# 6 {#section .Chapter-# .unnumbered}

# Disability and Secondary Conditions

6-1 Standard definition of people with disabilities in data sets

6-2 Feelings and depression among children with disabilities

6-3 Feelings and depression interfering with activities among adults
with disabilities

6-4 Social participation among adults with disabilities

6-5 Sufficient emotional support among adults with disabilities

6-6 Satisfaction with life among adults with disabilities

6-7 Congregate care of children and adults with disabilities

6-7a Adults aged 22 years and older

6-7b Persons aged 21 years and under

6-8 Employment parity

6-9 Inclusion of children and youth with disabilities in regular
education programs

6-10 Accessibility of health and wellness programs

6-11 Assistive devices and technology

6-12 Environmental barriers affecting participation in activities

6-13 Surveillance and health promotion programs

6-13a States and the District of Columbia

6-13b Tribes

  ----------------------- -----------------------------------------------
  6-1. Include in the     
  core of all relevant    
  Healthy People 2010     
  surveillance            
  instruments a           
  standardized set of     
  questions that identify 
  "people with            
  disabilities."          

  **National Data         CDC, NCEH, Office on Disability and Health.
  Source**                

  **State Data Source**   Not identified.

  **Healthy People 2000   Not applicable.
  Objective**             

  **Measure**             Percent.

  **Baseline**            0 (1999).

  **Numerator**           Number of relevant surveillance instruments
                          used to measure Healthy People 2010 objectives
                          that include in their core standardized
                          questions that identify people with
                          disabilities.

  **Denominator**         Number of relevant instruments used to measure
                          Healthy People 2010 objectives.

  **Questions Used To     Not applicable.
  Obtain the National     
  Data**                  

  **Expected              Annual.
  Periodicity**           

  **Comments**            The number of instruments to be included in
                          this measure was under review at the time of
                          publication.

                          No standardized set of questions that identify
                          people with disabilities currently exists.

                          CDC has proposed that a standardized set of
                          questions on disability status be developed. As
                          standard questions are adopted by the data
                          systems, the data produced from them will be
                          incorporated into the Healthy People 2010
                          objectives that specifically identify people
                          with disabilities. This presents the
                          opportunity in the future to have a standard
                          definition of people with disabilities that can
                          be used across data systems and geographic
                          levels.

                          See Appendix A for focus area contact
                          information.
  ----------------------- -----------------------------------------------

  

