A comparative analysis of self-identification and functional measures of disability.

backgroundDisability is typically measured in surveys using functional limitation questions rather than asking respondents to self-identify as having a disability. Little is known about the characteristics of those who self-identify with a disability and how they compare with those identified via functional limitation questions.

objectiveTo compare the prevalence and characteristics of people with disabilities measured by both functional and self-identification measures, and to assess the overlap between these populations.

methodsUsing nationally representative survey data from 2023, we conduct bivariate comparisons of demographic, health, functional characteristics and financial needs between populations captured by self-identification question, the Washington Group Short Set on Functioning (WG-SS) and the American Community Survey Six (ACS-6) Questions. We estimate a multivariable regression to explore predictors of self-identification.

resultsAdding a self-identification question doubles the population with disabilities relative to measuring disability with the WG-SS alone, and increases the population by 30 % relative to the ACS-6 alone. People who self identify are less likely to be female or Hispanic/Latinx, are in worse physical health and more likely to be LGBTQIA + compared to those identified only by functional measures. The group identified by both the self-identification and either functioning question set are in the worst health and are more likely to participate in disability programs.

conclusionIncluding a self-identification question in addition to functioning questions expands the prevalence of disability to varying degrees depending on which functional questions are used, but use of functioning and self-identification questions together enhances identification of the subgroup with highest needs.