National Academies Press: OpenBook

Visual Impairments: Determining Eligibility for Social Security Benefits (2002)

Chapter: Appendix A: Employment and Economic Consequences of Visual Impairment

« Previous: References
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Appendix A
EMPLOYMENT AND ECONOMIC CONSEQUENCES OF VISUAL IMPAIRMENT

Andrew J. Houtenville

School of Industrial and Labor Relations, Cornell University

Working-age people with disabilities work less and have less household income than working-age people without disabilities.1 There are also dramatic differences in the kinds and levels of disabilities within the working age population with disabilities.2 Those with severe vision impairments are particularly disadvantaged, for they face many barriers in accessing employment. This paper explores the economic experience and program participation of working-age people with chronic vision-related conditions over the past two decades and compares their experience with those of other working-age people with chronic conditions.

1  

See Trupin et al. (1997) and Burkhauser, Daly, and Houtenville (2000).

2  

See Trupin et al. (1997) for a comparison of the labor force participation of people with various disabilities.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

DATA AND IMPORTANT SAMPLING ISSUES

The National Health Interview Survey (NHIS) contains the economic and chronic condition information needed to conduct this study. The NHIS is a complex multistage probability sample of the civilian noninstitutionalized population of the United States.3 The NHIS is collected by the National Center for Health Statistics (NCHS) in the Department of Health and Human Services. The federal government uses data from the NHIS to monitor trends in illness and disability. Researchers use data from the NHIS to analyze access to health care and health insurance and to evaluate federal health programs.

The NHIS collected information on an average of about 60,000 working-age individuals (100,000 individuals in total) annually from 1983 through 1996.4 This paper separates survey participants into subgroups by chronic condition and gender. Some of these subgroups contain very small numbers of individuals, i.e., very small sample sizes. Smaller sample sizes lead to less precise sample estimates. This paper pools multiple years together to boost the sample sizes in these subgroups.

Specific health conditions and impairments are captured in two distinct methods. The differences between these two methods are very important in the interpretation of statistics generated using the NHIS. Very early the survey participants are randomly asked one of six condition checklists. These checklists directly inquire about

3  

The NHIS excludes those on active duty with the armed forces and U.S. nationals living in foreign countries. The dependents of those on active duty with the armed forces are included. The NHIS also excludes those in long-term care facilities, which may disproportionately represent people with disabilities.

4  

The NHIS interviews are performed in person in households. Adult (17 years of age and over) members of the household present at the time of the interview are asked to respond for themselves. A responsible adult (19 years of age and over) answers for children and adults not present at the time of the interview. Between 65 and 70 percent of adults answer for themselves (Massey, Moore, Parsons, & Tadros, 1989).

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

specific conditions. Table A-1 contains the checklist relevant to vision and the other conditions addressed in this report. In addition to the checklists, in later parts all survey participants are asked screening questions to reveal general health, doctor’s visits, hospital utilization, sick days, and functioning difficulties. If participants answer yes to these screening questions, they are then asked what conditions caused these issues. The top panel of Table A-2 contains the set of screening questions, while the bottom panel contains an example of the probing questions that follow a screening question.

Thus only one-sixth of NHIS participants are directly asked about blindness and visual impairment and can also reveal blindness or visual impairment if they reveal having general health/functioning difficulties. The remaining five-sixths of NHIS participants reveal blindness or visual impairment only if they reveal having general health/functioning difficulties. As a result, the subsample of NHIS participants reporting blindness in the one-sixth sample is a random subsample of those reporting blindness. The subsample of NHIS participants reporting blindness in the five-sixths sample is a choice-based subsample of those reporting blindness because being in this subsample depends on responses (choices) to the screening questions.5

From this point forward, the term “random sample” refers to the one-sixth of the NHIS sample who were directly asked about their condition, and the term “choice-based” sample is used to refer to those who where asked about their condition after having revealed general health/functioning difficulties.

Prevalence, employment, income, and program participation statistics are calculated separately for random and choice-based samples. There are likely to be important differences between the two samples. The prevalence of blindness should be higher in the random sample than in the choice-based sample, because there are likely to be people reporting blindness who do not have general health/functioning difficulties, i.e., who answer “no” to the question in the bottom panel

5  

The same is true for the subsample reporting visual impairment and the other conditions addressed in this paper.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

TABLE A-1 Condition Checklist Received by the Random Sample

H1.2a. Does anyone in the family {read names} NOW HAVE –

 

If “Yes,” ask 2b and c.

b. Who is that?

c. Does anyone else now have –

A.

Deafness in one or both ears?

B.

Any trouble hearing with one or both ears?

C.

Tinnitus or ringing in the ears?

D.

Blind in one or both eyes?

E.

Cataracts?

F.

Glaucoma?

G.

Color blindness?

H.

A detached retina or any other condition of the retina?

I.

Any other trouble seeing with one or both eyes EVEN when wearing glasses?

J.

A cleft palate or harelip?

K.

Stammering or stuttering?

L.

Any other speech defect?

M.

Loss of taste or smell which has lasted 3 months or more?

N.

A missing finger, hand or arm, toe, foot, or leg?

O.

A missing joint?

P.

A missing breast, kidney, or lung?

Q.

Palsy or cerebral palsy?

R.

Paralysis of any kind?

S.

Curvature of the spine?

T.

REPEATED trouble with neck, back, or spine?

U.

Any TROUBLE with fallen arches or flatfeet?

V.

A clubfoot?

W.

A trick knee?

X.

PERMANENT stiffness or any deformity of the foot, leg, or back?

Y.

PERMANENT stiffness or any deformity of the fingers, arm, or hand?

Z.

Mental retardation

AA.

Any condition caused by an accident or injury which happened more than 3 months ago? If “Yes,” ask: What is the condition?

Note: In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (this table contains list #2). Second, participants are asked broad questions to reveal general health and functioning (see the top panel of Table A-2). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see the second

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

panel of Table A-2). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions who have no health or functioning difficulties. So only one-sixth of the sample is directly asked about blindness. This one-sixth of the sample is a random sample, because being asked about blindness is not dependent on one’s response to another question. The remaining five-sixths of the sample is choice-based, because revealing blindness is dependent on one’s response (choice) to another question.

Source: National Health Interview Survey Core Questionnaire, 1985-94, National Center for Health Statistics, Series 10, No. 199.

of Table A-2. Similarly, employment rates and mean incomes are likely to be higher and program participation rates are likely to be lower among random sample members reporting blindness than among choice-based sample members reporting blindness. Choice-based members reporting blindness have already revealed health and functioning difficulties and are thus less likely to work or earn income and more likely to participate in government programs.6

6  

In the random sample there could be people who say “no” to the direct question about blindness, but say “yes” to the screening question and reveal blindness as the reason they said “yes.” This should not occur if respondents answer correctly when asked directly about blindness. There is no way of measuring how often this occurs. The public release data files include the condition but not whether the condition comes from the direct questions or the screening questions. Responding in this way could lead to an understatement of employment rate because the survey does not capture healthy people with blindness whom for some reason did not say “yes” to the direct question and answered “no” to the screening question. However, even if we did know whether the report of blindness came from the direct answer or screening questions, we would be left with the unanswerable question of which answer is correct.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

TABLE A-2 Broad Health Questions Used to Screen for Condition Information

Screening Questions

1.

