Disability in Great Britain: results of the 1996/7 Disability Follow-Up to the Family Resources Survey
A hard copy of this report summary can be obtained by contacting Paul Noakes [E-Mail: Paul.Noakes@dwp.gsi.gov.uk] or by writing to him at the 'Social Research Division, Department for Work and Pensions, 4th Floor, Adelphi, 1-11 John Adam Street, London WC2N 6HT'.
Research Report No. 94
By Emily Grundy, Dennis Ahlburg, Mohamed Ali, Elizabeth Breeze, and Andy Sloggett
The aim of the research was to find out the size and characteristics of the disabled population in Great Britain. The measure and definition of disability used in the survey is based on a set of questions developed by the Office for Population Census and Surveys (now the Office for National Statistics). The results of the questions are used to give an overall severity of disability score between 1 and 10, where 1 represents the least disabled and 10 the most. The OPCS measure deliberately sets the threshold of disability at a low level in order obtain information on a wide range of types and severity of disability.
The main findings are:
- There is a wide distribution in the severity of disability. According to the definition used:
- about a third (34%) of all disabled adults living in private households had severity of disability scores of 1 or 2 - the mildest disabilities;
- just under half (45%) of disabled adults had scores in the range 3 to 6 - middle range disabilities;
- one-fifth (21%) of disabled adults had scores of 7 or more - the severest disabilities.
- The group with severity of disability scores of 7 or more represented 4% of the population, equivalent to an estimated 1,836,000 people. In total, an estimated 8.6 million adults living in private households in Great Britain reported a disability with a severity score between 1 and 10, which is equivalent to 20% of the adult population.
- In general, disability increases with age. Nearly half (48%) the disabled population were aged 65 or over, and three in ten (29%) were aged 75 or more. This compares to 21% and 9% respectively for the general population. About three-quarters of those aged over 80 were disabled.
- Almost two-fifths (37%) of disabled men aged under 50 and just over one-fifth (22%) of those aged between 50 and retirement age 64 were working. For women, the figures were one-third (33%) and one quarter (25%) respectively. These proportions for disabled people compare with 78% for all men and 67% for all women.
Introduction
The report presents the results of the 1996/7 Disability Follow-Up to the Family Resources Survey. The aim of this survey was to find out the size and characteristics of the disabled adult population living in private households in Great Britain. The report covers the following topics: prevalence, severity and types of disability; socio-demographic characteristics; economic activity; financial circumstances; use of social and health services; needs for assistance; and social participation.
The Family Resources Survey (FRS) was used as a basis for the survey. The FRS is a DSS-sponsored survey of about 25,000 households in GB each year. During 1996/7, FRS respondents who were identified as disabled were asked to take part in a subsequent interview about their disability. Over 7,000 people completed the first part of the questionnaire, which included questions about severity and type of disability. These were substantially the same as the questions developed by ONS for the last major survey of disability, in 1985/6. Over 5,000 people assessed as disabled on this basis were included in the second part of the study which dealt with use of services, activities and needs for help.
The measure and definition of disability used in the survey is based on a set of questions developed by the Office for Population Census and Surveys (now the Office for National Statistics). These questions are, in turn, based on the World Health Organisation’s International Classification of Impairments, Disabilities and Handicaps. The OPCS measure deliberately sets the threshold of disability at a low level in order obtain information on a wide range of types and severity of disability. Therefore, the survey definition of reported disabilities does not correspond to eligibility criteria for disability benefits. Batteries of questions are asked to derive the extent of disability in thirteen domains of disability (e.g. locomotion, dexterity, behaviour). The results from each area are combined to give an overall severity of disability score between 1 and 10.
Scores at the lower end of the scale indicate the least severe disabilities, and those at the higher end indicate more severe disabilities. For example, a score of 1 would indicate somebody who: had difficulty hearing someone talking in a normal voice in a quiet room; had difficulty getting in and out of bed; could not see well enough to recognise a friend across the road; or could turn a tap with one hand but not the other. By contrast, someone with a high score would not be able to hear sounds at all and could not get into or out of bed without help.
