Slide 1

A Review of Disability Data for the Institutional Population of Working Age

Peiyun She

David C. Stapleton

Cornell Institute for Policy Research

Presented to participants of the

Cornell StatsRRTC Conference on:

The Future of Disability Statistics:

What We Know and Need to Know

October 5, 2006

Washington, DC

Slide 2

Motivation

• Limited disability data and research for the institutional population versus the non-institutional population, especially for working-age people.

• Impact of trends in institutionalization on trends of disability prevalence in the non-institutional population and the distributions of their socio-demographic characteristics.

• Difficulty in assessing the effects of policy efforts in promoting people with disabilities to live in the community.

• Possible effects of trends in institutionalization on persistent declines in employment among non-institutional working-age people with disabilities.

Slide 3

Group Quarters (GQ)

• Non-institutional GQ

– Military quarters

– College dormitories

– Other non-institutional GQ (e.g., group homes, shelters, etc.)

• Institutional GQ

– Correctional institutions

– Nursing homes

– Other institutions (e.g., mental hospitals, juvenile institutions, etc.)

Slide 4

Data Sources

• 1990 and 2000 Census

• Population estimates from the Bureau of the Census

• BJS surveys

– Survey of Inmates of Local Jails

– Survey of Inmates of State and Federal Correctional Facilities

• National Nursing Home Survey

Slide 5

Outline

• The size and distribution of the institutional population.

• The size, distribution, and characteristics of the institutional population with disabilities.

• Disability prevalence for people living in correctional institutions and nursing homes.

• Rate of institutionalization over time.

• Gaps in coverage, timing, and disability definitions.

Slide 6

Size and Proportion of the Institutional Populations,
1990 and 2000

All Institutions: 1990 3.33 million (1.3%); 2000 4.06 million (1.4%)

Nursing Homes:  1990 1.77 million (0.71%); 2000 1.72 million (0.61%)

Correctional Institutions:  1990 1.12 million (0.45%); 2000 1.98 million (0.70%)

Other:  1990 0.45 million (0.18%); 2000 0.36 million (0.13%)

Source: Census 1990 and 2000.

Slide 7

Distribution of the Institutional Population
by Institution Type, 1990 and 2000

Nursing Homes:  1990 53 percent; 2000 42 percent.

Correctional Institutions:  1990 33 percent; 2000 49 percent.

Other Institutions:  1990 13 percent; 2000 9 percent.

Source:  Census 1990 and 2000

Slide 8

Institutional Population of Working Age
(18-64), 1990 and 2000

It increased from 1.5 million people in 1990  to 2.3 million people in 2000, that is, from near one percent of the entire working-age population in 1990 to 1.3 percent in 2000.

Working-age people accounted for 56% of the institutional population in 2000, increased from 45% in 1990.  

All Institutions:  1990.

Slide 9

Age Distribution of the Institutional
Population by Institution Type, 2000

Nursing Homes:  Under 18, 0%; 18-64, 9%; 65 and over, 91%

Correctional Institutions:  Under 18, 1%; 18-64, 98%; 65 and over, 1%.

Other Institutions:  Under 18, 38%; 18-64, 44%; 65 and over, 19%.

Slide 10

Distribution of People in Various Age Groups
by Institution Type, 2000

Under 18:  Nursing homes, 0%; Correctional Institutions, 13%, Other institutions, 87%

18-64:  Nursing homes, 7%; Correctional Institutions, 86%; Other institutions, 7%

65 and over:  Nursing homes, 95%; Correctional institutions, 1%; Other institutions, 4%.

Slide 11

Census 2000 Disability Measures

• Self-care (bathing, dressing, or getting around inside the home)

• Mental (learning, remembering, or concentration)

• Physical (walking, climbing stairs, reaching, lifting, or carrying)

• Sensory (blindness, deafness, or a severe vision or hearing impairment)

• [Go outside home] (going outside the home alone to shop or visit a doctor’s office)

• [Employment] (working at a job or business)

Slide 12

Disability Prevalence by Living Quarters, 2000

All: 12%

Housing Units:  11%

Non-institutional GQs:  22%

Institutional GQs:  54%.

