Brown University News Bureau

The Brown University News Bureau

1998-1999 index

Distributed May 17, 1999
Contact: Kristen Cole

R.I. disability study

Best way to reduce adult disability: Improve high school graduation rates

A new analysis of a 1996 survey of 4,682 Rhode Islanders found nearly one in four experience some type of limitation in functioning. Researchers concluded that one of the most effective ways to reduce disability is to improve high school graduation rates.

PROVIDENCE, R.I. -- The best strategy for reducing disability among Rhode Island's adult population may be to improve high school graduation rates, according to a joint study by Brown University and the Rhode Island Department of Health.

Nearly a quarter of Rhode Island adults experience some type of disability, and those without a high school degree who are below the poverty level have the highest incidence of disability. The study also found that blacks and Hispanics have higher rates of disability than white non-Hispanics, but they are also more likely to have lower income and education levels.

The findings suggest that improving high school graduation rates among all persons - especially those who are poor or who belong to an ethnic minority - would be one of the most effective social interventions, said Dennis P. Hogan, a study author, and director of the Brown University Population Studies and Training Center (PSTC).

Editors: Copies of the study are available from the News Bureau.

Researchers analyzed data from telephone interviews conducted from February to October 1996 on non-institutionalized adults - a sample of 4,682 people aged 18 and older. That is the most recent information available about disability in Rhode Island.

Residents were asked about four types of functional limitations: mobility, self-care, communication and vision. Mobility is defined as the ability to get in and out of chairs and beds, shop, do housework and climb stairs; self-care is defined as the ability to shower, dress, eat, and manage money; communication is defined as the ability to hear normal conversations and use the telephone; and vision is defined as the ability to read newsprint. Differences in the prevalence of limitations were analyzed by educational level, poverty status, ethnicity, age and gender.

Researchers found those who had not completed high school were more than twice as likely as those who had a college education to have mobility, vision and self-care limitations. Additionally, lower-income residents had a greater risk of each type of disability. Compared to the middle class, those with household incomes below poverty level were more than three times as likely to have mobility and vision limitations, and almost six times as likely to suffer self-care limitations. Rates among various ethnic populations correlated with the income and education findings.

Although the study did not include an explanation of the education and income results, reasons have been documented in other studies, said Hogan. Compared to high school graduates, those who are less educated may take riskier jobs; may live in areas with greater environmental hazards; may not afford corrective eye glasses or hearing aids; and may not visit the doctor early on for a health problem. For example, a less-educated person with diabetes may not visit a doctor at the first symptoms and, in waiting, suffer debilitating effects to eyesight and ability to get around.

"The costs to the state are extreme." said Hogan. "They are direct costs, like health care services, and indirect costs - people losing their ability to contribute to the community."

For the adult population, the most significant consequence of disability is its implications for employment. At issue for the elderly is the ability to carry on regular activities of daily living at home without moving into a long-term care facility.

Regarding employment, researchers found most people with milder limitations still worked. However, once a serious functional limitation occurred, permanent work disability became much more common: 17 percent of people with one serious limitation and 41 percent with two or more serious limitations were permanently work-disabled. Statistics were not available to compare the work disability rates to the rest of the nation.

Researchers were able to compare disability among Rhode Island's elderly to the national level and did not find any significant differences. About 14 percent of the state's elderly experience one or more limitations of their activities of daily living. That percentage increases significantly with age, although with proper support services many of the elderly would likely be able to remain living at home, said Hogan.

The study did not find any significant differences in disabilities between women and men.

Funded by the Centers for Disease Control and Prevention, Office of Disaibility and Health, the $15,000 project was conducted by the Rhode Island Department of Health's Disability and Health Program and Brown University (Roger Avery, adjunct associate professor of sociology; Jennifer Park, graduate student; and Dennis P. Hogan, director of the Population Studies and Training Center). It is part of a larger, four-year investigation into disability in Rhode Island, for which Brown has agreed to provide demographic support and technical assistance.