Mobility problems and perceptions of disability by self-respondents and proxy respondents

BACKGROUND. The Americans With Disabilities Act defines disability on the b asis of physical or mental impairments or external perceptions of impairmen t. OBJECTIVES. The objective of this study was to examine perceptions of disab ility among people with lower-extremity mobility difficulties. RESEARCH DESIGN. This study used a cross-sectional, nationally representati ve survey, the 1994 to 1995 National Health Interview Survey-Disability (NH IS-D) supplement. Using SAS-callable SUDAAN for all analyses, we produced n ational population estimates. SUBJECTS. This study included 142,572 noninstitutionalized, civilian reside nts of the United States who were greater than or equal to 18 years of age, with 80,423 self-respondents and 49,883 proxy respondents. MEASURES. We created a 4-level mobility variable using NHIS-D questions abo ut the ability to walk, climb sl:airs, stand and the use of mobility aids. We examined associations between mobility and answers to 2 questions about self- and external perceptions of disability. RESULTS. The results showed that 3.1% (estimated 5.82 million persons) repo rted major mobility difficulties, including 3.7% of self-respondents and 2. 7% of those with proxy respondents. Among persons with major mobility probl ems, 70.8% perceived themselves as disabled, whereas 64.8% thought other pe ople see them as disabled. Also, 80.5% of manual wheelchair users saw thems elves as disabled. Proxies were somewhat more likely to perceive disability than self-respondents, although differences were not generally statistical ly significant. In multivariable regressions, mobility level was the strong est predictor of self-perceived disability, followed by general health stat us. CONCLUSIONS. Mobility problems increase the likelihood that people will see themselves as disabled, but these perceptions are not universal. Although the schematic of wheelchair users has become an international symbol of dis ability, many people with serious mobility problems do not view themselves as disabled.