+----------------------+-----------------------------------------------+
| 6-2. Reduce the      |                                               |
| proportion of        |                                               |
| children and         |                                               |
| adolescents with     |                                               |
| disabilities who are |                                               |
| reported to be sad,  |                                               |
| unhappy, or          |                                               |
| depressed.           |                                               |
+----------------------+-----------------------------------------------+
| **National Data      | National Health Interview Survey (NHIS), CDC, |
| Source**             | NCHS.                                         |
+----------------------+-----------------------------------------------+
| **State Data         | Not identified.                               |
| Source**             |                                               |
+----------------------+-----------------------------------------------+
| **Healthy People     | Not applicable.                               |
| 2000 Objective**     |                                               |
+----------------------+-----------------------------------------------+
| **Measure**          | Percent.                                      |
+----------------------+-----------------------------------------------+
| **Baseline**         | 31 (1997).                                    |
+----------------------+-----------------------------------------------+
| **Numerator**        | Number of children and adolescents aged 4 to  |
|                      | 11 years with disabilities who are reported   |
|                      | to be unhappy, sad, or depressed.             |
+----------------------+-----------------------------------------------+
| **Denominator**      | Number of children and adolescents aged 4 to  |
|                      | 11 years with disabilities.                   |
+----------------------+-----------------------------------------------+
| **Population         | U.S. civilian, noninstitutionalized           |
| Targeted**           | population.                                   |
+----------------------+-----------------------------------------------+
| **Questions Used To  | From the 1997 National Health Interview       |
| Obtain the National  | Survey:                                       |
| Data**               |                                               |
+----------------------+-----------------------------------------------+
|                      | \[NUMERATOR:\]                                |
|                      |                                               |
|                      | -   During the past 6 months has              |
|                      |     ([Person]{.underline}) been unhappy, sad, |
|                      |     or depressed?                             |
+----------------------+-----------------------------------------------+
|                      | \[DENOMINATOR:\]                              |
|                      |                                               |
|                      | -   I am now going to ask you about           |
|                      |     (your/the) general health (of family      |
|                      |     members) and the effects of any physical, |
|                      |     mental, or emotional health problems.     |
+----------------------+-----------------------------------------------+
|                      | \[For children under 5:\]                     |
|                      |                                               |
|                      | -   (Are/Is) ([Person]{.underline}) limited   |
|                      |     in the kind or amount of play activities  |
|                      |     he/she/they can do because of a physical, |
|                      |     mental or emotional problem?              |
+----------------------+-----------------------------------------------+
|                      | \[For children 3 to 17:\]                     |
|                      |                                               |
|                      | -   Because of a physical, mental or          |
|                      |     emotional problem (do/does) (you/anyone)  |
|                      |     in the family need the help of other      |
|                      |     persons with PERSONAL CARE NEEDS, such as |
|                      |     eating, bathing, dressing, or getting     |
|                      |     around inside this home?                  |
+----------------------+-----------------------------------------------+
|                      | \[For children 5 to 17:\]                     |
|                      |                                               |
|                      | -   Because of a physical, mental or          |
|                      |     emotional problem (do/does) (you/anyone)  |
|                      |     in the family need the help of other      |
|                      |     persons in handling ROUTINE NEEDS, such   |
|                      |     as everyday household chores, doing       |
|                      |     necessary business, shopping, or getting  |
|                      |     around for other purposes?                |
+----------------------+-----------------------------------------------+
|                      | \[For children under 18:\]                    |
|                      |                                               |
|                      | -   Do any of the children under 18 in this   |
|                      |     family receive Special Education or Early |
|                      |     Intervention Services?                    |
+----------------------+-----------------------------------------------+
|                      | -   Because of a health problem, (do/does)    |
|                      |     (you/anyone) in the family have           |
|                      |     difficulty walking without using any      |
|                      |     special equipment?                        |
+----------------------+-----------------------------------------------+
|                      | -   (Are/Is) (you/anyone) in the family       |
|                      |     LIMITED IN ANY WAY in any activities      |
|                      |     because of difficulty remembering or      |
|                      |     because {you/they} experience periods of  |
|                      |     confusion?                                |
+----------------------+-----------------------------------------------+
|                      | -   (Are/Is) (you/anyone) in the family       |
|                      |     LIMITED IN ANY WAY in any activities      |
|                      |     because of physical, mental or emotional  |
|                      |     problems?                                 |
+----------------------+-----------------------------------------------+
|                      | -   Does ([Person]{.underline}) have an       |
|                      |     impairment or health problem that         |
|                      |     requires {him/her} to use special         |
|                      |     equipment, such as a brace, a wheelchair, |
|                      |     or a hearing aid (excluding ordinary      |
|                      |     eyeglasses or corrective shoes)?          |
+----------------------+-----------------------------------------------+
| **Expected           | Annual.                                       |
| Periodicity**        |                                               |
+----------------------+-----------------------------------------------+
| **Comments**         | Children and adolescents aged 4 to 11 are     |
|                      | defined as having a disability if the proxy   |
|                      | adult respondent responds "yes" to any of the |
|                      | limitation, special services, or special      |
|                      | equipment questions listed above in the       |
|                      | DENOMINATOR section.                          |
+----------------------+-----------------------------------------------+
|                      | A child/adolescent is considered sad, unhappy |
|                      | or depressed if any of these feelings have    |
|                      | been observed by the proxy adult respondent   |
|                      | during the past 6 months.                     |
+----------------------+-----------------------------------------------+
|                      | Baseline percents are based on data obtained  |
|                      | in the last two quarters of the 1997 NHIS     |
|                      | collection period.                            |
+----------------------+-----------------------------------------------+
|                      | This objective was intended to target all     |
|                      | children and adolescents aged 2 to 18 years.  |
|                      | However with the 1997 NHIS, it was not        |
|                      | possible to combine data for the entire age   |
|                      | range into one measure. Instead, proxy data   |
|                      | for children and adolescents aged 4 to 11     |
|                      | years have been provided.                     |
+----------------------+-----------------------------------------------+
|                      | See Part C for a description of NHIS and      |
|                      | Appendix A for focus area contact             |
|                      | information.                                  |
+----------------------+-----------------------------------------------+
| 6-3. Reduce the      |                                               |
| proportion of adults |                                               |
| with disabilities    |                                               |
| who report feelings  |                                               |
| such as sadness,     |                                               |
