Mobility	Device	Use	and	Hearing	Impairments	Among	Individuals and	

Households,	1990-2010

Mitchell P.	LaPlante,	Ph.D.	and	H.	Stephen Kaye,	Ph.D.

February	15,	2013

In response	to	a	request	by	the	US	Access	Board	for	population	based	data	in	

conjunction	with	proposed	scoping	requirements	for	guest	rooms	with	mobility	

features	and	guest	rooms with	communication	features	on	cruise	ships, this	report	

provides	updated	population	based	statistics	on	trends in the	percentage	of

individuals and	households	with members who	use	wheelchairs	or	other	mobility	

devices	and	the	percentage	of	individuals	and households	with members	who	have	

hearing	impairments.	

Data	and	Methods

We	use	all available	data	from	the	Survey	of	Income	and	Program	Participation

(SIPP)	over the	period 1990	to	2010.	 The	SIPP	provides	stability	in	measuring	

disability	over	a	long	time	period	with	a	large	sample	that	is	representative	of	US	

households	and	individuals.		The	SIPP	is	the	best	source	of	information	on	use	of	

wheelchairs	and	other	mobility	devices	over	time	and	also	provides useful

information	on	hearing	impairments.	 The	statistics	are	for	the	civilian	household	

(non-institutional)	population ages	6	and	older or	ages	18	and	older	as	noted.

Household members often travel	together	on	recreational	trips,	especially	cruises.	 A	

guest	room	with	mobility	features	or	communication	features	is needed	when	any	

travelling	household member	requires	these	features.	 Therefore, in	considering	

proposed	scoping	requirements	for	guest	rooms with	mobility	features	or	

communication	features,	statistics	on	households	are more	applicable than	statistics	

on	individuals.	 However,	national	statistics	on	disability	are	rarely	published for	

households;	this	report	presents	the	authors’	analysis	of the	SIPP	for	households as	

well	as	individuals.	 The	data	and	methods	employed	in	analyzing	the	SIPP for adults

are	described	elsewhere	(1).	 In	the analysis of	households,	the	same	methods	were	

used,	with	the	additional	step	that	information	from	all	household	members	was

aggregated to	the	household	level,	e.g.,	households	in	which	any	member used a	

wheelchair.	 For	estimation of	household	statistics,	the	survey	weight	for	the	head	of	

the	household	was	used.	 For	mobility	device	trends,	household	statistics include

only members ages	18 and	above	because	the	SIPP	did	not	ask	about	mobility	device	

use	among	children	ages	6-17	in	1990-1995.	Hearing	questions	were	changed	in	the	

SIPP	in	1997	and	are	not	comparable	to	earlier	years;	thus	the	time	period	covered	

is	1997	to	2010.	 Household	statistics for	hearing	impairment	include members ages	

6	and	older.
Mobility Device Use

The	SIPP	has	asked	about	use	of	mobility	devices,	including	wheelchairs,	scooters,	

canes,	crutches,	and	walkers,	among	all	adults	since	1990	and	for	all	persons	ages	6	

and	over	since	1997. 1

From	1990	to	2010,	the	household	rate	of	wheelchair	use	doubled from	1.5	to	3	

percent	(Figure	1).	 This	reflects	the	growth	in	use of	wheelchairs that	we	have

observed previously	for individuals	(2).	 If	past	trends	continue,	a linear	

extrapolation	to	2025	suggests	a	rate	of	just	above	4 percent	of	households	with

wheelchair	using	members.	 The	rate	of	wheelchair	use	for	adults	has	also	doubled	

from	0.8	percent	in	1990	to	1.6 percent in	2010	(Table	1).	

Ten percent	of	households	had	a member	who	used any mobility	device—including	

wheelchairs,	scooters,	canes,	crutches,	and	walkers—in	2010 (Figure	2).	 The

household	rate	of	using	mobility	devices has	grown	by	about	67	percent	from	1990	

to	2010 with	a	trend	that	is close	to	linear.	 If	past	trends	continue,	a	linear	

extrapolation	to	2025	suggests	a	rate	of	about	13	percent	of	households	with	

members	using	mobility	devices.	

These	statistics	are	based	on	just	the	adult	members	of	the	household.	 Starting	in	

1997,	children	ages	6	and	older	have	also	been	asked	about	mobility	device	use.	

However,	the	number	of	children	using	mobility	devices	is small	compared	to	adults.	

Including	these	children	increases	the	household	rate	by	only	2-5	percent,	

depending	on	the	year	(Table	1)	and has	no effect	on	the	trend	or	its	extrapolation.	

																																																							

1		In	this	report,	data	on	wheelchair	use	includes	scooter	use.
Note:	Author’s	analysis	of	the	Survey	of	Income	and	Program	Participation.	Includes	

adult	household	members	ages	18	and	older.