Prevalence, severity and types of disability
Thirty four per cent of these disabled people had severity of disability scores of 1 or 2, indicating quite mild disability, 45% had severity scores in the range 3-6 and 21% had scores of 7 or more. This latter seriously disabled group represented 4% of the adult population – an estimated 1,836,000 people.
Results from the survey showed that an estimated 8,582,200 adults in Great Britain – 20% of the adult population – had a disability with a severity score between 1 and 10.
The distribution of those assessed as disabled according to severity of disability was close to that found in the 1985 survey of disability among adults in private households.
In general the prevalence of disability increased with age. Nearly half (48%) the disabled population were aged 65 or over, and three in ten (29%) were aged 75 or more. This compares to 21% and 9% respectively for the general population. About three-quarters of those aged over 80 were disabled.
However, there were some anomalies in the age and gender patterns found suggesting a relative underestimation of the prevalence of disability among those between ‘retirement age’ (65 for men, 60 for women) and the age of 75. These reflect the criteria used to screen people from the Family Resources Survey into the 1996/7 Disability Survey, which varied between age groups.
Rates of disability varied between regions, and were highest in Wales (27%) and the North (25%). They were lowest in Greater London (18%), the South West (17%) and the South East (17%). The prevalence of more serious disability (severity scores of 6 or more) was twice as high in Wales as in the South East.
Differences in prevalence between ethnic groups were also found. Age standardized prevalence of disability rates were lower among those from South Asian ethnic groups than white groups (16% compared to 20%).
Disabilities of locomotion were the most common, reported by 72% of disabled people. A third or slightly more had disabilities in the areas of dexterity, personal care, hearing or behaviour.
Socio-demographic characteristics
Disability varied by many socio-demographic characteristics. In general, rates of disability were lower among married men than among men of other marital statuses. For example, 10% of married men aged 40 to 49 were disabled, compared to 15% of those who were single.
The household composition of the disabled population is quite different to the general population, which reflects their older age profile. In particular, disabled people were more likely to live alone and less likely to live in households with children.
Disability also varies according to housing tenure. Just over a third (35%) of those renting from a local authority or housing association were disabled, compared to 15% of owner-occupiers.
About two-fifths of disabled men (40%) and women (42%) aged 20 to 39 had no educational qualifications. The proportion was higher in the older age group (40-59/64), exceeding 60% for both men and women.
Economic activity
Almost two-fifths (37%) of disabled men aged under 50 and just over one-fifth (22%) of those aged between 50 and retirement age 64 were working. For women, the figures were one-third (33%) and one quarter (25%) respectively. These proportions for disabled people compare with 78% for all men and 67% for all women.
Substantial proportions of men and women reported they were permanently unable to work. For example, just over two-fifths of men under 50 (43%) and almost two-thirds of men aged 50 to 64 (63%) said this. For men and women younger than fifty, almost 15% were either looking for work or would be once they had overcome temporary illness. The corresponding figure was about 7% for older men and women. Very few disabled individuals were in full-time education or training.
Holding an educational qualification was associated with higher chances of working, especially for women. There were also differences according to housing tenure. Being a public sector tenant was associated with lower chances of working.
Financial circumstances
Incomes of households with at least one disabled person were lower than the incomes of all households. They were 20% to 30% less depending on the type of household.
Fewer disabled households received income from work than non-disabled households and more received income from disability benefits. For example, 29% of two adult disabled households received income from earnings, compared to 54% of two adult non-disabled households. Over half (56%) of two adult disabled households received income from disability benefits.
Total income does not vary markedly by severity of disability. Income was the highest for the least disabled households, but the income of the most disabled households was 93% of the income of the least disabled households. While earnings and non-state pensions decrease with severity of disability, disability and other benefits increase to keep income from falling in line with lower earnings from work.
Most (89%) disabled people received some form of social security. The main benefits received were Retirement Pension (49%), Council Tax Benefit (38%), Income Support (26%), Incapacity Benefit (20%), Disability Living Allowance mobility component (14%), and Disability Living Allowance care component (11%). The pattern of benefit receipt varies according to family status.