| unhappiness, or      |                                               |
| depression that      |                                               |
| prevent them from    |                                               |
| being active.        |                                               |
+----------------------+-----------------------------------------------+
| **National Data      | National Health Interview Survey (NHIS), CDC, |
| Source**             | NCHS                                          |
+----------------------+-----------------------------------------------+
| **State Data         | Behavioral Risk Factor Surveillance System    |
| Source**             | (BRFSS), CDC, NCCDPHP.                        |
+----------------------+-----------------------------------------------+
| **Healthy People     | Not applicable.                               |
| 2000 Objective**     |                                               |
+----------------------+-----------------------------------------------+
| **Measure**          | Percent (age adjusted---see Comments).        |
+----------------------+-----------------------------------------------+
| **Baseline**         | 28 (1997).                                    |
+----------------------+-----------------------------------------------+
| **Numerator**        | Number of adults aged 18 years and older with |
|                      | disabilities who report negative feelings     |
|                      | that prevented them from being active in the  |
|                      | last 30 days.                                 |
+----------------------+-----------------------------------------------+
| **Denominator**      | Number of adults aged 18 years and older with |
|                      | disabilities.                                 |
+----------------------+-----------------------------------------------+
| **Population         | U.S. civilian, noninstitutionalized           |
| Targeted**           | population.                                   |
+----------------------+-----------------------------------------------+
| **Questions Used To  | From the 1997 National Health Interview       |
| Obtain the National  | Survey:                                       |
| Data**               |                                               |
+----------------------+-----------------------------------------------+
|                      | \[NUMERATOR:\]                                |
|                      |                                               |
|                      | -   During the PAST 30 DAYS, how often did    |
|                      |     you feel                                  |
|                      |                                               |
|                      |     \... so sad that nothing could cheer you  |
|                      |     up?\                                      |
|                      |     \... nervous?\                            |
|                      |     \... restless or fidgety?\                |
|                      |     \... hopeless?\                           |
|                      |     \... that everything was an effort?\      |
|                      |     \... worthless?                           |
|                      |                                               |
|                      |     ALL of the time\                          |
|                      |     MOST of the time\                         |
|                      |     SOME of the time\                         |
|                      |     A LITTLE of the time\                     |
|                      |     NONE of the time\                         |
|                      |     Refused/Not ascertained/Don't know        |
+----------------------+-----------------------------------------------+
|                      | \[Asked of persons who at least some of the   |
|                      | time, have felt sad, nervous, restless or     |
|                      | fidgety, hopeless, that everything was an     |
|                      | effort, or worthless in the past 30 days.\]   |
|                      |                                               |
|                      | -   We just talked about a number of feelings |
|                      |     you had during the PAST 30 DAYS.          |
|                      |     Altogether, how MUCH did these feelings   |
|                      |     interfere with your life or activities: a |
|                      |     lot, some, a little, or not at all?       |
+----------------------+-----------------------------------------------+
|                      | \[DENOMINATOR:\]                              |
|                      |                                               |
|                      | -   I am now going to ask you about           |
|                      |     (your/the) general health (of family      |
|                      |     members) and the effects of any physical, |
|                      |     mental, or emotional health problems.     |
+----------------------+-----------------------------------------------+
|                      | -   Because of a physical, mental or          |
|                      |     emotional problem (do/does) (you/anyone)  |
|                      |     in the family need the help of other      |
|                      |     persons with PERSONAL CARE NEEDS, such as |
|                      |     eating, bathing, dressing, or getting     |
|                      |     around inside this home?                  |
+----------------------+-----------------------------------------------+
|                      | -   Because of a physical, mental or          |
|                      |     emotional problem (do/does) (you/anyone)  |
|                      |     in the family need the help of other      |
|                      |     persons in handling ROUTINE NEEDS, such   |
|                      |     as everyday household chores, doing       |
|                      |     necessary business, shopping, or getting  |
|                      |     around for other purposes?                |
+----------------------+-----------------------------------------------+
|                      | -   Does a physical, mental or emotional      |
|                      |     problem NOW keep (you/any family members  |
|                      |     aged 18 and older) from working at a job  |
|                      |     or business?                              |
+----------------------+-----------------------------------------------+
|                      | -   (Are any family members aged 18 and       |
|                      |     older) limited in the kind OR amount of   |
|                      |     work (you/they) can do because of a       |
|                      |     physical, mental or emotional problem?    |
+----------------------+-----------------------------------------------+
|                      | -   Because of a health problem, (do/does)    |
|                      |     (you/anyone) in the family have           |
|                      |     difficulty walking without using any      |
|                      |     special equipment?                        |
+----------------------+-----------------------------------------------+
|                      | -   (Are/Is) (you/anyone) in the family       |
|                      |     LIMITED IN ANY WAY in any activities      |
|                      |     because of difficulty remembering or      |
|                      |     because {you/they} experience periods of  |
|                      |     confusion?                                |
+----------------------+-----------------------------------------------+
|                      | -   (Are/Is) (you/anyone) in the family       |
|                      |     LIMITED IN ANY WAY in any activities      |
|                      |     because of physical, mental or emotional  |
|                      |     problems?                                 |
+----------------------+-----------------------------------------------+
|                      | -   Do you now have any health problems that  |
|                      |     requires you to use special equipment,    |
|                      |     such as a cane, a wheelchair, a special   |
|                      |     bed, or a special telephone?              |
+----------------------+-----------------------------------------------+
| **Expected           | Annual.                                       |
| Periodicity**        |                                               |
+----------------------+-----------------------------------------------+
| **Comments**         | Adults aged 18 years and older are defined as |
|                      | having a disability if a "yes" response is    |
|                      | obtained to any of the limitation or special  |
|                      | equipment questions listed above in the       |
|                      | DENOMINATOR section.                          |
+----------------------+-----------------------------------------------+
|                      | An adult is considered to have feelings that  |
|                      | prevent them from being active if he/she      |
|                      | answered the feelings interfered "a lot" or   |
|                      | "some" with their life or activities.         |
+----------------------+-----------------------------------------------+
|                      | Data are age adjusted to the 2000 standard    |
|                      | population. Age-adjusted percents are         |
|                      | weighted sums of age-specific percents. For a |
|                      | discussion of age adjustment, see Part A,     |
|                      | section 5.                                    |
+----------------------+-----------------------------------------------+
|                      | See Part C for a description of NHIS and      |
|                      | BRFSS, and Appendix A for focus area contact  |
|                      | information.                                  |
+----------------------+-----------------------------------------------+