Does any impairment or health problem NOW keep [you] from working at a job or business?

2.

Does any impairment or health problem NOW keep [you] from doing any housework at all?

3.

Is [you] limited in ANY WAY in any activities because of an impairment or health problem?

4.

During those 2 weeks, did [you] miss any time from a job or business because of illness or injury?

5.

During those 2 weeks, did [you] miss any time from school because of illness or injury?

6.

During those 2 weeks, did [you] stay in bed because of illness or injury?

7.

Was there any {OTHER} time during those 2 weeks that [you] cut down on the things [you] usually does because of illness or injury?

8.

During those 2 weeks, how many times did [you] see or talk to a medical doctor? {include all types of doctors, such as dermatologists, psychiatrists, and ophthalmologists, as well as general practitioners and osteopaths.}

9.

{Besides the time(s) mentioned in [previously]} During those 2 weeks, did anyone in the family receive health care at home or go to a doctor’s office, clinic, hospital or some other place? 2b. Who received this care?

10.

{Besides the time(s) you already told me about} During those 2 weeks, did anyone in the family get any medical advice, prescriptions or test results over the phone from a doctor, nurse, or anyone working with or for a medical doctor?

An Example of Probing Questions (These are the probing questions for the first screening question above.)

A.

What (other) condition causes this?

Ask if injury or operation: When did [the (injury) occur? / [you] have the operation?]

Ask if operation over 3 months ago: For what condition did [you] have the operation?

B.

Besides (condition) is there any other condition that causes this limitation?

C.

Is this limitation caused by any (other) specific condition?

D.

Which of these conditions would you say is the MAIN cause of this limitation?

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Source: Design and Estimation of the 1985-94 National Health Interview Survey, Series 2, No. 110, National Center for Health Statistics, Hyattsville, MD, 1989.

Note: In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (the questions in the top panel of this table). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (for example, the questions in the second panel of this table). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions who have no health or functioning difficulties. So only one-sixth of the sample is directly asked about blindness. This one-sixth of the sample is a random sample, because being asked about blindness is not dependent on one’s response to another question. The remaining five-sixths of the sample is choice-based, because revealing blindness is dependent on one’s response (choice) to another question.

CONCEPTUAL FRAMEWORK AND DEFINITIONS

Nagi (1965) developed a framework for defining disability, in which diseases/disorders result in the impairment of required functions that then interact with the socioeconomic and physical environment and lead to disability. Using the Nagi framework, this paper distinguishes those with chronic vision-related diseases/disorders, such as cataracts, from those with chronic visual impairments, such as being blind in one eye. Those with cataracts are not necessarily visually impaired.7 This distinction is important in the context of economic experience because impaired function, rather than a specific disease/disorder, is expected to have a greater influence on employment and program participation.

7  

It is also possible for an individual to be visually impaired and not report having a vision-related disease/disorder.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

The central focus of this paper is the economic experience of those who are blind in both eyes, for they are the group among people with vision-related conditions at the greatest risk of economic difficulties. They are also most likely to be eligible for Social Security Disability Insurance (SSDI) payments, Supplemental Security Income (SSI) benefits, and other government programs based on their medical conditions. The economic experience of those who are blind in both eyes is compared with that of those with other visual impairments. Economic statistics are also provided for those with vision-related diseases/disorders, which include glaucoma, cataracts, color blindness, and an “other” category, which consolidates conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.8

For comparison purposes the economic experiences of those with some other functional impairments are provided in this report. These functional impairment groups are also seriously at risk of low rates of employment and diminished economic well-being. These categories are deafness in both ears, other hearing impairment, mental retardation, paraplegia, hemiplegia, quadriplegia, and cerebral palsy.

Defining Chronic Conditions

The NHIS provides extensive information on chronic conditions. The term “condition” refers to diseases/disorders and impairments. Chronic conditions are conditions that exist for three or more months, although some conditions are considered chronic regardless of duration.

As mentioned above, the NHIS captures condition information in two ways: (1) checklists of specific conditions and (2) screening questions followed by open-ended probing questions. The next step is to consolidate and classify survey responses from all points in the survey into a set of condition categories based on the International Classification of Diseases. NCHS hires special medical coders to perform this complex task.

8  

This consolidation is required because of the small sample sizes.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

According to the NHIS Medical Coding Manual, participants are classified as being blind in both eyes if they describe their condition as blind, no vision, or can’t see. If there is no clear indication that only one eye is involved, it is assumed that both eyes are involved.

The NHIS also provides a category entitled “other visual impairments.” Participants who are blind in one eye are in this category. This category also includes those who describe their eyesight, seeing, sight, or vision as being bad, blurred, defective, limited, poor, double, problem with, trouble with, or who use phrases like partially blind, blind spots, half-blind. Double-vision, color blindness, night blindness, and day blindness are combined into a single “other visual impairments” group. In addition, any active vision-related diseases/ disorders reported by participants are also classified, regardless of whether they cause visual impairment. The NHIS provides the following categories of diseases/disorders: glaucoma, cataracts, color blindness, conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, diseases of the retina, and others vision-related of eye and adnexa.

The NHIS defines other chronic impairments in a similar manner to visual impairments. Participants who are reported as being deaf in both ears, having no useful hearing in both ears, or can’t hear in both ears are classified as deaf in both ears. Those reported being partially deaf in both ears or a little deaf in both ears are coded as other hearing impairment. If only one ear is involved, a code of “other hearing impairment” is given. If the medical coder is unable to determine whether one or both ears are involved, the individual is coded as other hearing impairment. Hearing problems relating to allergies or earwax are not classified.

Mental retardation includes mental deficiency or retardation, and those describing themselves as can’t learn, slow learner. Mental retardation is considered chronic regardless of onset.

The NHIS codes paralysis as partial or complete and for various parts or portions of the body. Paraplegia is complete paralysis of the lower body, both legs, or from the waist down. Hemiplegia is complete paralysis of one side of the body, including limbs. Quadriplegia is complete paralysis of the entire body or four limbs. Paralysis must

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

exist for three or more months to be considered chronic. Cerebral palsy (and its synonyms) is chronic regardless of date of onset and includes those who describe themselves as congenitally “spastic.”

Definitions of Economic Variables

Economic experience is captured via employment rates, mean household size-adjusted income, and receipt of SSDI and SSI payments. The employment rate is based on the following NHIS questions. “During [the past two calendar weeks], did [you] work at any time at a job or business not counting work around the house? (Include unpaid work in family [farm/business].)” Persons not working were asked, “[e]ven though [you] did not work during those 2 weeks, did [you] have a job or business?” Persons who answer “yes” to the first question or “yes” to the second question are considered employed.

Household income is the sum of all income in the household. Households can contain more than one family. The NHIS uses the following questions to determine family income: “Was the total FAMILY income during the past 12 months—that is, yours, [and other family members] more or less than $20,000? Include money from jobs, social security, retirement income, unemployment payments, public assistance, and so forth. Also include income from interest, dividends, net income from businesses, farm, or rent and any other money income received.” And then, “[of the income brackets provided] which [bracket] best represents the total combined FAMILY income during the past 12 months—that is, yours, [and other family members]? Include wages, salaries, and other items we just talked about.” The respondents can choose from 26 income brackets. To obtain a dollar value for family income, family income is assigned the midpoint of the chosen income bracket. Respondents choosing the top bracket ($50,000 and above) are assigned the mean annual family income among those families above $50,000 as estimated from the Current Population Survey.

