Aron Spector by Levone


									On Using Survey and Administrative Disability Data: A Canadian Perspective
Aron Spector, Senior Researcher, Strategic Policy Research Directorate (SPRD) Human Resources and Social Development Canada (HRSDC) For: The ISDS State of the Art Conference: Developing Improved Disability Data Washington, D.C. July 11-12, 2006

Background: The HRSDC Mandate
Foster participation in work, learning, communities and society  Improve economic security  Support families and children  Promote lifelong learning and skills improvement  Build capacity and networks of support  Promote an efficient and inclusive labour market

HRSDC and Disability
HRSDC has leading role on disability issues including:
– Canada Pension Plan--Disability Benefit (CPP-D)
• (counterpart of SSDI)

– Office for Disability Issues which has Federal co-ordination function and administers:
• Opportunities Fund (supports in returning to work; self-employment) • Labour Market Agreements for Persons with Disabilities (costshared with provinces/territories) • Social Development Partnerships Program—Disability (works with non-profits in furthering disability agenda)

– Employment Insurance—Sickness benefit and EI training – Labour Branch administers Employment Equity Act


Strategic Policy Research Directorate (SPRD) Functions
SPRD is a corporate research group with a broad supportive scope-working as required with HRSDC policy and program partners
– Primary policy research on social development (including seniors, family and caregiving), labour market, and skills issues

– Examples:
• • • • Cost/uptake estimation of new program options Identifying current/future trends in program use Identifying/assessing unmet needs/gaps Developing policy-related research for general use

Primary Data Resources on Disability
From Statistics Canada:  Participation and Activities Limitation Survey (PALS)
– Post Censal survey funded by HRSDC in 2001 and 2006 – Adults, children whose day-to-day activities may be limited because of condition/health
– Longitudinal (5 year waves) and annual cross-sectional since 1993 – Detailed income, labour force and schooling data for Adults 15+

 Survey of Labour and Income Dynamics (SLID)  National Population Health Survey (NPHS)
– Longitudinal (beginning in 1991) biennial survey, same initial sample – Health and related socio-economics

 Canadian Community Health Survey (CCHS)
– cross-sectional annual survey of health determinants, health status, health system utilization and related socio-demographics

From Program Administrative Sources:  CPPD administrative database  Longitudinal Administrative Data

 Planned: Provincial/Territorial Workers’ Compensation; Social Assistance data bases; consultations with private disability insurers

– (Sample of personal tax returns maintained by Statistics Canada)

Most Statistics Canada Surveys use the same “Activity Limitations” Disability Filter Questions
Disability filters based on the 2000 Census: 1. Do you have any difficulty hearing, seeing, communicating, walking, climbing stairs, bending, learning or doing any similar activities? (Yes, sometimes; Yes, often; No) 2. Does a physical condition or mental condition or health problem reduce the amount or the kind of activity you can do: (a) at home? (b) at work or at school? (c) in other activities -- for example transportation or leisure? (Yes, sometimes; Yes, often; No).

Advantages/Issues: Current Filter Questions
Use of same questions provide advantages: However:  Evidence of heterogeneity of interpretation
– Consistency across surveys and over time – Constancy of linkage with a functional model of disability – Clear French/English variations; other cross-cultural differences – Other socio-demographic variations—generational, age-related differences; variations with level of educational attainment

 Evidence of contextual effects

• Example: ―Disappearance‖ of learning difficulties as middle age approaches

 Considerable variation when response personal vs. proxy  ―False‖ negatives and positives
– Issue of self-concept rather than image of others

– Shifts in responses with subject of survey; preceding survey material

– Perception/self-assessment varies over time for reasons other than condition change
• Example: Evidence that disability perception changes with engagement in activities-such as having a job 7

Advantages/Issues: Administrative Disability Data
 Internally consistent/ auditable However:  Lack of cross-program definitional consistency  Administrative, regulatory change reduces value as longitudinal instrument  Range of health, socio-economic data limited and determined by regulatory requirements

