Impairment & Participation

Introduction

One of the greatest problems associated with the onset of an impairment is the reduction of activities and participation that follow. There have been a variety of studies examining this topic, but few are based on population-based sampling methods. The following results show how impairment groups, defined by questions from the American Community Survey (ACS), differ in where they go and what they do.

Huddle of basketball players in wheelchairs

Sample

We recruited people who could endorse one of six ACS questions from 10,000 randomly selected households in a small Western Metropolitan Statistical Area. We collected surveys from 525 individuals who represented each of six impairment groups and a group of individuals without an impairment. For more complete details on the sampling method and demographic characteristics of the sample, visit the Longitudinal Survey Sample page.

The following Impairment types included:

Impairment Types Represented by Images

  • None: Individuals with no impairments.
  • Hearing: Individuals with hearing impairments.
  • Vision: Individuals who are blind, or have serious difficulty seeing even when wearing glasses.
  • Mobility: Individuals who have difficulty walking or climbing stairs.
  • Memory: Individuals who have difficulty concentrating, remembering, or making decisions.
  • Self-care: Individuals who have difficulty bathing and/or dressing.
  • Errands: Individuals who have difficulty doing errands such as vising a doctor's office or shopping.

Measures

In addition to the ACS questions used to identify impairment type, we also used the Brief Community Engagement Questionnaire (Livingston, 2015). This instrument has individuals report how often the went to the following locations, how often they engaged in the following activities and how many hours they spent in employment, volunteering or educational activities.

LocationsParargliders

  • Grocery: Grocery stores.
  • Healthcare: Doctors or other healthcare providers.
  • Pharmacies: Drugstores or Pharmacies.
  • Restaurants: Restaurants.
  • Large Box Stores: Large box stores such as Walmart or Costco.
  • Parks: Public parks or recreation areas.
  • Exercise: Exercise facilities.
  • Shopping Malls: Shopping Malls.

Activities

  • Active Recreation: exercise, sports or fishing.
  • Socializing: socializing outside the home.
  • Religious Activities: religious activities such as church services
  • Community activities: voting, community meetings, or other civic involvement.
  • Entertainment: movies or sporting events.

Major Activities

  • Employment 
  • School/Education 
  • Volunteering 

Results

In general, people with impairments report going to more medically oriented places like pharmacies and healthcare provider offices and fewer places for recreation and leisure. They also report fewer social and recreational activities and spend less time engaging major activities. The graphs below demonstrate the relationships between impairment groups and visits to given locations within this study. Major activities such as employment or education are reported based on number of hours spent engaging in that specific activity.

Impairment by Location 

The graphs below demonstrate the relationships between impairment and visits to given locations.

Shopping Malls

Visits to Shopping Malls. Non-impaired individuals had an average of 0.59 visits. Hearing impaired individuals had an average of 0.46 visits. Vision impaired individuals had an average of 0.35 visits. Mobility impaired individuals had an average of 0.32 visits. Memory impaired individuals had an average of 0.32 visits. Self-care impaired individuals had an average of 0.28 visits. Errands impaired individuals had an average of 0.27 visits.

Exercise Facility

Number of Visits to Exercise Facilities. Non-impaired individuals had an average of 1.27 visits. Hearing impaired individuals had an average of 0.62 visits. Vision impaired individuals had an average of 0.52 visits. Walking impaired individuals had an average of 0.47 visits. Memory impaired individuals had an average of 0.53 visits. Self-care impaired individuals had an average of 0.37 visits. Errands impaired individuals had an average of 0.41 visits.

Parks

Number of Visits to Parks. Non-impaired individuals had an average of 1.14 visits. Hearing impaired individuals had an average of 0.59 visits. Vision impaired individuals had an average of 0.41 visits. Mobility impaired individuals had an average of 0.37 visits. Memory impaired individuals had an average of 0.52 visits. Self-care impaired individuals had an average of 0.45 visits. Errands impaired individuals had an average of 0.35 visits.

Healthcare

Number of Visits to Healthcare Providers. Non-impaired individuals had an average of 0.54 visits. Hearing impaired individuals had an average of 0.81 visits. Vision impaired individuals had an average of 1.1 visits. Mobility impaired individuals had an average of 0.9 visits. Memory impaired individuals had an average of 0.11 visits. Self-care impaired individuals had an average of 1.11 visits. Errands impaired individuals had an average of 0.97 visits.

Pharmacy

Number of Visits to a Pharmacy. Non-impaired individuals had an average of 0.55 visits. Hearing impaired individuals had an average of 0.66 visits. Vision impaired individuals had an average of 0.9 visits. Mobility impaired individuals had an average of 0.83 visits. Memory impaired individuals had an average of 0.98 visits. Self-care impaired individuals had an average of 0.88 visits. Errands impaired individuals had an average of 0.8 visits.

Restaurant

Number of Visits to Restaurants. Non-impaired individuals had an average of 1.83 visits. Hearing impaired individuals had an average of 1.57 visits. Vision impaired individuals had an average of 1.24 visits. Mobility impaired individuals had an average of 1.28 visits. Memory impaired individuals had an average of 1.11 visits. Self-care impaired individuals had an average of 1.03 visits. Errands impaired individuals had an average of 1.07 visits.