Household income is adjusted for household size to get a better measure of an individual’s access to household resources. This paper

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

follows the common practice of dividing household income by the square root of household size. This accounts for the fact that $500 per week provides a higher standard of living for a single-person household than it does for individuals belonging to larger households.9 Because we are comparing income across years, we adjust income using the consumer price index-urban (CPI-U); all income values are in 1998 dollars.

Receipt of SSDI and SSI payments is determined with relatively straightforward questions and refers to receipt of payments in the month prior to the survey. SSDI and SSI recipiency information is available only for 1990-1992, 1994, and 1995.

This paper focuses on working-age men and women (ages 25 to 61). Using this age range avoids confusing reductions in work or economic well-being associated with disability with reductions or declines associated with retirement at older ages or initial transitions in and out of the labor force related to job shopping at younger ages. Men and women are evaluated separately.

RESULTS

To get an idea of the size of populations with the various chronic conditions used in this study, Annex Table A-1 shows the prevalence rates of these chronic conditions in the working-age population in the United States, by gender and the random and choice samples. Annex Tables A-2a through A-2d show the sample sizes used to generate the economic statistics reported below.

Tables A-3 through A-7 compare differences across subgroups. These tables contain employment rates (Table A-3), mean household size-adjusted incomes (Table A-4), the percentages receiving SSDI payments

9  

Using the square root of household size reduces the impact of an each additional household member. An alternative is household income per household member, which places equal weight on adding a second person to a household and adding a sixth person to a household.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

(Table A-5), SSI benefits (Table A-6), and either SSDI or SSI payments or both (Table A-7). In these tables, the estimates of those who are blind in both eyes are compared with the estimates of the other groups. Asterisks indicate when the difference between those who are blind in both eyes and another group is statistically significant. The remaining tables illustrate changes over time in employment rates (Table A-8) and mean household size-adjusted income (Table A-9) for the choice-based sample. Sample sizes in the random sample are insufficient to accurately measure changes over time. In these tables, asterisks indicate when the difference between 1983-1987 and 1992-1996 is statistically significant.

Table A-10 compares the employment rates for those who are blind in both eyes and visually impaired with the findings of Trupin et al. (1997) and Kirchner et al. (1999).

Prevalence

As expected, the prevalence rates reported in Annex Table A-1 are higher in the random sample than in the choice-based sample for all of the chronic conditions used in this study. This suggests that there are some individuals with chronic conditions who do not have any of the health issues listed in the top panel of Table A-2. This may also suggest that when asked directly about a specific condition, survey participants are more likely to report these conditions.

The relative prevalence rates (Annex Table A-1, columns 3 and 6) reveal that the difference between the random and choice-based samples is least among those with paraplegia/hemiplegia/quadriplegia, mental retardation, cerebral palsy, and those who are blind in both eyes. This suggests individuals with these chronic conditions are more affected by the health issues listed in the top panel of Table A-2. The difference between the random and choice-based samples is dramatically higher among those who report hearing impairments and other visual impairments, diseases, and disorders.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Employment

The discussion of employment, income, and program participation focuses mainly on the random sample. Unless specified otherwise, all results discussed below refer to the random samples.

The first column of Table A-3 shows that 88.8 percent of all working-age men without any visual impairment were employed in the period 1983-1996. Over the same period, the employment rate among men who are blind in both eyes was 49.4 percent. The second column of Table A-3 shows that the relative employment rate of men without visual impairments was 1.80, which means that men without visual impairments were 1.80 times as likely to be employed as men who are blind in both eyes.10 Men with other visual impairments were employed at a rate of 82.3 percent—1.64 times as likely to be employed as men who are blind in both eyes. Similarly, the employment rate of men with vision-related diseases or disorders was 85.0 percent.

Among the other chronic impairments, only men with paraplegia, hemiplegia, or quadriplegia and men with mental retardation were employed at a lower rate than men who are blind in both eyes. Men with paraplegia, hemiplegia, or quadriplegia were about half (0.45) as likely to be employed as men who are blind in both eyes. Similarly, men with mental retardation were about 0.70 times as likely to be employed than men who are blind in both eyes. The employment rate of men with cerebral palsy (58.3 percent) is similar to that of men who are blind in both eyes, and the difference is statistically insignificant. This suggests that there may be no difference or that the sample sizes are insufficient to identify a difference. Men who are deaf in both ears were about one and a half (1.53) times as likely to be employed as men who are blind in both eyes.

In general, the employment rates of working-age women are lower than those of working-age men. However, when comparing across chronic conditions, the employment patterns of women are similar.

10  

The relative employment rate is the employment rate of a given group divided by the employment rate of those who are blind in both eyes.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

TABLE A-3 Employment Rates of Noninstitutionalized Working-Age Civilians (Ages 25 to 61) with Various Chronic Impairments, Diseases, and Disorders, Pooled Over 1983 Through 1996, by Sample and Gender

 

Random Samplea

 

Men

Group

Employment Rate

Relative Rateb

No visual impairments

88.8

1.80***

Visual impairments

81.2

1.64***

-Blind in both eyes

49.4

1.00

-Other visual impairments

82.3

1.67***

Vision-related diseases/disorders

85.0

1.72***

-Glaucoma

67.6

1.37***

-Cataracts

67.4

1.36***

-Color blindness

91.4

1.85***

-Other vision-related diseases/disordersc

85.1

1.72***

Other impairments

-Hearing impairments

81.6

1.65***

—Deaf in both ears

75.4

1.53***

—Other hearing impairments

81.9

1.66***

-Mental retardation

34.6

0.70**

-Paraplegia, hemiplegia, or quadriplegia

22.3

0.45***

-Cerebral palsy

58.3

1.18

Note: Asterisks signify when the difference between blind in both eyes and another group is statistically significant at the 99 percent (***), 95 percent (**), and 90 percent (*) levels. NA refers to groups for which sample size is insufficient.

a In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions who have no health or functioning difficulties. So only one-sixth of the sample is directly asked

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

 

Choice-Based Samplea

Women

Men

Women

Employment Rate

Relative Rateb

Employment Rate

Relative Rateb

Employment Rate

Relative Rateb

69.2

2.30***

88.5

2.73***

68.8

2.97***

52.9

1.76***

52.0

1.60***

36.9

1.60***

30.0

1.00

32.4

1.00

23.1

1.00

54.7

1.82***

56.4

1.74***

40.5

1.75***

51.3

1.71***

63.7

1.96***

46.5

2.01***

45.5

1.51***

53.9

1.66***

40.0

1.73***

46.0

1.53***

56.2

1.73***

35.8

1.55***

64.7

2.15***

86.7

2.67***

NA

NA

56.4

1.88***

69.7

2.15***

55.5

2.40***

 

58.4

1.94***

77.0

2.37***

53.5

2.31***

50.3

1.68***

64.1

1.98***

44.6

1.93***

58.7

1.96***

78.0

2.40***

54.5

2.36***

29.1

0.97

33.0

1.02

27.9

1.21

17.7

0.59

20.4

0.63***

19.4

0.84

27.8

0.93

43.7

1.35**

32.3

1.39*

about blindness. This one-sixth of the sample is a random sample, because being asked about blindness is not dependent on one’s response to another question. The remaining five-sixths of the sample is choice-based, because revealing blindness is dependent on one’s response (choice) to another question.

