Mobility Device Use and Hearing Impairments Among Individuals and Households, 1990-2010

Mitchell P. LaPlante, Ph.D. and H. Stephen Kaye, Ph.D.
February 15, 2013

In response to a request by the US Access Board for population based data in conjunction with proposed scoping requirements for guest rooms with mobility features and guest rooms with communication features on cruise ships, this report provides updated population based statistics on trends in the percentage of individuals and households with members who use wheelchairs or other mobility devices and the percentage of individuals and households with members who have hearing impairments.

Data and Methods

We use all available data from the Survey of Income and Program Participation (SIPP) over the period 1990 to 2010.  The SIPP provides stability in measuring disability over a long time period with a large sample that is representative of US households and individuals.  The SIPP is the best source of information on use of wheelchairs and other mobility devices over time and also provides useful information on hearing impairments.  The statistics are for the civilian household (non-institutional) population ages 6 and older or ages 18 and older as noted.

Household members often travel together on recreational trips, especially cruises.  A guest room with mobility features or communication features is needed when any travelling household member requires these features.  Therefore, in considering proposed scoping requirements for guest rooms with mobility features or communication features, statistics on households are more applicable than statistics on individuals.  However, national statistics on disability are rarely published for households; this report presents the authors’ analysis of the SIPP for households as well as individuals.  The data and methods employed in analyzing the SIPP for adults are described elsewhere (1).  In the analysis of households, the same methods were used, with the additional step that information from all household members was aggregated to the household level, e.g., households in which any member used a wheelchair.  For estimation of household statistics, the survey weight for the head of the household was used.  For mobility device trends, household statistics include only members ages 18 and above because the SIPP did not ask about mobility device use among children ages 6-17 in 1990-1995.  Hearing questions were changed in the SIPP in 1997 and are not comparable to earlier years; thus the time period covered is 1997 to 2010.  Household statistics for hearing impairment include members ages 6 and older.

Mobility Device Use

The SIPP has asked about use of mobility devices, including wheelchairs, scooters, canes, crutches, and walkers, among all adults since 1990 and for all persons ages 6 and over since 1997.[1]

From 1990 to 2010, the household rate of wheelchair use doubled from 1.5 to 3 percent (Figure 1).  This reflects the growth in use of wheelchairs that we have observed previously for individuals (2).  If past trends continue, a linear extrapolation to 2025 suggests a rate of just above 4 percent of households with wheelchair using members.  The rate of wheelchair use for adults has also doubled from 0.8 percent in 1990 to 1.6 percent in 2010 (Table 1).

Ten percent of households had a member who used any mobility device — including wheelchairs, scooters, canes, crutches, and walkers — in 2010 (Figure 2).  The household rate of using mobility devices has grown by about 67 percent from 1990 to 2010 with a trend that is close to linear.  If past trends continue, a linear extrapolation to 2025 suggests a rate of about 13 percent of households with members using mobility devices.

These statistics are based on just the adult members of the household.  Starting in 1997, children ages 6 and older have also been asked about mobility device use.  However, the number of children using mobility devices is small compared to adults.  Including these children increases the household rate by only 2-5 percent, depending on the year (Table 1) and has no effect on the trend or its extrapolation.

Figure 1 graph.  Rates of households with members who use mobility devices, 1990-2010 and extrapolated to 2025.  Data for points shown follow below in Table 1.

Note:  Author’s analysis of the Survey of Income and Program Participation.  Includes adult household members ages 18 and older.