  

+----------------------+-----------------------------------------------+
| 6-4. Increase the    |                                               |
| proportion of adults |                                               |
| with disabilities    |                                               |
| who participate in   |                                               |
| social activities.   |                                               |
+----------------------+-----------------------------------------------+
| **National Data      | National Health Interview Survey (NHIS), CDC, |
| Source**             | NCHS.                                         |
+----------------------+-----------------------------------------------+
| **State Data         | Behavioral Risk Factor Surveillance System    |
| Source**             | (BRFSS), CDC, NCCDPHP.                        |
+----------------------+-----------------------------------------------+
| **Healthy People     | Not applicable.                               |
| 2000 Objective**     |                                               |
+----------------------+-----------------------------------------------+
| **Measure**          | Percent (age adjusted---see Comments).        |
+----------------------+-----------------------------------------------+
| **Baseline**         | 95.4 (1997).                                  |
+----------------------+-----------------------------------------------+
| **Numerator**        | Number of adults aged 18 years and older with |
|                      | disabilities who report participation in      |
|                      | social activities.                            |
+----------------------+-----------------------------------------------+
| **Denominator**      | Number of adults aged 18 years and older with |
|                      | disabilities.                                 |
+----------------------+-----------------------------------------------+
| **Population         | U.S. civilian, noninstitutionalized           |
| Targeted**           | population.                                   |
+----------------------+-----------------------------------------------+
| **Questions Used To  | From the 1997 National Health Interview       |
| Obtain the National  | Survey:                                       |
| Data**               |                                               |
+----------------------+-----------------------------------------------+
|                      | \[NUMERATOR:\]                                |
|                      |                                               |
|                      | -   By yourself, and WITHOUT using any        |
|                      |     special equipment, how difficult is it    |
|                      |     for you to . . . Go out to things like    |
|                      |     shopping, movies, or sporting events?     |
|                      |                                               |
|                      |     Not at all difficult\                     |
|                      |     Only a little difficult\                  |
|                      |     Somewhat difficult\                       |
|                      |     Very difficult\                           |
|                      |     Can't do at all\                          |
|                      |     Do not do this activity\                  |
|                      |     Refused/Not ascertained/Don't know        |
+----------------------+-----------------------------------------------+
|                      | \[DENOMINATOR:\]                              |
|                      |                                               |
|                      | See Questions Used To Obtain the National     |
|                      | Data (DENOMINATOR) provided with objective    |
|                      | 6-3.                                          |
+----------------------+-----------------------------------------------+
| **Expected           | Annual.                                       |
| Periodicity**        |                                               |
+----------------------+-----------------------------------------------+
| **Comments**         | Adults aged 18 years and older are defined as |
|                      | having a disability if he/she responds "yes"  |
|                      | to any of the limitation questions listed in  |
|                      | the DENOMINATOR section for objective 6-3.    |
+----------------------+-----------------------------------------------+
|                      | An adult is considered to participate in      |
|                      | social activities if he/she responded "not at |
|                      | all difficult," "only a little difficult,"    |
|                      | "somewhat difficult," or "very difficult" to  |
|                      | the question listed in the NUMERATOR section  |
|                      | above.                                        |
+----------------------+-----------------------------------------------+
|                      | This objective was intended to measure        |
|                      | whether persons with disabilities engage in   |
|                      | social activity. It is currently possible to  |
|                      | measure only how difficult it is for someone  |
|                      | to participate in social activities from the  |
|                      | NHIS, thus a proxy measure has been used. The |
|                      | 1999 BRFSS piloted another set of             |
|                      | participation questions in Colorado. Future   |
|                      | periodic NHIS modules or BRFSS surveys may    |
|                      | include these or similar questions in the     |
|                      | next few years.                               |
+----------------------+-----------------------------------------------+
|                      | Data are age adjusted to the 2000 standard    |
|                      | population. Age-adjusted percents are         |
|                      | weighted sums of age-specific percents. For a |
|                      | discussion of age adjustment, see Part A,     |
|                      | section 5.                                    |
+----------------------+-----------------------------------------------+
|                      | See Part C for a description of NHIS and      |
|                      | BRFSS, and Appendix A for focus area contact  |
|                      | information.                                  |
+----------------------+-----------------------------------------------+

  

+----------------------+-----------------------------------------------+
| 6-5. Increase the    |                                               |
| proportion of adults |                                               |
| with disabilities    |                                               |
| reporting sufficient |                                               |
| emotional support.   |                                               |
+----------------------+-----------------------------------------------+
| **National Data      | Behavioral Risk Factor Surveillance System    |
| Source**             | (BRFSS), CDC, NCCDPHP.                        |
+----------------------+-----------------------------------------------+
| **State Data         | Behavioral Risk Factor Surveillance System    |
| Source**             | (BRFSS), CDC, NCCDPHP.                        |
+----------------------+-----------------------------------------------+
| **Healthy People     | Not applicable.                               |
| 2000 Objective**     |                                               |
+----------------------+-----------------------------------------------+
| **Measure**          | Percent (age adjusted---see Comments).        |
+----------------------+-----------------------------------------------+
| **Baseline**         | 71 (1998) (10 States and the District of      |
|                      | Columbia---see Comments).                     |
+----------------------+-----------------------------------------------+
| **Numerator**        | Number of adults aged 18 years and older with |
|                      | disabilities who report receiving sufficient  |
|                      | emotional support.                            |
+----------------------+-----------------------------------------------+
| **Denominator**      | Number of adults aged 18 years and older with |
|                      | disabilities.                                 |
+----------------------+-----------------------------------------------+
| **Population         | Civilian, noninstitutionalized population of  |
| Targeted**           | selected States (see Comments).               |
+----------------------+-----------------------------------------------+
| **Questions Used To  | From the 1998 Behavioral Risk Factor          |
| Obtain the National  | Surveillance System:                          |
| Data**               |                                               |
+----------------------+-----------------------------------------------+
|                      | \[NUMERATOR:\]                                |
|                      |                                               |
|                      | -   How often do you get the social and       |
|                      |     emotional support you need?               |
|                      |                                               |
|                      |     Always\                                   |
|                      |     Usually\                                  |
|                      |     Sometimes\                                |
|                      |     Rarely\                                   |
|                      |     Never\                                    |
|                      |     Refused/Not ascertained/Don't know        |
+----------------------+-----------------------------------------------+
|                      | \[DENOMINATOR:\]                              |
|                      |                                               |
|                      | -   Are you limited in any way in any         |
|                      |     activities because of any impairment or   |
|                      |     health problem?                           |
+----------------------+-----------------------------------------------+
|                      | -   If you use special equipment or help from |
|                      |     others to get around, what type do you    |
|                      |     use?                                      |
+----------------------+-----------------------------------------------+
| **Expected           | Periodic.                                     |
| Periodicity**        |                                               |
+----------------------+-----------------------------------------------+
| **Comments**         | For this objective, adults with disabilities  |
|                      | are defined as persons aged 18 years and      |
|                      | older who report being limited in any         |
|                      | activity because of impairments or health     |
|                      | problems or who require special equipment. An |
|                      | adult is considered to have sufficient social |
|                      | support if he/she reported "always" or        |
|                      | "usually" to the question listed in the       |
|                      | NUMERATOR section above.                      |
+----------------------+-----------------------------------------------+
|                      | 1998 baseline data are based on responses     |
|                      | from 10 States and the District of Columbia.  |
+----------------------+-----------------------------------------------+
|                      | Data are age adjusted to the 2000 standard    |
|                      | population. Age-adjusted percents are         |
|                      | weighted sums of age-specific percents. For a |
|                      | discussion of age adjustment, see Part A,     |
|                      | section 5.                                    |
+----------------------+-----------------------------------------------+
|                      | See Part C for a description of BRFSS and     |
|                      | Appendix A for focus area contact             |
|                      | information.                                  |
+----------------------+-----------------------------------------------+

