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Richard V. Burkhauser, Cornell University and University of Melbourne

Using the 2009 CPS-ASEC-SSA Matched Dataset to Show Who is and is Not Captured in the Official Six-Question Sequence on Disability. Richard V. Burkhauser, Cornell University and University of Melbourne T. Lynn Fisher, Social Security Administration

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Richard V. Burkhauser, Cornell University and University of Melbourne

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  1. Using the 2009 CPS-ASEC-SSA Matched Dataset to Show Who is and is Not Captured in the Official Six-Question Sequence on Disability Richard V. Burkhauser, Cornell University and University of Melbourne T. Lynn Fisher, Social Security Administration Andrew J. Houtenville, University of New Hampshire Jennifer R. Tennant, Ithaca College 14th Annual Joint Conference of the RRC Consortium August 2-3, 2012 Washington, DC

  2. What Do Policymakers Want to Know About a Vulnerable Population? • Definition of Group (e.g. Aged, Women, Minority, Disability) • Prevalence of Group • Success Parameters Employment Program Participation Economic Well-Being (income, poverty)

  3. Is the disability population harder to capture than other protected classes? • Conceptually more complex to define • Operationally more complex to identify • Mutable vs. Immutable

  4. How is disability defined? Conceptual Definition • ICF (International Classification of Functioning, Disability and Health) (WHO, 2001) Operational Definition • Small set of questions capturing a random sample of true population • Work limitation question in CPS-ASEC (since 1981) • Six-Question Sequence (6QS) in the ACS (since 2008) and in the CPS-BMS (since June 2008)

  5. Evolution of the 6QS • 6QS initially designed to: • Monitor integration of people with disabilities. • Monitor independent living and service needs. • In response to ACA mandate, HHS Secretary Sebelius chose 6QS as the minimum set of questions for all national health surveys. • Work limitation question is not included in 6QS, remains in the CPS-ASEC (March supplement)

  6. Six-Question Sequence (CPS version) • Hearing: “Is anyone deaf or does anyone have serious difficulty hearing? • Vision: “Is anyone blind or does anyone have serious difficulty seeing even when wearing glasses? • Cognition: “Because of a physical, mental, or emotional condition, does anyone have serious difficulty concentrating, remembering, or making decisions? • Ambulation: “Does anyone have serious difficulty walking or climbing stairs • Self-Care: “Does anyone have difficulty dressing or bathing?” • Independent Living: “Because of a physical, mental, or emotional condition, does anyone have difficulty doing errands alone such as visiting doctor’s office/shopping?”

  7. Concentric circle model of disability

  8. The model of concentric circles does not hold up in the data • An overlapping Venn diagram is the pattern seen in the data • Some with a work limitation are not captured by the 6QS • People with WL have different social success estimates than people who are captured by the 6QS • Elimination of “work limitation only” leads to biased estimates

  9. Prevalence rate of non-institutionalized civilians ages 25-61, by disability type, 2009 Matched SSA/CPS-ASEC Work Limitation (B + C) (8.4%) Six question sequence (A + B) (8.2%) Both six question sequence and work-activity limitation (B) (4.8%) Six question sequence and/or work-activity limitation(A + B + C) (11.8%) Neither six question sequence nor work-activity limitation (88.2%)

  10. Prevalence, demographics and economic outcomes by disability population, 2009 Matched SSA/CPS-ASEC

  11. A Face Validity Test • SSA certifies SSDI/SSI recipients are unable to do SGA so are part of any ICF-based disability population. • Use 2009 Matched SSA/CPS-ASEC data on SSDI/SSI recipients to show share captured by WL and 6QS. • public-use CPS matched to SSA (NUMIDENT, MBR and SSR) files • has diagnosis of primary medical condition • Burkhauser, Houtenville, Tennant (2012)

  12. Prevalence of non-institutionalized civilians ages 25-61 with SSDI-SSI by disability type, 2009 Matched SSA/CPS-ASEC Work Limitation (B + C) (78.0%) Six question sequence (A + B) (66.0%) Both six question sequence and work-activity limitation (B) (54.8%) Six question sequence and/or work-activity limitation (A + B + C) (89.2%) Neither six question sequence nor work-activity limitation (10.8%)

  13. Share distribution by diagnostic group among SSDI/SSI participants ages 25-61, by disability type

  14. Capturing different diagnosis groups: Comparing total SSDI/SSI population to 6QS, WL and 7QS • 6QS does a reasonably good job matching the overall shares across diagnosis group, primary medical condition • Smaller proportion of “intellectual disabilities” (6.5 vs. 7.0 percent) • Larger proportion of “nervous system or sense organs” (10.4 vs. 8.4 percent) • WL shares by diagnosis group more closely aligned to overall shares • Union of the 6QS and the WL comes closest to capturing the shares across diagnosis groups

  15. Conclusion • The 6QS only captures 66.0 percent of SSDI/SSI recipients • Those who report a work limitation have worse social success outcomes than those who are captured by the 6QS • Elimination leads to biased estimates • A 7QS (6QS and WL) improves measurement • total population eligible for SSDI/SSI benefits • shares across diagnosis group

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