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1990 1995 2000 2005 2010 2015 2020 2025

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Figure 1. Rates of households with members who use 

mobility devices, 1990–2010 and extrapolated to 2025

Any mobility device use

Wheelchair use
Hearing Impairments

Several	national	surveys	attempt	to	measure	hearing	loss,	but	measurement	is	not	

standardized,	with	large	variability in	question	wording and	consequently	

estimates.	Audiometric	testing	is	considered	the	best	way	to	assess	hearing	loss.	The

National	Health	and	Nutrition	Examination	Survey	(NHANES)	is	the	only	survey	to	

include	audiometric	testing	for hearing	loss	of	25	dB	of	the	pure-tone	average	of	

hearing	thresholds	at	speech	frequencies.	 Audiometric	results	from	NHANES	show	

that	about	9	percent	of	men	and	about	4	percent	of	women	20-69	years	old	have	

hearing	loss (3).	 A	comparison	of	survey	reports	from	NHANES,	the National	Health	

Interview	Survey	(NHIS),	the	Medical	Expenditure	Panel	Survey	(MEPS),	and	the	

SIPP	against	audiometric	test	results	found,	for	adults	ages	20-69,	that	both	the

MEPS	and	the	SIPP	underreported	hearing	impairment and	that	the	NHANES	and	

the	NHIS	produced	substantial	overreporting,	with	up	to	25	percent	of	men	

reporting	some	trouble	hearing	in	NHANES (3).	 Survey	questions	in NHANES	and	

the	NHIS	are	based	on	a	four	point	rating	scale	of	hearing	trouble	(no	trouble,	a	

little,	a	lot,	deaf).	 In	contrast,	the	SIPP	questions	ask	whether	a	person	uses	a	

hearing	aid, and whether	a	person	has	difficulty	hearing	what	is	said	in	a	normal	

conversation	(even	when	wearing	a	hearing	aid) or	is	deaf.	 This	appears	to	be a	

more	objective	approach than	using	a	rating	scale	of	hearing	difficulty although	it	

results	in	some underreporting compared	to	audiometric	testing. In	this	report,	we	

present	results	from	the	SIPP	based	on	a	positive	response	to either	question	for	the

prevalence	of	any	hearing	impairment.2 For	the	prevalence	of	severe	hearing	

impairment,	we	present	results	based	on	a	positive	response	if	the person	uses	a	

hearing	aid	or	the	person	is	deaf.	

About	4-5	percent	of	households	have	a	member	who	uses	a	hearing	aid	or	is	deaf.	

Unlike	for	mobility	devices,	no	consistent trend over	time is	apparent (Figure	2).	

The	rate	among	individuals	aged	6	and	older	is	approximately	2	percent	(Table	2).	

From 8-10	percent	of	households	have	a	member	with	any	hearing	impairment	

(Figure	1).		Among	individuals	aged 6	and	older,	the	rate	was	about	4	percent.	

While	some	analysts	have	suggested an	increase	in	hearing	difficulty	due	to	the	

aging	of	the	population,	two	studies	have	noted	a	decline	in	hearing	difficulty	since	

1990 that	has	appeared	to	level	off	after	2000	(1,	3).	 In	the	absence	of	any	clear	

trends,	the	best	estimate	for	the	prevalence	of	hearing	impairments	in	households	

by 2025	is	the	current	rate	of	8-9	percent.		

																																																							

2		Persons	who responded positively	to	uses	a	hearing	aid	and	has	difficulty	hearing	what	is	said	in	a	

normal	conversation	even	when	wearing	a	hearing	aid are	counted	once.
Note:	Author’s	analysis	of	the	Survey	of	Income	and	Program	Participation.	Includes	

adult	household	members	ages	6	and	older.

References:	

1. Kaye	HS.	Disability	rates	for	working-age	adults	and	for	the	elderly	have	

stabilized,	but	trends	for	each	mean	different	results	for	costs.	Health	Aff	

(Millwood).	2012	Jan;32(1):127-34.

2. LaPlante	MP,	Kaye	HS.	Demographics	and	trends	in	wheeled	mobility	

equipment	use	and	accessibility	in	the	community.	Assistive	Technology.	

2010;22(1):3-17.

3. Ikeda	N,	Murray	CJ,	Salomon	JA.	Tracking	population	health	based	on	selfreported	impairments:	Trends	in	the	prevalence	of	hearing	loss	in	US	adults,	1976-

2006.	Am	J	Epidemiol.	2009	Jul	1;170(1):80-7.

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Figure 2. Rates of households with members who have 

hearing impairments, 1997–2010

Any hearing impairment

Deaf or uses hearing aid