Income among disabled households is more evenly distributed than income among all households, although earnings from work among disabled households are more unevenly distributed than among all households. Among disabled households who did have some earnings, their earnings were 70% to 80% of the earnings of non-disabled households.
Use of social and health services
Almost 70% of disabled people had visited a hospital or clinic in the last year, and nearly a third had received a home visit from a healthcare professional in the last 6 months. The percentage of disabled people who had visited a hospital or clinic did not increase substantially with the level of severity of disability, but it did for a visit from a health professional.
Only a small percentage (15%) used the other services available such as home helps or meals on wheels, and the same proportion made regular use of day centres for training or social activities. Both types of service were more likely to be used by severely disabled people.
Needs for assistance
Overall, two-fifths (40%) of disabled people needed help at least once a week with practical tasks such as cooking, shopping or cleaning. About half of the disabled people needing practical help also needed personal day-time care, amounting to 19% of the disabled population. About 13% reported they needed help with personal care at night.
Most of the help provided to disabled people came from informal sources. About 40% of all disabled people who needed care received it from their partners, and a similar proportion received it from other informal sources in the household. About one-fifth (21%) of disabled people received some formal help from outside the household.
Respondents were asked about excess expenditure of goods and services because of their health problem or disability. Relatively high proportions reported added expenses on medications (91%), medical supplies (35%), heating (45%), and transport (35%). More severely disabled people were likely to report additional costs. Very few people reported receiving any assistance with these added costs, except for transport, but it is not clear what people regarded as assistance.
Social participation
Most disabled people included in the survey had made outings of various kinds in the past four weeks. For example, 69% had been on a shopping trip, and 77% had visited family or friends.
However, over 40% of the most severely disabled people (severity 9-10) and a quarter of disabled people aged 70 and over had not been out shopping, to visit family or friends or on any kind of excursion in the four weeks prior to interview. A quarter of more seriously disabled people said they would make more outings if help were available or facilities better.
Prevalence compared with 1985
The prevalence of disability reported in the 1996/7survey was much higher than in the earlier 1985 survey of disabled adults in private households. This is not consistent with what is known about disability trends from other sources. None of the methodological differences examined were able to account for this. For example, nearly all of those included in the 1996/7 survey would have met the criteria for selection to the 1985 sample. One possibility that may account for some of these differences is that responses to the questions used to derive the ONS scales were more strongly influenced by the context in which they are asked and by the general socio-economic and employment climate than is sometimes assumed.
Overall these results show that a large proportion of the British population are affected by disability, either personally or indirectly as a co-resident or helper of someone with a disability. Further policy initiatives designed to reduce the extent of, or mitigate the consequences of, disability would benefit a large section of the population.
Relevant publications
R Dorsett, L Finlayson, R Ford, A Marsh, M White and G Zarb (1998) “Leaving Incapacity Benefit” (Department of Social Security Research Report No.86)
G Zarb, N Jackson & P Taylor (1996) “Helping Disabled Workers ”(Department of Social Security Research Report No.57), London: TSO
K Rowlingson & R Berthoud (1996) “Disability, Benefits and Employment ”(Department of Social Security Research Report No.54), London: TSO
R Sainsbury, M Hirst & D Lawton (1995) “Evaluation of Disability Living Allowance and Attendance Allowance ”(Department of Social Security Research Report No.41), London: HMSO
A Hedges & A Thomas (1994) “Making a Claim for Disability Benefits” (Department of Social Security Research Report No.27), London: HMSO
B Erens & D Ghate (1993) “Invalidity Benefit. A longitudinal survey of new recipients ”(Department of Social Security Research Report No.20), London: HMSO
S Lonsdale, C Lessof & G Ferris (1993) “Invalidity Benefit. A survey of recipients ”(Department of Social Security Research Report No.19), London: HMSO
A Matthews & P Truscott (1990) “Disability, Household Income and Expenditure ”(Department of Social Security Research Report No.2), London: HMSO