DESCRIPTION OF THE US WORKING AGE DISABLED POPULATIONS LIVING IN INSTITUTIONS AND IN THE COMMUNITY

This study provides national estimates of the size of the US working a ge disabled populations in institutions and in the community, and desc ribes these populations along a number of dimensions. By using data fr om the Institutional Population and Household Survey Components of the 1987 National Medical Expenditure Survey, the study represents the fi rst time that these populations have been studied using comparable dat a. The working age disabled population was identified as persons betwe en the ages of 21, and 64 who experienced difficulty with at least one of the activities of daily living (ADLs). Using this definition, appr oximately 1% of the total US population was found to be working age di sabled (n = 2.6 million). Of these, 11% (n = 282000) resided in long-t erm care facilities. Significant differences were observed between the institutionalized population having mental retardation (MR) and those with physical disabilities only. Relative to the MR population, membe rs of the physically disabled population had more severe limitations i n ADLs, entered the facility at a later age, had much shorter stays, a nd were more likely to have a spouse and children who might provide su pport for community-based living. However, some physically disabled pe rsons were admitted early in life for very long stays, similar to the situation for most persons with MR. Comparisons of the working age dis abled populations in institutions and in the community showed that tho se in the community had fewer ADL limitations than their institutional ized counterparts and were much more likely to be married. Although a surprisingly large proportion of the community-based disabled populati on lived alone (23%), 70% lived with at least one relative. Help with ADLs was usually provided by a relative living in the same home; littl e use of community support services was reported. Finally, a significa nt proportion of disabled young adults currently living with their par ent(s) appear to be at high risk of eventual institutionalization.