  

+----------------------+-----------------------------------------------+
| 6-6. Increase the    |                                               |
| proportion of adults |                                               |
| with disabilities    |                                               |
| reporting            |                                               |
| satisfaction with    |                                               |
| life.                |                                               |
+----------------------+-----------------------------------------------+
| **National Data      | Behavioral Risk Factor Surveillance System    |
| Source**             | (BRFSS), CDC, NCCDPHP.                        |
+----------------------+-----------------------------------------------+
| **State Data         | Behavioral Risk Factor Surveillance System    |
| Source**             | (BRFSS), CDC, NCCDPHP.                        |
+----------------------+-----------------------------------------------+
| **Healthy People     | Not applicable.                               |
| 2000 Objective**     |                                               |
+----------------------+-----------------------------------------------+
| **Measure**          | Percent (age adjusted---see Comments).        |
+----------------------+-----------------------------------------------+
| **Baseline**         | 87 (1998) (10 States and the District of      |
|                      | Columbia---see Comments).                     |
+----------------------+-----------------------------------------------+
| **Numerator**        | Number of adults aged 18 years and older with |
|                      | disabilities who report satisfaction with     |
|                      | life.                                         |
+----------------------+-----------------------------------------------+
| **Denominator**      | Number of adults aged 18 years and older with |
|                      | disabilities.                                 |
+----------------------+-----------------------------------------------+
| **Population         | Civilian, noninstitutionalized population of  |
| Targeted**           | selected States (see Comments).               |
+----------------------+-----------------------------------------------+
| **Questions Used To  | From the 1998 Behavioral Risk Factor          |
| Obtain the National  | Surveillance System:                          |
| Data**               |                                               |
+----------------------+-----------------------------------------------+
|                      | \[NUMERATOR:\]                                |
|                      |                                               |
|                      | -   In general, how satisfied are you with    |
|                      |     your life?                                |
|                      |                                               |
|                      |     Very satisfied\                           |
|                      |     Satisfied\                                |
|                      |     Dissatisfied\                             |
|                      |     Very dissatisfied\                        |
|                      |     Refused/Not ascertained/Don't know        |
+----------------------+-----------------------------------------------+
|                      | \[DENOMINATOR:\]                              |
|                      |                                               |
|                      | -   Are you limited in any way in any         |
|                      |     activities because of any impairment or   |
|                      |     health problem?                           |
+----------------------+-----------------------------------------------+
|                      | -   If you use special equipment or help from |
|                      |     others to get around, what type do you    |
|                      |     use?                                      |
+----------------------+-----------------------------------------------+
| **Expected           | Periodic.                                     |
| Periodicity**        |                                               |
+----------------------+-----------------------------------------------+
| **Comments**         | For this objective, adults with disabilities  |
|                      | are defined as persons 18 years and older who |
|                      | report being limited in any activity because  |
|                      | of impairments or health problems or who      |
|                      | require special equipment. An adult is        |
|                      | considered to be satisfied with life if       |
|                      | he/she reported being "very satisfied" or     |
|                      | "satisfied" to the question listed in the     |
|                      | NUMERATOR section above.                      |
+----------------------+-----------------------------------------------+
|                      | Data are age adjusted to the 2000 standard    |
|                      | population. Age-adjusted percents are         |
|                      | weighted sums of age-specific percents. For a |
|                      | discussion of age adjustment, see Part A,     |
|                      | section 5.                                    |
+----------------------+-----------------------------------------------+
|                      | 1998 baseline data are based on responses     |
|                      | from 10 States and the District of Columbia.  |
+----------------------+-----------------------------------------------+
|                      | See Part C for a description of BRFSS and     |
|                      | Appendix A for focus area contact             |
|                      | information.                                  |
+----------------------+-----------------------------------------------+

  

6-7. Reduce the number of people with disabilities in congregate care
facilities, consistent with permanency planning principles.