Hearing Impairments

Several national surveys attempt to measure hearing loss, but measurement is not standardized, with large variability in question wording and consequently estimates.  Audiometric testing is considered the best way to assess hearing loss.  The National Health and Nutrition Examination Survey (NHANES) is the only survey to include audiometric testing for hearing loss of 25 dB of the pure-tone average of hearing thresholds at speech frequencies.  Audiometric results from NHANES show that about 9 percent of men and about 4 percent of women 20-69 years old have hearing loss (3).  A comparison of survey reports from NHANES, the National Health Interview Survey (NHIS), the Medical Expenditure Panel Survey (MEPS), and the SIPP against audiometric test results found, for adults ages 20-69, that both the MEPS and the SIPP underreported hearing impairment and that the NHANES and the NHIS produced substantial overreporting, with up to 25 percent of men reporting some trouble hearing in NHANES (3).  Survey questions in NHANES and the NHIS are based on a four point rating scale of hearing trouble (no trouble, a little, a lot, deaf).  In contrast, the SIPP questions ask whether a person uses a hearing aid, and whether a person has difficulty hearing what is said in a normal conversation (even when wearing a hearing aid) or is deaf.  This appears to be a more objective approach than using a rating scale of hearing difficulty although it results in some underreporting compared to audiometric testing.  In this report, we present results from the SIPP based on a positive response to either question for the prevalence of any hearing impairment.[2]  For the prevalence of severe hearing impairment, we present results based on a positive response if the person uses a hearing aid or the person is deaf.

About 4-5 percent of households have a member who uses a hearing aid or is deaf.  Unlike for mobility devices, no consistent trend over time is apparent (Figure 2).  The rate among individuals aged 6 and older is approximately 2 percent (Table 2).  From 8-10 percent of households have a member with any hearing impairment (Figure 1).  Among individuals aged 6 and older, the rate was about 4 percent.  While some analysts have suggested an increase in hearing difficulty due to the aging of the population, two studies have noted a decline in hearing difficulty since 1990 that has appeared to level off after 2000 (1, 3).  In the absence of any clear trends, the best estimate for the prevalence of hearing impairments in households by 2025 is the current rate of 8-9 percent.

Figure 2 graph.  Rates of households with members who have hearing impairments, 1997-2010.  Data for points shown follow below in Table 2.

Note:  Author’s analysis of the Survey of Income and Program Participation.  Includes adult household members ages 6 and older.

References:

1.  Kaye HS.  Disability rates for working-age adults and for the elderly have stabilized, but trends for each mean different results for costs.  Health Aff (Millwood).  2012 Jan;32(1):127-34.

2.  LaPlante MP, Kaye HS.  Demographics and trends in wheeled mobility equipment use and accessibility in the community.  Assistive Technology.  2010;22(1):3-17.

3.  Ikeda N, Murray CJ, Salomon JA.  Tracking population health based on self-reported impairments: Trends in the prevalence of hearing loss in US adults, 1976-2006.  Am J Epidemiol.  2009 Jul 1;170(1):80-7.


[1]  In this report, data on wheelchair use includes scooter use.

[2]  Persons who responded positively to uses a hearing aid and has difficulty hearing what is said in a normal conversation even when wearing a hearing aid are counted once.


 

