis are used: Arthritis and Other Rheumatic Conditions (Broad coverage of joint and connective tissue conditions) and Arthritis (Subgroup of osteo, rheumatoid and axial arthritis). Disabilities and accommodations in various domains (Personal care, household management, home, work, transportation) are covered. Descriptive analyses provide national-level estimates of disabilities, buffers, and barriers for arthritis-disabled persons versus persons with disabilities due to other conditions. Multivariate models of social participation are estimated with sociodemographic, disability, and accommodations predictors. Two outcomes are studied: nonproductive main activity (an objective feature) and disability identity (subjective). Cross-sectional and longitudinal models are estimated. We hypothesize that participation is facilitated by buffers, but hampered by barriers and extensive disability. Results of the project will be disseminated not only in journal publications, but also in presentations to public health and medical professions. The project has two distinctive contributions: (1) Multiplicity: disability and accommodations are described in compact whole-persons ways. (2) Accommodations: buffers that enhance and barriers that inhibit the involvement of arthritis-disabled persons in their community are identified. Buffers and barriers are modifiable factors, so the results will give sound clues about accommodations that can be vigorously promoted to help arthritis-disabled persons.
Verbrugge, Lois M; Juarez, Lucia (2008) Arthritis disability and heart disease disability. Arthritis Rheum 59:1445-57 |