+----------------------+-----------------------------------------------+
| 6-7a. Persons aged   |                                               |
| 22 years and older   |                                               |
| in 16 or more bed    |                                               |
| congregate           |                                               |
| facilities.          |                                               |
+----------------------+-----------------------------------------------+
| **National Data      | Survey of U.S. Residential Facilities,        |
| Source**             | University of Minnesota.                      |
+----------------------+-----------------------------------------------+
| **State Data         | Not identified.                               |
| Source**             |                                               |
+----------------------+-----------------------------------------------+
| **Healthy People     | Not applicable.                               |
| 2000 Objective**     |                                               |
+----------------------+-----------------------------------------------+
| **Measure**          | Number.                                       |
+----------------------+-----------------------------------------------+
| **Baseline**         | 93,362 (1997).                                |
+----------------------+-----------------------------------------------+
| **Numerator**        | Number of adults aged 22 years and older in   |
|                      | congregate care facilities with 16 or more    |
|                      | beds.                                         |
+----------------------+-----------------------------------------------+
| **Denominator**      | Not applicable.                               |
+----------------------+-----------------------------------------------+
| **Population         | U.S. resident population.                     |
| Targeted**           |                                               |
+----------------------+-----------------------------------------------+
| **Questions Used To  | From the 1997 Survey of U.S. Residential      |
| Obtain the National  | Facilities:                                   |
| Data**               |                                               |
+----------------------+-----------------------------------------------+
|                      | -   Facility type, number of beds, age of     |
|                      |     residents.                                |
+----------------------+-----------------------------------------------+
| **Expected           | Annual.                                       |
| Periodicity**        |                                               |
+----------------------+-----------------------------------------------+
| **Comments**         | State residential facilities are asked to     |
|                      | complete a form and the information is        |
|                      | abstracted, analyzed by investigators at the  |
|                      | University of Minnesota, and reported in      |
|                      | Residential Services for Persons with         |
|                      | Developmental Disabilities: Status and        |
|                      | Trends.**^1^**                                |
+----------------------+-----------------------------------------------+
|                      | See Appendix A for focus area contact         |
|                      | information.                                  |
+----------------------+-----------------------------------------------+

  

+----------------------+-----------------------------------------------+
| 6-7b. Persons aged   |                                               |
| 21 years and under   |                                               |
| in congregate care   |                                               |
| facilities.          |                                               |
+======================+===============================================+
| **National Data      | Survey of U.S. Residential Facilities,        |
| Source**             | University of Minnesota.                      |
+----------------------+-----------------------------------------------+
| **State Data         | Not identified.                               |
| Source**             |                                               |
+----------------------+-----------------------------------------------+
| **Healthy People     | Not applicable.                               |
| 2000 Objective**     |                                               |
+----------------------+-----------------------------------------------+
| **Measure**          | Percent.                                      |
+----------------------+-----------------------------------------------+
| **Baseline**         | 24,300 (1997).                                |
+----------------------+-----------------------------------------------+
| **Numerator**        | Number of persons aged 22 years and under in  |
|                      | congregate care facilities with 16 or more    |
|                      | beds.                                         |
+----------------------+-----------------------------------------------+
| **Denominator**      | Not applicable.                               |
+----------------------+-----------------------------------------------+
| **Population         | U.S. resident population.                     |
| Targeted**           |                                               |
+----------------------+-----------------------------------------------+
| **Questions Used To  | From the 1997 Survey of U.S. Residential      |
| Obtain the National  | Facilities:                                   |
| Data**               |                                               |
+----------------------+-----------------------------------------------+
| **Expected           | -   Facility type, number of beds, age of     |
| Periodicity**        |     residents.                                |
+----------------------+-----------------------------------------------+
| **Comments**         | Annual.                                       |
+----------------------+-----------------------------------------------+
|                      | State residential facilities are asked to     |
|                      | complete a form and the information is        |
|                      | abstracted, analyzed by investigators at the  |
|                      | University of Minnesota, and reported in      |
|                      | Residential Services for Persons with         |
|                      | Developmental Disabilities: Status and        |
|                      | Trends.**^1^**                                |
+----------------------+-----------------------------------------------+
|                      | See Appendix A for focus area contact         |
|                      | information.                                  |
+----------------------+-----------------------------------------------+

  