Box Store

Number of Visits to Box Stores. Non-impaired individuals had an average of 1.56 visits. Hearing impaired individuals had an average of 1.34 visits. Vision impaired individuals had an average of 0.89 visits. Mobility impaired individuals had an average of 1.14 visits. Memory impaired individuals had an average of 1.21 visits. Self-care impaired individuals had an average of 1.03 visits. Errands impaired individuals had an average of 0.82 visits.

Grocery Stores

Number of Visits to Grocery Stores. Non-impaired individuals had an average of 2.57 visits. Hearing impaired individuals had an average of 2.18 visits. Vision impaired individuals had an average of 1.79 visits. Mobility impaired individuals had an average of 1.85 visits. Memory impaired individuals had an average of 1.88 visits. Self-care impaired individuals had an average of 1.59 visits. Errands impaired individuals had an average of 1.48 visits.

Activities by Impairment

Community Activities

Number of Times Participating in Community Activities. Non-impaired individuals participated an average of 0.45 times. Hearing impaired individuals participated an average of 0.33 times. Vision impaired individuals participated an average of 0.24 times. Mobility impaired individuals participated an average of 0.27 times. Memory impaired individuals participated an average of 0.17 times. Self-care impaired individuals participated an average of 0.21 times. Errands impaired individuals participated had an average of 0.19 times.

Religious activities

Number of Times Participating in Religious Activities. Non-impaired individuals participated an average of 0.52 times. Hearing impaired individuals participated an average of 0.56 times. Vision impaired individuals participated an average of 0.48 times. Mobility impaired individuals participated an average of 0.43 times. Memory impaired individuals participated an average of 0.34 times. Self-care impaired individuals participated an average of 0.41 times. Errands impaired individuals participated had an average of 0.44 times.

Entertainment

Number of Times Participating in Entertainment. Non-impaired individuals participated an average of 0.76 times. Hearing impaired individuals participated an average of 0.51 times. Vision impaired individuals participated an average of 0.38 times. Mobility impaired individuals participated an average of 0.39 times. Memory impaired individuals participated an average of 0.39 times. Self-care impaired individuals participated an average of 0.35 times. Errands impaired individuals participated had an average of 0.30 times.

Socializing

Number of Times Participating in Socializing. Non-impaired individuals participated an average of 2.39 times. Hearing impaired individuals participated an average of 1.86 times. Vision impaired individuals participated an average of 1.69 times. Mobility impaired individuals participated an average of 1.63 times. Memory impaired individuals participated an average of 1.46 times. Self-care impaired individuals participated an average of 1.35 times. Errands impaired individuals participated had an average of 1.4 times.

Active Recreation

Number of Times Participating in Active Recreation. Non-impaired individuals participated an average of 2.13 times. Hearing impaired individuals participated an average of 1.24 times. Vision impaired individuals participated an average of 1.07 times. Mobility impaired individuals participated an average of 0.87 times. Memory impaired individuals participated an average of 1.02 times. Self-care impaired individuals participated an average of 0.74 times. Errands impaired individuals participated had an average of 0.74 times.

Major Activities by Impairment

School

Number of Hours Spent Engaging in Education. Non-impaired individuals participated in education an average of 1.52 hours. Hearing impaired individuals participated an average of 0.70 hours. Vision impaired individuals participated an average of 0.75 hours. Mobility impaired individuals participated an average of 0.98 hours. Memory impaired individuals participated an average of 1.55 hours. Self-care impaired individuals participated an average of 0.89 hours. Errands impaired individuals participated an average of 0.86 hours.

Volunteer

Number of Hours Spent Volunteering. Non-impaired individuals participated in volunteer activities an average of 2.23 hours. Hearing impaired individuals participated an average of 1.47 hours. Vision impaired individuals participated an average of 1.17 hours. Mobility impaired individuals participated an average of 1.37 hours. Memory impaired individuals participated an average of 1.02 hours. Self-care impaired individuals participated an average of 0.92 hours. Errands impaired individuals participated an average of 0.91 hours.

Employment

Number of Hours Engaging in Employment. Non-impaired individuals participated an average of 18.17 hours. Hearing impaired individuals participated an average of 6.12 hours. Vision impaired individuals participated an average of 3.65 hours. Mobility impaired individuals participated an average of 5.23 hours. Memory impaired individuals participated an average of 5.60 hours. Self-care impaired individuals participated an average of 4.11 hours. Errands impaired individuals participated an average of 3.53 hours.

Time Spent Participating in Major Activities, Impaired vs. Non-impaired 

Participating in Major Activities without an Impairment
Participating in Major Activities without an Impairment.
Total Time spent participating in major activities: 29.93 hours. None impaired individuals spent 83% of their time employed, 7% of their time in school, and 10% of their time volunteering.

Participating in Major Activities with an Impairment

Participating in Major Activities with an Impairment. Total time spent participating in major activities for all groups with impairments: 40.85. Impaired individuals spent 69% of their time employed, 14% of their time in school, and 17% of their time volunteering.

Discussion

These results highlight the relative amount of community engagement among people reporting varying impairment types.  While these results are not geographically representative, they may represent the relative impact of impairment type on engagement. Consistent with the purpose of the ACS screening questions, people who report having difficulty doing errands without assistance report the least engagement of all groups, followed by those with self-care and mobility impairments.

These results may lead community development specialists and those who develop policy to consider how resources may be allocated to "level" the playing field between people with and without impairments and perhaps, among impairment groups.  Further research using these methods may explore the mechanism of effects shown here.