b The relative employment rate is the employment rate of a given group divided by the employment rate of those who are blind in both eyes.

c The category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

TABLE A-4 Mean Household Size-Adjusted Income (HHSAI) of Noninstitutionalized Working-Age Civilians (Ages 25 to 61) with Various Chronic Impairments, Diseases, and Disorders, Pooled Over 1983 Through 1996, by Sample and Gender

 

Random Samplea

 

Men

Group

Mean HHSAI

Relative HHSAIb

No visual impairments

31,067

1.22***

Visual impairments

29,361

1.15*

-Blind in both eyes

25,503

1.00

-Other visual impairments

29,504

1.16*

Vision-related diseases/disorders

31,655

1.24***

-Glaucoma

28,978

1.14

-Cataracts

26,859

1.05

-Color blindness

32,991

1.29***

-Other vision-related diseases/disordersc

33,155

1.30***

Other impairments

-Hearing impairments

30,954

1.21**

—Deaf in both ears

28,702

1.13

—Other hearing impairments

31,070

1.22***

-Mental retardation

17,382

0.68***

-Paraplegia, hemiplegia, or quadriplegia

20,067

0.79*

-Cerebral palsy

23,614

0.93

Note: Asterisks signify when the difference between blind in both eyes and another group is statistically significant at the 99 percent (***), 95 percent (**), and 90 percent (*) levels. NA refers to groups for which sample size is insufficient.

a In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions who have no health or functioning difficulties. So only one-sixth of the sample is directly asked about blindness.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

 

Choice-Based Samplea

Women

Men

Women

Mean HHSAI

Relative HHSAIb

Mean HHSAI

Relative HHSAIb

Mean HHSAI

Relative HHSAIb

28,578

1.37***

31,110

1.70***

28,696

1.47***

22,821

1.10

21,631

1.18***

20,624

1.05

20,837

1.00

18,348

1.00

19,567

1.00

22,975

1.10

22,363

1.22***

20,901

1.07

26,516

1.27***

26,627

1.45***

25,149

1.29***

26,246

1.26**

25,385

1.38***

22,019

1.13

24,072

1.16

23,310

1.27***

22,786

1.16*

27,692

1.33**

33,194

1.81***

NA

NA

29,422

1.41***

28,277

1.54***

28,185

1.44***

 

25,641

1.23**

29,434

1.60***

24,966

1.28***

23,088

1.11

26,098

1.42***

19,888

1.02

25,758

1.24**

29,690

1.62***

25,534

1.30***

18,049

0.87

16,147

0.88***

16,927

0.87**

23,304

1.12

20,245

1.10

20,362

1.04

17,677

0.85

18,438

1.00

19,147

0.98

This one-sixth of the sample is a random sample, because being asked about blindness is not dependent on one’s response to another question. The remaining five-sixths of the sample is choice-based, because revealing blindness is dependent on one’s response (choice) to another question.

b The relative HHSAI is the mean HHSAI of a given group divided by mean HHSAI of those who are blind in both eyes.

c The category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

TABLE A-5 Percentage Receiving Social Security Disability Insurance (SSDI) Payments among Noninstitutionalized Working-Age Civilians (Ages 25 to 61) with Various Chronic Impairments, Diseases, and Disorders, Pooled Over 1983 Through 1996, by Sample and Gender

 

Random Samplea

 

Men

Group

Percentage Receiving SSDI

Relative Recipiencyb

No visual impairments

1.87

0.08***

Visual impairments

6.61

0.28**

-Blind in both eyes

23.76

1.00

-Other visual impairments

5.79

0.24**

Vision-related diseases/disorders

4.32

0.18**

-Glaucoma

11.64

0.49

-Cataracts

9.72

0.41*

-Color blindness

1.97

0.08***

-Other vision-related diseases/disordersc

8.84

0.37*

Other impairments

-Hearing impairments

4.29

0.18**

—Deaf in both ears

9.80

0.41

—Other hearing impairments

4.02

0.17**

-Mental retardation

37.25

1.57

-Paraplegia, hemiplegia, or quadriplegia

55.05

2.32**

-Cerebral palsy

27.45

1.16

Note: Asterisks signify when the difference between blind in both eyes and another group is statistically significant at the 99 percent (***), 95 percent (**), and 90 percent (*) levels. NA refers to groups where sample size is insufficient.

a In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

 

Choice-Based Samplea

Women

Men

Women

Percentage Receiving SSDI

Relative Recipiencyb

Percentage Receiving SSDI

Relative Recipiencyb

Percentage Receiving SSDI

Relative Recipiencyb

1.24

0.03***

2.37

0.05***

1.35

0.04***

8.43

0.21***

23.39

0.49***

14.75

0.38***

39.31

1.00

47.43

1.00

38.66

1.00

6.24

0.16***

16.86

0.36***

8.55

0.22***

6.12

0.16***

16.68

0.35***

9.79

0.25***

5.59

0.14***

22.81

0.48***

10.77

0.28***

6.08

0.15***

12.43

0.26***

11.24

0.29***

2.47

0.06***

NA

NA

NA

NA

11.90

0.30**

22.16

0.47***

9.37

0.24***

 

3.98

0.10***

5.87

0.12***

3.68

0.10***

23.50

0.60

15.55

0.33***

5.96

0.15***

3.36

0.09**

5.45

0.11***

3.55

0.09***

29.52

0.75

49.31

1.04

40.82

1.06

28.61

0.73

69.07

1.46***

33.37

0.86

11.37

0.29*

40.52

0.85

48.59

1.26

about blindness. This one-sixth of the sample is a random sample because being asked about blindness is not dependent one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent one’s response (choice) to another question.

b The relative recipiency is the percentage of a given group divided by the recipiency of those who are blind in both eyes.

c The category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

TABLE A-6 Percentage Receiving Supplemental Security Income (SSI) among Noninstitutionalized Working-Age Civilians (Ages 25 to 61) with Various Chronic Impairments, Diseases, and Disorders, Pooled Over 1990-1992, 1994, and 1995, by Sample and Gender

 

Random Samplea

 

Men

Group

Percentage Receiving SSI

Relative Recipiencyb

No visual impairments

0.99

0.04***

Visual impairments

3.97

0.16***

-Blind in both eyes

24.69

1.00

-Other visual impairments

2.97

0.12***

Vision-related diseases/disorders

2.28

0.09***

-Glaucoma

9.40

0.38*

-Cataracts

4.97

0.20***

-Color blindness

0.36

0.01***

-Other vision-related diseases/disordersc

5.91

0.24**

Other impairments

-Hearing impairments

1.86

0.08***

—Deaf in both ears

4.41

0.18***

—Other hearing impairments

1.73

0.07***

-Mental retardation

42.73

1.73*

-Paraplegia, hemiplegia, or quadriplegia

34.64

1.40

-Cerebral palsy

31.07

1.26

Note: Asterisks signify when the difference between blind in both eyes and another group is statistically significant at the 99 percent (***), 95 percent (**), and 90 percent (*) levels. NA refers to groups where sample size is insufficient.

a In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

 