More Generally: Is What We Get What We Want to Understand?
How do we create a stable and consistent foundation of questions which:
– Create a common language/understanding – Minimize exogenous influences/noise

While addressing multiple implications/meanings of disability?
– Disability is a social/cultural concept related to condition and impairment:
• relating to expectations and demands of activities of everyday life • often an artefact of perception, language; the design of built, instrumental environments

Despite Shortcomings, Research based on Filter Question Responses Points to Policy Relevant Results
1. Disability and Low Income in Non-senior Adult Population (PALS 2001/NPHS 1991-2001)
 People living alone/lone parents worst off in terms of both current and persistent low income  Disability has greatest influence on the incidence of low income on those 45-54—people in their prime earning years  Duration and Severity increase the likelihood of current and prolonged low-income Learning/Speech/Developmental conditions much more likely to experience current and persistent low income than others with disability  Degree Holders doing almost as well as those without disability

2. Requirements, Unmet Need for Aids
/Devices/Supports (PALS 2001)
Some parallels with likelihood of low-income:  Support gaps are widest when life-course pressures heaviest
 Unmet need is highest for those most likely to be raising a family, maintaining a household, consolidating a career
 Not necessarily persons with low income

 Unmet need highest when living alone or as a single parent
 For others: Support predominantly from those living under the same roof

But other factors also come to the fore:  Likelihood of unmet need increases with duration but not strongly linked with severity  Likelihood of unmet need highest when needs “atypical”  Access barriers getting to work and at workplaces primary in keeping many from jobs

3. Disability and Employment—Monitoring Trends (SLID 1999-2003)
Employment rates, earnings lag that of others in the labour market
 However, Canada’s strong labour market seems to have resulted in higher: labour force participation, employment, weeks worked, average earnings

Improvements primarily among younger people with disabilities, those with post-secondary training Little change in employment for older people with disabilities (45+)—especially men, those who had low skilled work
– Are also much less likely to receive training following disability onset; return to labour market after absence

New Insights Are also Being Developed from Administrative Data
1. Moving from Impairment to Disability (CPP-D administrative data base)
Data allows examination of earnings from point of first employment to start of benefits  In comparison to population, CPP-D beneficiaries typically have:
– Earnings Leveling Stage: Often beginning many years prior to becoming beneficiary when earnings remain steady, while others increases Earnings Decline Stage: Often begins in 46 years immediately prior to benefit start— real decline in earnings
Men 45--Annual Earnings: Population and CPP Beneficiaries
$50,000 $45,000


$35,000 $30,00 0 $25,000


$20,000 $15,000

 Stage length related to sex, age, condition. For example, often:
– – No Levelling stage for persons with neoplasms (cancers), short, sharp decline stage Prolonged levelling, decline stages for those with musculo-skeletal-connective tissue conditions

$10,000 $5,000

$23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 Age CPP-Pop All Men 45


2. Forecasting Disability Rates (Multiple sources including Workers’ Compensation time-loss injuries, health statistics)
Preliminary Results point to net decline in disability rates Downward pushes particularly among men:
– Administrative data and health statistics showing major declines in death, impairment related to heart disease, lung cancer (predominantly men aged 45-64) – Decline in Workers’ Compensation time loss injury/illness claims
• shift to white-collar work and safer work environments (primarily men)

– Slightly augmented by decline in significant injuries rates due to motor vehicle accidents (primarily men) Counter Balanced by:  Baby boom bulge in older adults where disability rates tend to increase  Some disease/health factor risk increases (diabetes, obesity)  Higher labour force participation among women (higher exposure to a number of risk factors)

Some of the Places We May Go From Here
 Better understanding the data:
– Examining the psychometrics of the current screening questions to understanding question semantics; relationships to proximate concepts
• Testing responses in controlled experimental context

 Moving on what we’ve seen
– Working together in developing disability prevention models – Focusing policy levers on income and functional loss in mid-life – Addressing employment-related access issues


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