Measuring Disability Prevalence in Healthcare: A Study Comparing Two Disability Measures

People with disabilities experience significant health disparities and interventions are needed to address them. Measuring disability prevalence is an essential aspect of designing effective, data-driven healthcare strategies. Accurately measuring disability prevalence is challenging given disability is a complex phenomenon, with biological, social, environmental, and cultural components. Previous studies have compared a variety of disability status measurements and found that measurements were incongruent with each other. This study examines the concordance between disability status using two different measures: the nationally recognized American Community Survey (ACS-6) functional difficulty questions and one disability identity question. We used data from 3,621 adult patients participating in a COVID-19 vaccination intervention designed to reach people with disabilities. The results of this study indicate that older patients (age 65+) were less likely to self-identify as disabled or having a disability, even when having one or more impairment-related functional difficulties. Conversely, a higher prevalence of adults under the age of 65 (ages 18-64) answered yes to the identity question, despite answering no to all the ACS-6 functional difficulty questions. These findings suggest that disability prevalence may be more accurately measured using a combination of disability measurements that includes a self-identifying measurement and a more standardized measurement that aligns with a biomedical definition of disability.