Table 1.  Mobility Device Use, SIPP Data 1990-2010
  Percentage of individuals who use mobility devices Percentage of households with mobility device users Number of individuals who use mobility devices Number of households with mobility device users
Survey Period covered Year Population ages 18+ Population ages 6+ Number of households Use wheelchair
(ages 18+)
Use any mobility device
(ages 18+)
Use wheelchair
(ages 6+)
Use any mobility device
(ages 6+)
With wheelchair user
(ages 18+)
With any mobilty device user
(ages 18+)
With wheelchair user
(ages 6+)
With any mobility device user
(ages 6+)
Wheelchair users
(ages 18+)
Any mobility device users
(ages 18+)
Wheelchair users
(ages 6+)
Any mobility device users
(ages 6+)
With wheelchair user
(ages 18+)
With any mobility device user
(ages 18+)
With wheelchair user
(ages 6+)
With any mobility device user
(ages 6+)
NA=not applicable.
SIPP1990 W3 10/90-1/91 1990 183,056,091 NA 94,586,985 0.78 3.45 NA NA 1.47 6.31 NA NA 1,425,505 6,317,723 NA NA 1,385,884 5,968,326 NA NA
SIPP1991 W3 & 1990 W6 10/91-1/92 1991 184,705,991 NA 95,742,299 0.79 3.41 NA NA 1.52 6.29 NA NA 1,463,911 6,304,905 NA NA 1,452,857 6,021,552 NA NA
SIPP1992 W6 & 1993 W3 10/93-1/94 1993 189,291,807 NA 98,242,774 0.80 3.62 NA NA 1.49 6.60 NA NA 1,515,794 6,845,037 NA NA 1,465,159 6,488,250 NA NA
SIPP1992 W9 & 1993 W6 10/94-1/95 1994 191,158,449 NA 99,714,850 0.89 3.60 NA NA 1.66 6.62 NA NA 1,700,397 6,880,448 NA NA 1,653,999 6,596,420 NA NA
SIPP1996 W5 8/97-11/97 1997 196,144,980 243,853,755 101,887,248 1.09 4.33 0.91 3.53 1.99 7.73 2.09 7.84 2,130,477 8,488,495 2,225,440 8,617,284 2,031,160 7,873,189 2,128,489 7,991,690
SIPP1996 W11 8/99-11/99 1999 200,667,976 249,246,731 104,852,149 1.14 4.57 0.96 3.75 2.09 8.22 2.18 8.35 2,282,629 9,180,192 2,398,313 9,335,013 2,190,109 8,619,038 2,289,497 8,753,724
SIPP2001 W5 6/02-9/02 2002 210,022,408 259,421,230 109,871,534 1.26 4.76 1.07 3.93 2.29 8.49 2.41 8.64 2,638,706 10,005,863 2,783,453 10,187,417 2,515,919 9,332,061 2,651,815 9,494,331
SIPP2001 W8 6/03-9/03 2003 213,627,306 262,910,968 111,653,310 1.25 4.51 1.06 3.72 2.30 8.18 2.40 8.30 2,665,291 9,642,035 2,775,901 9,784,962 2,572,642 9,134,316 2,678,355 9,266,204
SIPP2004 W5 6/05-9/05 2005 217,569,637 266,752,086 114,320,238 1.50 5.16 1.27 4.27 2.76 9.23 2.87 9.37 3,259,920 11,226,069 3,394,297 11,389,621 3,155,766 10,555,095 3,280,928 10,707,253
SIPP2008 W6 5/10-8/10 2010 229,155,031 278,221,377 118,411,158 1.58 5.46 1.33 4.54 2.96 9.90 3.03 9.98 3,609,584 12,515,881 3,703,859 12,633,769 3,502,987 11,716,846 3,590,292 11,820,703

 

Table 2.  Hearing Impairments, SIPP Data 1997-2010
  Percentage of individuals with hearing impairments Percentage of households with members with hearing impairments Number of individuals with hearing impairments Number of households with members with hearing impairments
Survey Period covered Year Population ages 6+ Number of households Deaf or uses hearing aid
(ages 6+, %)
Any hearing impairment
(ages 6+, %)
Deaf or uses hearing aid
(ages 6+, %)
Any hearing impairment
(ages 6+, %)
Deaf or uses hearing aid
(ages 6+, %)
Any hearing impairment
(ages 6+, %)
Deaf or uses hearing aid
(ages 6+, %)
Any hearing impairment
(ages 6+, %)
SIPP1996 W5 8/97-11/97 1997 243,853,755 101,887,248 1.91 4.30 4.34 9.47 4,647,910 10,481,137 4,424,457 9,646,643
SIPP1996 W11 8/99-11/99 1999 249,246,731 104,852,149 1.85 3.86 4.22 8.59 4,622,224 9,623,342 4,421,215 9,009,708
SIPP2001 W5 6/02-9/02 2002 259,421,230 109,871,534 1.89 4.05 4.25 8.91 4,901,239 10,496,504 4,667,466 9,790,878
SIPP2001 W8 6/03-9/03 2003 262,910,968 111,653,310 1.74 3.56 3.91 7.84 4,572,472 9,349,077 4,371,330 8,752,863
SIPP2004 W5 6/05-9/05 2005 266,752,086 114,320,238 1.89 3.97 4.21 8.65 5,049,761 10,583,383 4,817,629 9,889,353
SIPP2008 W6 5/10-8/10 2010 278,221,377 118,411,158 2.27 4.03 5.04 8.79 6,318,062 11,215,260 5,964,285 10,411,482