Choice-Based Samplea

Women

Men

Women

Percentage Receiving SSI

Relative Recipiencyb

Percentage Receiving SSI

Relative Recipiencyb

Percentage Receiving SSI

Relative Recipiencyb

1.46

0.06***

1.08

0.04***

1.39

0.04***

10.38

0.42

9.97

0.36***

15.76

0.46***

24.74

1.00

27.43

1.00

34.57

1.00

9.36

0.38*

5.23

0.19***

10.88

0.31***

8.44

0.34*

7.45

0.27***

9.46

0.27***

8.89

0.36*

9.22

0.34***

12.76

0.37***

10.59

0.43

10.74

0.39**

10.82

0.31***

1.23

0.05***

NA

NA

NA

NA

12.57

0.51

6.03

0.22***

7.50

0.22***

 

3.35

0.14**

2.34

0.09***

5.93

0.17***

9.19

0.37

4.12

0.15***

12.84

0.37***

3.16

0.13***

2.26

0.08***

5.55

0.16***

52.36

2.12***

45.18

1.65***

40.71

1.18

24.03

0.97

26.51

0.97

17.28

0.50**

40.26

1.63

34.00

1.24

46.27

1.34

about blindness. This one-sixth of the sample is a random sample because being asked about blindness is not dependent one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent one’s response (choice) to another question.

b The relative recipiency is the percentage of a given group divided by the recipiency of those who are blind in both eyes.

c The category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

TABLE A-7 Percentage Receiving Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSDI) Payments among Noninstitutionalized Working-Age Civilians (Ages 25 to 61) with Various Chronic Impairments, Diseases, and Disorders, Pooled Over 1990-1992, 1994, and 1995, by Sample and Gender

 

Random Samplea

 

Men

Group

Percentage Receiving SSDI, SSI

Relative Recipiencyb

No visual impairments

2.62

0.07***

Visual impairments

9.08

0.24***

-Blind in both eyes

37.38

1.00

-Other visual impairments

7.72

0.21***

Vision-related diseases/disorders

5.88

0.16***

-Glaucoma

15.56

0.42**

-Cataracts

13.55

0.36***

-Color blindness

2.33

0.06***

-Other vision-related diseases/disordersc

14.75

0.39**

Other impairments

-Hearing impairments

5.97

0.16***

—Deaf in both ears

14.21

0.38**

—Other hearing impairments

5.57

0.15***

-Mental retardation

63.56

1.70**

-Paraplegia, hemiplegia, or quadriplegia

79.19

2.12***

-Cerebral palsy

51.34

1.37

Note: Asterisks signify when the difference between blind in both eyes and another group is statistically significant at the 99 percent (***), 95 percent (**), and 90 percent (*) levels. NA refers to groups where sample size is insufficient.

a In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

 

Choice-Based Samplea

Women

Men

Women

Percentage Receiving SSDI, SSI

Relative Recipiencyb

Percentage Receiving SSDI, SSI

Relative Recipiencyb

Percentage Receiving SSDI, SSI

Relative Recipiencyb

2.47

0.05***

3.08

0.05***

2.44

0.04***

15.74

0.33***

28.49

0.48***

27.27

0.45***

47.87

1.00

59.75

1.00

60.87

1.00

13.46

0.28***

20.00

0.33***

18.56

0.30***

12.14

0.25***

20.18

0.34***

16.14

0.27***

13.92

0.29***

28.04

0.47***

19.46

0.32***

13.41

0.28***

18.45

0.31***

17.35

0.29***

3.69

0.08***

NA

NA

NA

NA

19.26

0.40**

22.16

0.37***

13.52

0.22***

 

6.84

0.14***

7.38

0.12***

8.84

0.15***

26.89

0.56

16.98

0.28***

15.97

0.26***

6.20

0.13***

6.96

0.12***

8.45

0.14***

70.29

1.47*

72.75

1.22**

67.72

1.11

52.64

1.10

84.37

1.41***

41.68

0.68**

51.63

1.08

63.01

1.05

77.28

1.27*

about blindness. This one-sixth of the sample is a random sample because being asked about blindness is not dependent one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent one’s response (choice) to another question.

b The relative recipiency is the percentage of a given group divided by the recipiency of those who are blind in both eyes.

c The category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

TABLE A-8 Employment Rates of Noninstitutionalized Working-Age Civilians (Ages 25 to 61) in the Choice-Based Sample with Various Chronic Impairments, Diseases, and Disorders, Pooled Over 1983-1987 and 1992-1996 and Percentage Changes, by Gender

 

Group

No visual impairments

Visual impairments

-Blind in both eyes

-Other visual impairments

Vision-related diseases/disorders

-Glaucoma

-Cataracts

-Color blindness

-Other vision-related diseases/disordersb

Other impairments

-Hearing impairments

—Deaf in both ears

—Other hearing impairments

-Mental retardation

-Paraplegia, hemiplegia, or quadriplegia

-Cerebral palsy

Note: Asterisks signify when the difference between 1983-1987 and 1992-1996 is statistically significant at the 99 percent (***), 95 percent (**), and 90 percent (*) levels. NA refers to groups where sample size is insufficient.

In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Men

Women

1983-87

1992-96

Percentage Changea

1983-87

1992-96

Percentage Changea

88.6

87.9

−0.79***

65.2

71.1

8.66***

54.5

48.5

−11.65*

34.5

39.9

14.52

34.8

27.3

−24.15

19.5

27.8

35.10

58.7

53.2

−9.83

38.1

43.6

13.46

62.7

63.3

0.95

41.1

48.8

17.13

50.6

52.0

2.73

33.3

40.5

19.51

53.3

59.4

10.83

33.3

34.2

2.67

92.0

77.2

−17.49

NA

NA

NA

71.5

69.6

−2.69

50.1

59.8

17.65

 

65.9

65.2

−1.07

43.6

48.2

10.02

61.1

58.8

−3.84

37.6

44.4

16.59

66.8

66.1

−1.05

45.0

49.1

8.71

32.9

34.3

4.17

23.6

31.5

28.68**

19.1

22.7

17.22

7.2

29.5

121.53***

44.2

33.8

−26.67

35.6

27.7

−24.96

about blindness. This one-sixth of the sample is a random sample because being asked about blindness is not dependent one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent one’s response (choice) to another question.

a The percentage change is the difference between the two periods divided by the average of the two periods multiplied by 100.

b The category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

TABLE A-9 Mean Household Size-Adjusted Income of Noninstitutionalized Working-Age Civilians (Ages 25 to 61) in the Choice-Based Sample with Various Chronic Impairments, Diseases, and Disorders, Pooled Over 1983-1987 and 1992-1996 and Percentage Changes, by Gender

 

Group

No visual impairments

Visual impairments

-Blind in both eyes

-Other visual impairments

Vision-related diseases/disorders

-Glaucoma

-Cataracts

-Color blindness

-Other vision-related diseases/disordersb

Other impairments

-Hearing impairments

—Deaf in both ears

—Other hearing impairments

-Mental retardation

-Paraplegia, hemiplegia, or quadriplegia

-Cerebral palsy

Note: Asterisks signify when the difference between 1983-87 and 1992-96 is statistically significant at the 99 percent (***), 95 percent (**), and 90 percent (*) levels. NA refers to groups where sample size is insufficient.

