Download While we wanted to present the most current picture of disability

World report on disability and Data
December 2
Second panel: 12.00 - 13:15
Representatives of member states, distinguished guests, ladies and gentlemen,
Thank you for the opportunity to speak briefly about conceptual frameworks,
methodologies, approaches and data sources used by WHO in the preparation of
the World report on disability - a joint product of WHO and the World Bank.
The World report on disability provides the foremost global assessment of
disability to date, and it does so using the latest scientific evidence on this
complex subject.
The Convention on the Rights of Persons with Disabilities (CRPD) is the "moral
compass of the report", while the International Classification of Functioning:
disability and Health (known as the ICF) provides the conceptual framework.
The CRPD understands disability to arise from the relationship between a person
with impairment and the wider environment. This interactional approach is
consistent with the WHO ICF classification, which emphasizes the role of the
environment in either enabling or disabling people with health conditions.
Now lets turn to the evidence of the Report.
Firstly the report gives the world the first new prevalence estimates since the
1970s. The new estimates now tell us that more than one billion people
experience some form of disability. Of these, some 110 to 190 million people
encounter very significant difficulties in their daily lives.
Since the 1970s, WHO has reported that 10% of the global population are
disabled. Now, through analysis of the World Health Survey (WHS), the Global
Burden of Disease (GBD) Survey, and national surveys, we can see that a more
accurate estimate is 15% or one billion people.
Secondly, the report indicates that the number of people with disabilities is
increasing because we are living longer and because chronic diseases such as
diabetes and heart diseases are on the rise. Other environmental factors like road
traffic crashes, disasters and conflict contribute to the growing numbers in
certain contexts.
Third, the World report on disability found that people who are poor, women and
older people are more likely to experience disability.
The World Report provides strong evidence on some of the most common
barriers faced by people with disabilities across the world. These include stigma
and discrimination, lack of adequate health care and rehabilitation services, and
inaccessible transport. Other barriers arise from the design of buildings, such as
schools and workplaces, and of information and communication technologies.
As a result of these barriers, people with disabilities have poorer health, lower
educational achievements, fewer economic opportunities, and higher rates of
poverty than people without disabilities.
I would like to give more details on the main data sources used in the Report.
The World health Survey (WHS) collected data on difficulties that people
experience in day to day life in eight domains – mobility, self care, vision,
cognition, interpersonal relationships, pain, sleep, energy and affect. Responses
ranged from “no difficulty” to “cannot do at all”. A composite score was
calculated for each person from his or her answers. This produced a continuous
range of functioning levels. A threshold was set, above which people were
considered to be disabled. This cut off approximates people with significant
difficulties in functioning including people with blindness, paralysis, arthritis or
people being treated for chronic diseases such as diabetes, depression or heart
disease.
We also calculated the prevalence of Years lived with disability (YLD) from the
Global burden of disease, 2004 update. The YLD uses core health domains mobility, dexterity, affect, pain, cognition, vision and hearing. The GBD calculates
disability differently from the WHS. It starts with the prevalence of health
conditions and distributions of limitations in functioning, where they are
available, and then estimates the severity of related disability. This estimate
includes people with moderate and severe disability, which equates to people
with low vision of blindness, Down syndrome, quadriplegia, arthritis, severe
depression and alcohol dependency.
Globally the WHS and GBD are picking up a disability prevalence rate of rate
around 15-16 per cent whereas the country reported data shows a much lower
rate of 7%.
In high-income countries the estimates from country reported data are in line
with WHS and GBD estimates. Moving from high to middle and low-income
countries the problem of under-estimation is increasing. In low-income countries
- were one would expect higher disability prevalence rates- country reported
data show the lowest prevalence rates. These countries tend to rely only on
measures focussed on a selection of impairments, whereas higher income
countries increasingly look at the full scope of disability, including impairments,
activity limitations and participation restrictions.
While we wanted to present the most current picture of disability possible, we
also wanted to acknowledge that disability statistics and information require
further development.
To move disability data forward the Report recommends the following:
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Internationally, methodologies for collecting data on people with disabilities
need to be developed, tested cross-culturally, and applied consistently.
Adopt the ICF: Data need to be standardized and internationally comparable
to benchmark and monitor progress on disability policies and on the
implementation of the CRPD nationally and internationally. This can be
achieved by using the ICF as a data standard.
Improve comparability of data. Uniform definitions of disability, based on
the ICF, can allow for internationally comparable data.
Improve national Statistics: Nationally, disability should be included in data
collection. As a first step, national population census data can be collected in
line with recommendations from the United Nations Washington Group on
Disability and the United Nations statistical commission. A cost-effective and
efficient approach is to include disability questions – or a disability module –
in existing sample surveys. Data also need to be disaggregated by population
features to uncover patterns, trends and information about subgroups of
persons with disabilities. Dedicated disability surveys can also gain more
comprehensive information on disability characteristics, such as prevalence,
health conditions associated with disability, use of and need for services,
quality of life, opportunities, and rehabilitation needs.
Thank you