The incidence of disability and its associated determinants

Background

Disability was a serious public health issue in China. But, the proportion of disability among adults living in the community and their relationship to chronic physical ailments were not clear. We sought to determine the incidence of disabilities as well as the associated factors within an extensive community-based group in China.

Methods

Local permanent residents of 18 years and above and who had completed the assessments for disability were selected for inclusion in the Cohort study of chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei (CHCN-BTH) between 2017 and 2019. Disability was evaluated by answering five questions regarding impairments and limitations to activity in accordance with the International Classification of Functioning (ICF) as well as disabilities and Health. Multilevel, multivariate and univariate logistic regressions were carried out to assess the connections between disability and the associated factors.

Results

In total, 12,871 adults living in the community took part in the study. In the majority of the respondents, 12.9% (95% 95% CI: 12.3%-13.5%) reported having a impairment. The proportion of disabilities was significantly higher among those with a higher age group widowed, retired, or widowed smokers, who had greater BMI, a monthly income of less than 500 RMB as well as a lower educational level and lower exercise frequency and heavy physical work. Multilevel logistic regressions revealed that there were significant correlations with physical disabilities that are chronic illnesses, specifically for those who suffer from vision impairment, lower back pain, hearing impairments as and difficulty walking with no special equipment that could cause injuries.

Conclusions

A large number of Chinese adults suffer from disabilities. Continuous efforts must be made to create specific preventive and health-related strategies for disability in China.

Introduction

Definitions for disability differed between “body structure impairment”, “capacity limitations” to “participation restriction” as a result of the evolution of models for medicine [6, 7]. To make it easier to compare disabilities across countries, WHO published a classification system for disability dubbed “The International Classification of Functioning, Disability and Health (ICF)” which classified disability in terms of “an umbrella term for an impairment of body structure, a limitation of activity or a restriction in participation, and the interaction between individuals with a health condition and personal and environmental factors” [88. A variety of assessment tools for disabilities have been created based on the principles of ICF and include the WHO disability assessment schedule, second version (WHODAS 2.0) ([9] and the Washington group’s short set of questions about disability (WGSS) and being the 6 questions on the status of a person with disabilities developed through members of the Washington Group and were integrated into the U.S National Health Interview Survey (NHIS) in the census of population and housing between 2016 and 2020 [10,11,12(see below).

While ICF has gained widespread acceptance and encompassed more domains which could give more detailed information on the disability and its measurement, its implementation is different from study to study. Poor and developing countries tend to use an approach that is based on the specific definition of impairments, and have a lower disability prevalence rate than higher-income countries due to their poor economic conditions and inadequate social security systems and other sociocultural aspects [13 14[13, 14]. In China two massive, household surveys that were representative of the entire country took place in the years 1987 and 2006. and the proportion of disabled was 4.9 percentage and 6.5 percent respectively [4 5 and 4]. Lestari et al. employed cross-sectional analysis of data from the WHO multi-country longitudinal Study on Global AGEing and Adult Health (SAGE) Wave 1 (2007-2010) They determined that disabilities as a major cause of impairment among Chinese individuals aged 50 years and older was 16.2 percent [15].

The 2006 survey included the ICF however, the assessments of disability were mainly based on the physical impairment rather than the functional barriers or social flexibility [1616]. For the China health and retirement longitudinal survey (CHARLS) the impairments were assessed using self-reported physical limitations and impairments in daily activities (ADL) as well as instrumental daily activities (IADL). The extent of disability could be underestimated due to the unistructural measurementThe measurement was unistructural [17. It is important to research the condition using an ICF-based method to increase comparability between nations.

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