All dollar values are adjusted for inflation to 1998 dollar values. In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked about blindness. This one-

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Men

Women

1983-87

1992-96

Percentage Changea

1983-87

1992-96

Percentage Changea

29,574

31,885

7.52***

27,082

29,608

8.91***

21,110

21,349

1.13

19,339

21,152

8.96

16,969

17,741

4.45

20,925

18,613

−11.70

21,989

22,149

0.72

18,952

21,947

14.65**

24,270

28,104

14.64**

24,321

24,432

0.46

21,423

27,657

25.40**

21,143

20,775

−1.76

23,668

24,375

2.94

20,663

24,464

16.85

34,189

32,155

−6.13

NA

NA

NA

24,484

29,204

17.58*

28,234

27,058

−4.25

24,027

26,532

9.91*

22,321

22,580

1.15

26,077

22,847

−13.20

19,832

18,181

−8.69

23,682

27,102

13.47**

22,911

23,597

2.95

15,593

15,234

−2.33

15,451

17,102

10.14

17,702

22,264

22.83**

17,844

21,849

20.18

19,116

17,698

−7.70

20,477

16,655

−20.59

sixth of the sample is a random sample because being asked about blindness is not dependent one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent one’s response (choice) to another question.

a The percentage change is the difference between the two periods divided by the average of the two periods multiplied by 100.

b The category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

TABLE A-10 Comparison with Results from Other Study of Vision-Related Conditions and Labor Market Attachment

 

Study of Vision-Related Conditions and Labor Market Attachment

Descriptions

This Study

Dataset

National Health Interview Survey

Time period

Pooled over 1983-96

Age group

Aged 25 to 61

Measure of labor market attachmentb

Have a job in the previous two weeks

Secondary restrictions

Random samplec

Choice-based samplec

Measures of vision-related conditions

Blind in both eyes

Other visual impairments

Blind in both eyes

Other visual impairments

Percentage attached to the labor market

39.5

73.1

28.2

49.8

a Trupin et al. (1997) report annual estimates from 1983-1994. The pooled results below are my calculations using their annual estimates.

b All three studies are based on the same set of questions. Trupin et al. (1997) include those who are looking for work but mention similar estimates are obtained when excluding those who are looking for work.

c In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

 

Trupin et al. (1997)

Kirchner et al. (1999)

National Health Interview Survey on Disability, Phase I

National Health Interview Survey

Pooled over 1983-94a

Pooled over 1994-95

Aged 18 to 64

Aged 18 to 54

Have a job or looking for work in the previous two weeks

Have a job in the previous two weeks

Condition is the main cause of work and/or activity limitationsd

None

Blind in both eyes

Other visual impairments

Serious visual impairment even when wearing glassese

30.1

61.0

59.0

about blindness. This one-sixth of the sample is a random sample because being asked about blindness is not dependent one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent one’s response (choice) to another question.

d Trupin et al. (1997) restrict their sample to only those who report blindness as the main source of work and/or activity limitation, which is a subset of the prompting questions referred to in Table A-2. This allows them to disregard the distinction between recipients and nonrecipients of List #2, yet they ignore those with conditions who are not limited.

e In Kirchner et al. (1999) individuals are considered to have a “serious visual impairment” if they have “SERIOUS difficulty seeing even when wearing glasses or contact lenses” and then identify themselves as “legally blind” or expect themselves “to have SERIOUS difficulty seeing, for at least the next 12 months.”

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

The third column of Table A-3 shows that 69.2 percent of working-age women without visual impairments were employed in the period 1983-1996. The employment rate among women who are visually impaired is 52.9 percent and the rate for women who are blind in both eyes is 30.0 percent. The fourth column of Table A-3 reveals that women without visual impairments were over twice (2.30) as likely to be employed as women who are blind in both eyes. Women with other visual impairments were employed at a rate of 54.7 percent. The employment rate of women with vision-related diseases or disorders is 51.3 percent.

Among the other chronic conditions, the employment rates of women with cerebral palsy, paraplegia/hemiplegia/quadriplegia, and mental retardation are statistically indistinguishable from the employment rates of women who are blind in both eyes. This suggests that there may be no difference or that the sample sizes are insufficient to identify a difference. All other groups were employed at higher rates than women who are blind in both eyes.

As expected, among all groups, the employment rate of men in the random sample is higher than the employment rate of men in the choice-based sample. This is also true among women, except for women with cerebral palsy and paraplegia/hemiplegia/quadriplegia.11 Comparing the employment rates of the random sample and the choice-based sample, it appears that four groups always had the lowest employment rate: (1) those who are blind in both eyes and those with (2) cerebral palsy, (3) paraplegia/hemiplegia/quadriplegia, and (4) mental retardation. This is consistent with the finding that these groups are more affected by the health issues listed in Table A-2.

11  

The difference between the employment rates of women with cerebral palsy in the random sample and the employment rates of women with cerebral palsy in the choice-based sample is likely to be within the margin of error, likewise for women with paraplegia/hemiplegia/quadriplegia.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Household Size-Adjusted Income

Unless specified otherwise, all results discussed below refer to the random samples. The mean household size-adjusted income among working-age men without visual impairments was $31,067 (Table A-4, column 1) for the period 1983-1996. This figure is 1.22 times higher than the mean household size-adjusted income among men who are blind in both eyes ($25,503). Men with other visual impairments had a mean household size-adjusted income of $29,504, which is 1.16 times the mean household size-adjusted income of men who are blind in both eyes. The mean household size-adjusted income of men with vision-related diseases or disorders was $31,655.

Among the other chronic conditions, mean household size-adjusted incomes lower than that of men who are blind in both eyes are found among men with mental retardation and paraplegia/hemiplegia/ quadriplegia. Men with cerebral palsy and men who are deaf in both ears have similar mean household size-adjusted income; the differences are statistically insignificant.

The cross-condition comparisons are fairly similar for working-age women. The third column of Table A-4 reveals that the mean household size-adjusted income among working-age women without visual impairments was $28,578, compared with $20,837 among working-age women who are blind in both eyes. Mean household size-adjusted income of women with other visual impairments ($22,975) was slightly higher than that of women who are blind in both eyes. Interestingly, the mean household size-adjusted income of women who are deaf in both ears is not statistically different than that of women who are blind in both eyes.

As expected, among all groups, the mean household size-adjusted income of those in the random sample was higher than the mean household size-adjusted income of those in the choice-based sample, except for men with paraplegia/hemiplegia/quadriplegia and women with cerebral palsy.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Program Participation

Unless specified otherwise, all results discussed below refer to the random samples. Table A-5 shows the percentage of men and women receiving SSDI payments and their rates relative to those who are blind in both eyes. (Note that SSDI eligibility must be established by working for a prescribed length of time.) These results are based on data pooled over the years 1990-1992, 1994, and 1995. Few working-age men without visual impairments received SSDI, 1.87 percent (Table A-5, column 1). Among men who are blind in both eyes, only about a quarter (23.76 percent) received SSDI payments. Only 5.79 percent of men with other visual impairments received SSDI payments, which may reflect the severity of these impairments.

Among other groups, only men with paraplegia/hemiplegia/ quadriplegia received SSDI payments at a higher rate (55.05 percent); they were 2.32 times as likely to receive SSDI payments. The difference in SSDI recipiency between men who are blind in both eyes (23.76 percent) and men with mental retardation (37.25) is not statistically significant. Men who are deaf in both ears received SSDI payments at a rate of 9.80 percent and were thus 0.41 times as likely to receive SSDI payments as men who are blind in both eyes, although the difference between the two groups is statistically insignificant.