+----------------------+-----------------------------------------------+
| 6-8. Eliminate       |                                               |
| disparities in       |                                               |
| employment rates     |                                               |
| between working-aged |                                               |
| adults with and      |                                               |
| without              |                                               |
| disabilities.        |                                               |
+----------------------+-----------------------------------------------+
| **National Data      | Survey of Income and Program Participation    |
| Source**             | (SIPP), Department of Commerce, Bureau of     |
|                      | Census.                                       |
+----------------------+-----------------------------------------------+
| **State Data         | Not identified.                               |
| Source**             |                                               |
+----------------------+-----------------------------------------------+
| **Healthy People     | Not applicable.                               |
| 2000 Objective**     |                                               |
+----------------------+-----------------------------------------------+
| **Measure**          | Percent.                                      |
+----------------------+-----------------------------------------------+
| **Baseline**         | 52 (1994--95).                                |
+----------------------+-----------------------------------------------+
| **Numerator**        | Number of adults aged 21 to 64 years with     |
|                      | disabilities who are employed.                |
+----------------------+-----------------------------------------------+
| **Denominator**      | Number of adults aged 21 to 64 years with     |
|                      | disabilities.                                 |
+----------------------+-----------------------------------------------+
| **Population         | U.S. civilian, noninstitutionalized           |
| Targeted**           | population.                                   |
+----------------------+-----------------------------------------------+
| **Questions Used To  | From Wave 6 of the 1993 Survey of Income and  |
| Obtain the National  | Program Participation:                        |
| Data**               |                                               |
+----------------------+-----------------------------------------------+
|                      | \[NUMERATOR:\]                                |
|                      |                                               |
|                      | -   During the 4-month period outlined on     |
|                      |     this calendar, that is from ([4 months    |
|                      |     ago]{.underline}) through ([last          |
|                      |     month]{.underline}), did                  |
|                      |     ([Person]{.underline}) have a job or      |
|                      |     business, either full time or part time,  |
|                      |     even for only a few days? (Mark "yes" for |
|                      |     active duty in the Armed Forces, any      |
|                      |     temporary or part-time work, and work     |
|                      |     without pay in a family business or farm) |
+----------------------+-----------------------------------------------+
|                      | -   Even though ([Person]{.underline}) did    |
|                      |     not have a job during this period, did    |
|                      |     [(Person]{.underline}) do any work at all |
|                      |     that earned some money?                   |
+----------------------+-----------------------------------------------+
|                      | -   Did ([Person]{.underline}) have a job or  |
|                      |     business, either full or part time,       |
|                      |     during EACH of the weeks in this period?  |
+----------------------+-----------------------------------------------+
|                      | -   During the weeks that                     |
|                      |     ([Person]{.underline}) did not have a     |
|                      |     job, did ([Person]{.underline}) do any    |
|                      |     work at all that earned some money?       |
+----------------------+-----------------------------------------------+
|                      | \[DENOMINATOR:\]                              |
|                      |                                               |
|                      | -   (Mark by observation if apparent.) Does   |
|                      |     ([Person]{.underline}) use any of the     |
|                      |     following aids to get around?             |
|                      |                                               |
|                      |     a\. A cane, crutches, or a walker\        |
|                      |     b. A wheelchair                           |
+----------------------+-----------------------------------------------+
|                      | \[If "yes" to a or b above:\]                 |
|                      |                                               |
|                      | -   Has ([Person]{.underline}) used ([Aid     |
|                      |     mentioned in a or b above]{.underline})   |
|                      |     for six months or longer?                 |
+----------------------+-----------------------------------------------+
|                      | -   Does ([Person]{.underline}) have          |
|                      |     difficulty seeing the words and letters   |
|                      |     in ordinary newspaper print even when     |
|                      |     wearing glasses or contact lenses if \... |
|                      |     usually wears them?                       |
+----------------------+-----------------------------------------------+
|                      | -   Does ([Person]{.underline}) have any      |
|                      |     difficulty hearing what is said in normal |
|                      |     conversation with another person (using a |
|                      |     hearing aid if ([Person]{.underline})     |
|                      |     usually wears one)?                       |
+----------------------+-----------------------------------------------+
|                      | -   Because of a health condition or problem, |
|                      |     does ([Person]{.underline}) have any      |
|                      |     difficulty having his/her speech          |
|                      |     understood?                               |
+----------------------+-----------------------------------------------+
|                      | -   Does ([Person]{.underline}) have any      |
|                      |     difficulty lifting and carrying something |
|                      |     as heavy as 10 lbs., such as a full bag   |
|                      |     of groceries?                             |
+----------------------+-----------------------------------------------+
|                      | -   Does ([Person]{.underline}) have any      |
|                      |     difficulty climbing a flight of stairs    |
|                      |     without resting?                          |
+----------------------+-----------------------------------------------+
|                      | -   Does ([Person]{.underline}) have any      |
|                      |     difficulty walking a quarter of a mile -  |
|                      |     about 3 city blocks?                      |
+----------------------+-----------------------------------------------+
|                      | -   Does ([Person]{.underline}) have any      |
|                      |     difficulty using the telephone?           |
+----------------------+-----------------------------------------------+
|                      | -   Because of a physical or mental health    |
|                      |     condition, does ([Person]{.underline})    |
|                      |     have difficulty doing any of the          |
|                      |     following by himself/herself (exclude the |
|                      |     effects of temporary conditions)? (If an  |
|                      |     aid is used, ask whether the person has   |
|                      |     difficulty even when using the aid.)      |
|                      |                                               |
|                      |     Getting around INSIDE the home?\          |
|                      |     Going OUTSIDE the home, for example to    |
|                      |     shop or visit a doctor's office?\         |
|                      |     Getting in and out of bed or a chair?\    |
|                      |     Taking a bath or shower?\                 |
|                      |     Dressing?\                                |
|                      |     Walking?\                                 |
|                      |     Eating?\                                  |
|                      |     Using the toilet, including getting to    |
|                      |     the toilet?\                              |
|                      |     Keeping track of money and bills?\        |
|                      |     Preparing meals?\                         |
|                      |     Doing light housework, such as washing    |
|                      |     dishes or sweeping a floor?\              |
|                      |     Taking the right amount of prescribed     |
|                      |     medicine at the right time?               |
+----------------------+-----------------------------------------------+
|                      | -   Does ([Person]{.underline}) have --       |
|                      |                                               |
|                      |     Mental retardation?\                      |
|                      |     A developmental disability such as autism |
|                      |     or cerebral palsy?\                       |
|                      |     Alzheimer's disease, senility, dementia?\ |
|                      |     Any other mental or emotional conditions? |
+----------------------+-----------------------------------------------+
|                      | -   We have recorded that                     |
|                      |     ([Person]{.underline})'s health or        |
|                      |     condition limits the kind or amount of    |
|                      |     work ([Person]{.underline}) can do. Is    |
|                      |     that correct?                             |
+----------------------+-----------------------------------------------+
|                      | -   Does ([Person]{.underline}) have a        |
|                      |     physical, mental, or other health         |
|                      |     condition which limits the kind or amount |
|                      |     of work ([Person]{.underline}) can do?    |
+----------------------+-----------------------------------------------+
|                      | -   Does ([Person]{.underline}) have a        |
|                      |     physical, mental, or other health         |
|                      |     condition which limits the kind or amount |
|                      |     of work ([Person]{.underline}) can do     |
|                      |     around the house?                         |
+----------------------+-----------------------------------------------+
| **Expected           | Periodic.                                     |
| Periodicity**        |                                               |
+----------------------+-----------------------------------------------+
| **Comments**         | Adults aged 21 to 64 years are defined as     |
|                      | having a disability if he/she has used a      |
|                      | cane, crutch, walker or wheelchair to get     |
|                      | around for 6 months or longer or responds     |
|                      | "yes" to any of the limitation questions      |
|                      | listed in the DENOMINATOR section above.      |
+----------------------+-----------------------------------------------+
|                      | An adult is considered be employed if he/she  |
|                      | answered "yes" to any of the job-related      |
|                      | questions listed in the NUMERATOR section     |
|                      | above.                                        |
+----------------------+-----------------------------------------------+
|                      | Additional information on disability data     |
|                      | from the SIPP, can be found at the following  |
|                      | Web site:                                     |
|                      | www.census.gov/hhes/www/disable/dissipp.html. |
+----------------------+-----------------------------------------------+
|                      | See Appendix A for focus area contact         |
|                      | information.                                  |
+----------------------+-----------------------------------------------+