Source :  Census 2000

Slide 13

Distribution of People with Disabilities
by Living Quarters, 2000

Institutional GQs: 6.4% (2 million)

Non Institutional GQs: 2.3% (0.8 million)

Housing Units:  91.3% (31 million)

Source:  Census 2000

Slide 14

Working-age People with Disabilities Living in Institutions, by Gender and Race, 2000

• The share of males is much larger than the share of females (7.7% versus 1.7%).

• They are also disproportionately African American (38.6% of those ages 18-49 and 22.4% of those ages 50-64).

Slide 15

BJS Surveys Disability Measures, 1996 - 97

• Physical disability

• Sensory disability (vision, hearing, speech)

• Learning disability (such as dyslexia or attention deficit disorder)

• Mental disability (mental or emotional condition)

• Work disability (limitation in the kind or amount of work one can do)

Slide 16

Disability Prevalence in the Incarcerated Population,
1996 – 1997

Any Disability:  Jail 37%; State Prison 31%; Federal Prison 23%

Physical:  Jail 10%; State Prison 12%; Federal Prison 11%

Mental:  Jail 10%; State Prison 10%; Federal Prison 5%

Learning: Jail 0%; State Prison 10%; Federal Prison 5%

Source:  BJS surveys.

Slide 17

Changes in Incarceration Rate
by Age and Sex, 1989 - 91 to 1996 – 97

Age & Sex	Jail - 1989	Jail - 1996	Jail - 2002	Prison - 1991	Prison - 1997	Total - 1989-91	Total - 1996-97	Change - Number	Change - Percent
Ages 18 - 24	478	580	660	635	894	1,113	1,474	361	32.4
Ages 25 -34	393	486	532	869	1,204	1,262	1,690	428	33.9
Ages 35 - 44	178	283	385	491	827	669	1,110	441	65.9
Ages 45 - 54	73	99	166	224	377	297	476	179	60.3
Ages 55+	13	14	24	53	73	66	87	21	31.8
Total	159	194	231	313	444	472	638	166	35.2
Sex Male	296	358	415	630	884	926	1,242	316	34.1
Sex Female	30	39	53	36	58	66	97	31	47

* Incarceration rate is defined as the number of inmates per 100,000.

Source: Authors’ calculations based on data from the Census Bureau and the Bureau of Justice Statistics.

Slide 18

Disability Prevalence in the Nursing Home Population, 1999

Bathing:  Under 65 85%; 65 and over 95%

Dressing:  Under 65 77%; 65 and over 88%

Three or more ADLs:  Under 65 66%; 65 and over 76%

Source:  NNHS

Slide 19

Changes in Nursing Home Residence Rate by Age, 1977 to 1999

Age	Number of Residents per 100,000 - 1977	Number of Residents per 100,000 - 1985	Number of Residents per 100,000 - 1995	Number of Residents per 100,000 - 1997	Number of Residents per 100,000 - 1999	Change, 1977-1999 - Number	Change, 1977-1999 - Percent
Under 65	87	78	54	58	66	-21	-24.1
65-74	1,473	1,229	1,021	1,083	1,080	-393	-26.7
75-84	6,595	5,831	4,614	4,551	4,297	-2,298	-34.8
85+	24,219	23,845	20,089	19,203	18,250	-5,969	-24.6

Source: Authors’ calculations based on data from the Census Bureau and Decker (2005).

Slide 20

Gaps in Survey Coverage

• Institutional GQ: Nursing home and incarcerated populations are covered in periodic surveys, but not residents of other institutions.

• Non-institutional GQ: Limited information for the homeless and military populations.

Slide 21

Infrequent Collection

• Census long form survey: once per decade.

• BJS surveys: roughly every six years (1989-91, 1996-97, and 2002-04).

• NNHS: biennially from 1995 to 1999, and the most recent one five years later, in 2004.

• Some major national household surveys: annually.

Slide 22

Disability Definitions

Disability Definition	Census - 2000	BJS Surveys - 1996-97	NNHS - 1999
Sensory limitations	X	X	X
Functional limitations	X	X	X
Mental disability	X	X	X
ADL disability	X		X
IADL disability	X		X
Work disability	X	X
Learning disability		X

Slide 23

Discussion

• Change in the size and composition of the institutional population.

• Relatively high disability prevalence in the incarcerated population and the growth in incarceration.

• Decline in the nursing home residence rate.

• The inclusion of the GQ population in the ACS from 2006 forward.

End of slide presentation