The third column of Table A-5 shows that 39.31 percent of women who are blind in both eyes received SSDI payments. No other group has a higher recipiency, although the difference is statistically insignificant for women who are deaf in both ears and women with mental retardation or paraplegia/hemiplegia/quadriplegia.

Table A-6 reveals similar patterns for SSI recipiency. Among men who are blind in both eyes, 24.69 percent received SSI. Men with other visual impairments participated at a rate of 3.97 percent, which again may reflect the severity of other visual impairments. Men with mental retardation were 1.73 times as likely to receive SSI benefits as men who are blind in both eyes. Interestingly, men who are deaf in both ears were much less likely (0.18 times) to receive SSI benefits than men who are blind in both eyes. SSI recipiency is generally higher among women than among men (Table A-6, columns 3 and 4).

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

The patterns across conditions are similar to the patterns shown for men.

Dual eligibility for SSDI and SSI is possible, as long as SSDI payments do not cause an individual to go over the SSI means test. Table A-7 shows that 37.38 percent of men who are blind in both eyes participated in SSDI and/or SSI, which indicates that 11.07 percent participated in both programs.

Consistent with previous findings, the recipiency rates for SSDI and SSI are generally higher for those in the choice-based sample than for those in the random sample. Again, this may reflect the severity of the disability.

Changes Over Time

Due to sample size constraints, the over-time results were generated only for the choice-based sample. Tables A-8 and A-9 illustrate changes in employment rates and mean household size-adjusted income over time for the choice-based sample. Pooled results from 1983-1987 are compared with pooled results from 1992-1996. These years are chosen because they represent similar phases of the business cycle. Both represent recovery periods in the U.S. economy. The NHIS began collecting SSDI and SSI information in 1990; therefore changes in SSDI and SSI participation over time cannot be measured.

Those in the choice-based sample who are blind in both eyes can be thought of as those who are blind in both eyes and report being constrained by their condition. Recall from Table A-5 that when comparing the employment rates of the random sample and the choice-based sample, it appears that four groups always have the lowest employment rate: (1) those who are blind in both eyes and those with (2) cerebral palsy, (3) paraplegia/hemiplegia/quadriplegia, and (4) mental retardation.

The employment rate of working-age men in the choice-based sample without visual impairments was 88.6 percent in the period 1983-1987, and 87.9 percent in the period 1992-1996, which represents a

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

statistically significant decline of 0.79 percent (Table A-8, columns 1, 2, and 3). The employment rate of men in the choice-based sample with visual impairments declined by much more (11.65 percent), from 54.5 percent in the period 1983-1987 to 48.5 percent in the period 1992-1996. The changes in the employment rates for all other groups of men are not statistically significantly different from zero, which suggests that there may be little change or the sample sizes are insufficient to identify a change.12

The last three columns of Table A-8 show that the employment rates of working-age women in the choice-based sample without visual impairments rose by 8.66 percent, from 65.2 percent in 1983-1987 to 71.1 percent in 1992-1996. However, the change in the employment rates among women in the choice-based sample who are blind in both eyes is not statistically different from zero. Interestingly, the employment rates of women in the choice-based sample increased for those with mental retardation (23.6 to 31.5 percent) and paraplegia/ hemiplegia/quadriplegia (7.2 to 29.5 percent).

The third and sixth columns of Table A-9 show that the mean household size-adjusted income increased between the periods 1983-1987 and 1992-1996 by 7.52 percent among men in the choice-based sample without visual impairments and 8.91 percent among women in the choice-based sample without visual impairments. Changes in the mean household size-adjusted income among men and women in the choice-based sample who are blind in both eyes are not significantly different from zero.

12  

Comparison of six-year periods (1983-1988 and 1991-1996) and seven-year periods (1983-1989 and 1990-1996) without a significant change in patterns across subgroups. And even though more years are pooled, there are no substantial changes in statistical significance.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

COMPARISON WITH OTHER STUDIES

Table A-10 compares the employment results in this paper to the results of two other studies. The results are remarkably close. Trupin et al. (1997) used the NHIS over the period 1983-1994; thus they should find lower rates of labor force attachment than the ones reported here—1995 and 1996 were growth years in the overall economy. Trupin et al. (1997) report labor force participation rates, which include people who are actively looking for a job; thus their estimates should be higher than the employment rates presented in this paper. They analyzed the population for whom being blind in both eyes is the main cause of activity limitations; thus their sample is similar to the results from the choice-based sample for which main cause of activity limitations is one way of revealing blindness (see Table A-2). They evaluated those ages 18 to 64 and thus should capture lower rates of labor force attachment than those reported here. They combined women and men. Table A-10 adjusts the results of Table A-5 to pull together the results for men and women.

As is shown in the fifth column of Table A-10, Trupin et al. (1997) found a 1983-1994 labor force participation rate of 30.1 percent among those ages 18 to 64 for whom being blind in both eyes is the main cause of activity limitations. This is remarkably similar to the 1983-1996 employment rate of 28.2 percent for those age 25 to 61 in the choice-based sample who are blind in both eyes.

Kirchner et al. (1999) used the National Health Interview on Disability pooled over 1994-1995; thus they should find higher rates of labor force attachment than the ones reported here—they did not cover the recession of the early 1990s. They use exactly the same definition of employment used here. In their study, individuals were considered to have a “serious visual impairment,” if they have “SERIOUS difficulty seeing even when wearing glasses or contact lenses” and then identify themselves as “legally blind” or expect themselves “to have SERIOUS difficulty seeing, for at least the next 12 months.” Their results should fall between the random sample results for those who are blind in both eyes and those with other visual impairments. They evaluated those ages 18 to 54 and thus should also find lower rates of labor force

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

attachment than those reported here. They also combined women and men.

Kirchner et al. (1999) found a 1994-1995 employment rate of 59.9 percent among those ages 18 to 54 who are severely visually impaired. This is between the 1983-1996 employment rates of 39.5 and 73.1 percent for those ages 25 to 61 in the random sample who are blind in both eyes and who have other visual impairments, respectively.

A Canadian study by Fawcett (1996) estimated labor force participation (employed or actively looking for work) rates for the population with disabilities in Canada. Among working-age persons with “seeing disabilities,” 45.6 percent participated in the labor force in 1991. Similar rates were found among those with disabilities related to mobility (43.3), agility (46.0), speaking (41.8), and mental function/ learning (47.5). The labor force participation of those with hearing disabilities in Canada (62.7 percent) was higher than that of those with seeing disabilities in Canada. These cross-disability patterns are similar to employment patterns shown in Table A-3 for the United States.

CONCLUSION

This paper provides a statistical description of the economic experience of working-age individuals with chronic vision-related conditions over the period 1983-1996 using the NHIS. The economic experience of individuals who are blind in both eyes is compared with the economic experience of those with other chronic conditions. The economic experience of those who are blind in both eyes is worse than those with less severe visual impairments but similar to those with other serious chronic conditions (e.g., paraplegia/hemiplegia/ quadriplegia, mental retardation, and cerebral palsy).

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

ACKNOWLEDGMENT

The author thanks Richard V. Burkhauser and Corrine Kirchner for their helpful comments.

