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Disability in America: Toward a National Agenda for Prevention
FIGURE 6-1 Prevalence to top 10 chronic conditions, age 65 and over, 1988.
Source: National Center for Health Statistics, 1989a.
elderly (National Center for Health Statistics, 1989a). As noted in Chapter 2, however, one limitation of the NHIS data is that they are self-reported with no objective measurements.
Because of the large and significant contribution that chronic diseaseand aging make to disability, an in-depth study of this relationshipis warranted. It should focus on disability prevention, health promotion,quality of life, and implications for public health.
Chronic Conditions Causing Disability
The higher-ranking prevalent chronic health conditions are not necessarily those that cause the most disability (defined here in terms of activity limitations). For example, a recent analysis by LaPlante (1989b), based on four years (1983-1986) of the NHIS, showed an inverse relationship between the prevalence of chronic health conditions and the risk of disability. As shown in Figure 6-2, conditions with high prevalence have low risks of disability, whereas conditions low in prevalence have high risks of disability. For example, sinusitis ranks highest in prevalence for all ages, but less than one-half of 1 percent of the persons with this condition report being limited in activity. By contrast, the three least prevalent conditions—absence of arms and/or hands, multiple sclerosis, and lung or bronchial cancer—have significantly higher risks of disability. Three-fourths of those with lung or bronchial cancer report being limited in activity.
Current data on chronic and disabling conditions are restricted to national