  

  ----------------------- -----------------------------------------------
  6-9. Increase the       
  proportion of children  
  and youth with          
  disabilities who spend  
  at least 80 percent of  
  their time in regular   
  education programs.     

  **Comments**            A complete operational definition was not
                          specified at the time of publication.

                          See Appendix A for focus area contact
                          information.
  ----------------------- -----------------------------------------------

  

  ----------------------- -----------------------------------------------
  6-10. (Developmental)   
  Increase the proportion 
  of health and wellness  
  and treatment programs  
  and facilities that     
  provide full access for 
  people with             
  disabilities.           

  **Comments**            An operational definition could not be
                          specified at the time of publication. A
                          proposed national data source is the National
                          Independent Living Centers Network.

                          See Appendix A for focus area contact
                          information.
  ----------------------- -----------------------------------------------

  

  ----------------------- -----------------------------------------------
  6-11. (Developmental)   
  Reduce the proportion   
  of people with          
  disabilities who report 
  not having the          
  assistive devices and   
  technology needed.      

  **Comments**            An operational definition could not be
                          specified at the time of publication. A
                          proposed national data source is the National
                          Health Interview Survey (NHIS), CDC, NCHS.

                          See Appendix A for focus area contact
                          information.
  ----------------------- -----------------------------------------------

  

  ----------------------- -----------------------------------------------
  6-12. (Developmental)   
  Reduce the proportion   
  of people with          
  disabilities reporting  
  environmental barriers  
  to participation in     
  home, school, work, or  
  community activities.   

  **Comments**            An operational definition could not be
                          specified at the time of publication. A
                          possible data source is the Behavioral Risk
                          Factor Surveillance System (BRFSS), CDC,
                          NCCDPHP.

                          See Appendix A for focus area contact
                          information.
  ----------------------- -----------------------------------------------

  

6-13. Increase the number of Tribes, States, and the District of
Columbia that have public health surveillance and health promotion
programs for people with disabilities and caregivers.

  ----------------------- -----------------------------------------------
  6-13a. States and the   
  District of Columbia    

  **Comments**            A complete operational definition was not
                          specified at the time of publication.

                          See Appendix A for focus area contact
                          information.
  ----------------------- -----------------------------------------------

  

  ----------------------- -----------------------------------------------
  6-13b. (Developmental)  
  Tribes                  

  **Comments**            An operational definition could not be
                          specified at the time of publication. A
                          potential data source is the Office on
                          Disability and Health, CDC, NCEH.

                          See Appendix A for focus area contact
                          information.
  ----------------------- -----------------------------------------------

  

## Reference

1\. Prouty, R., and Lakin, K.C., eds. *Residential Services for Persons
With Developmental Disabilities: Status and Trends Through 1996*. Report
No. 49. Minneapolis, MN: University of Minnesota, Research and Training
Center on Community Living, Institute on Community Integration, 1997.