REFERENCES

Burkhauser, R. V., Daly, M. C., & Houtenville, A. J. (2000). How working age people with disabilities fared over the 1990s business cycle. In P. P. Budetti, R. V. Burkhauser, J. M. Gregory, & H. A. Hunt (eds.), Ensuring health and income security for an aging workforce . Kalamazoo, MI: W.E. UpJohn Institute for Employment Research.


Fawcett, G. M. (1996). Living with disability in Canada: An economic portrait. Hull, Quebec: Human Resources Development Canada, Office for Disability Issues.


Kirchner, C., Schmeidler, E., & Todorov, A. (1999). Looking at employment through a lifespan telescope: Age, health, and employment status of people with serious visual impairment. New York, NY: American Foundation for the Blind (subcontractor to Rehabilitation Research and Training Center on Bindness and Low Vision, Mississippi State University).


Massey, J. T., Moore, T. F., Parsons, V. L., & Tadros, W. (1989). Design and estimation for the National Health Interview Survey, 1985-1994. (Report No. PHS 89-1384). Hyattsville, MD: U.S. Department of Health and Human Services.


Nagi, S. Z. (1965). Some conceptual issues in disability and rehabilitation. In M. B. Sussman (ed.), Sociology and rehabilitation. Washington, DC: American Sociological Association.


Trupin, L., Sebesta, D. S., Yelin, E., & LaPlante, M. P. (1997). Disability statistics report: Trends in labor force participation among persons with disabilities, 1983-1994. (Report No. 10). San Francisco, CA: Disability Statistics Rehabilitation Research and Training Center, Institute for Health and Aging, University of California.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Annex Table A-1 Prevalence Rates of Various Chronic Impairments, Diseases, and Disorders Among Noninstitutionalized Working-Age Civilians (Ages 25 to 61) Pooled Over 1983 Through 1996, by Sample and Gender

 

Group

Visual impairments

-Blind in both eyes

-Other visual impairments

Vision-related diseases/disorders

-Glaucoma

-Cataracts

-Color blindness

-Other vision-related diseases/disordersc

Other impairments

-Hearing impairments

—Deaf in both ears

—Other hearing impairments

-Mental retardation

-Paraplegia, hemiplegia, or quadriplegia

-Cerebral palsy

Note: Asterisks signify when the difference between the random sample and choice-based sample is statistically significant at the 99 percent (***), 95 percent (**), and 90 percent (*) levels. NA refers to groups where sample size is insufficient.

a In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Men

Women

Random Samplea

Choice-Based Samplea

Relative Prevalenceb

Random Samplea

Choice-Based Samplea

Relative Prevalenceb

4.89

0.57

0.12***

2.38

0.39

0.17***

0.17

0.10

0.60***

0.17

0.08

0.48***

4.71

0.47

0.10***

2.21

0.31

0.14***

4.16

0.31

0.08***

1.97

0.36

0.18***

0.50

0.09

0.17***

0.47

0.11

0.24***

0.62

0.10

0.16***

0.82

0.10

0.12***

2.68

0.02

0.01***

0.27

0.00

0.00***

0.48

0.12

0.25***

0.51

0.16

0.32***

 

10.75

1.14

0.11***

5.94

0.62

0.10***

0.53

0.08

0.15***

0.26

0.06

0.24***

10.22

1.06

0.10***

5.68

0.55

0.10***

0.46

0.35

0.76***

0.35

0.25

0.71***

0.20

0.16

0.81*

0.09

0.06

0.66**

0.11

0.07

0.64**

0.09

0.06

0.63**

about blindness. This one-sixth of the sample is a random sample because being asked about blindness is not dependent one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent one’s response (choice) to another question.

b The relative prevalence is the prevalence in the random sample divided by the prevalence in the choice-based sample.

c The category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Annex Table A-2a Sample Size of Noninstitutionalized Working-Age Civilian Men (Ages 25 to 61) in the Random Sample with Various Chronic Impairments, Diseases, and Disorders, 1983-1996

 

Year

Group

1983

1984

1985

1986

1987

1988

No visual impairments

3,652

3,599

3,130

2,128

4,344

4,281

Visual impairments

204

187

180

113

219

233

Blind in both eyes

2

5

4

3

8

11

Other visual impairments

202

182

176

110

211

222

Vision-related diseases/ disorders

184

148

150

93

219

193

Glaucoma

14

20

22

8

23

24

Cataracts

29

27

32

11

28

27

Color blindness

126

90

83

67

144

126

Other vision-related diseases/disordersa

19

16

17

8

28

26

Other impairments

Hearing impairments

454

412

389

237

494

483

Deaf in both ears

29

29

21

12

21

23

Other hearing impairments

425

383

368

225

473

460

Mental retardation

15

12

14

16

14

21

Paraplegia, hemiplegia, or quadriplegia

6

5

8

7

10

3

Cerebral palsy

3

6

1

5

3

6

Note: In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked about blindness. This one-sixth of the sample is a random sample because

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

 

1989

1990

1991

1992

1993

1994

1995

1996

Sum

4,146

4,270

4,225

4,569

3,945

4,255

3,709

2,341

52,594

194

205

218

257

220

217

188

108

2,743

1

10

9

11

5

12

8

6

95

193

195

209

246

215

205

180

102

2,648

149

165

171

218

184

193

176

95

2,338

17

20

26

26

22

31

15

16

284

29

23

27

39

24

25

33

16

370

90

109

103

147

123

118

109

56

1,491

18

19

20

22

21

25

25

9

273

 

421

491

442

558

465

485

409

235

5,975

17

19

14

36

16

31

23

10

301

404

472

428

522

449

454

386

225

5,674

16

29

21

20

18

19

24

12

251

3

7

5

9

13

12

8

10

106

2

6

3

5

4

4

5

4

57

being asked about blindness is not dependent on one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent on one’s response (choice) to another question.

a The category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Annex Table A-2b Sample Size of Noninstitutionalized Working-Age Civilian Men (Ages 25 to 61) in the Choice-Based Sample with Various Chronic Impairments, Diseases, and Disorders, 1983-1996

 

Year

Group

1983

1984

1985

1986

1987

1988

No visual impairments

19,018

19,154

16,561

11,286

22,453

22,731

Visual impairments

120

122

104

66

127

135

Blind in both eyes

27

16

20

11

18

22

Other visual impairments

93

106

84

55

109

113

Vision-related diseases/ disorders

87

58

61

30

51

71

Glaucoma

25

12

17

6

14

22

Cataracts

32

15

23

13

22

21

Color blindness

7

6

1

3

3

2

Other vision-related diseases/disordersa

27

25

24

11

12

29

Other impairments

Hearing impairments

100

87

74

50

116

107

Deaf in both ears

21

12

17

5

7

9

Other hearing impairments

79

75

57

45

109

98

Mental retardation

65

41

45

42

64

90

Paraplegia, hemiplegia, or quadriplegia

40

38

29

16

36

30

Cerebral palsy

12

14

10

6

10

10

Note: In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked about blindness. This one-sixth of the sample is a random sample because

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

1989

1990

1991

1992

1993

1994

1995

1996

Sum

21,553

22,469

22,502

23,771

20,743

21,864

19,118

12,175

275,398

109

126

130

171

135

123

111

63

1,642

19

25

28

33

22

25

18

10

294

90

101

102

138

113

98

93

53

1,348

69

69

76

122

63

62

68

32

919

22

19

26

34

23

17

21

5

263

23

22

17

52

15

17

14

9

295

1

3

6

12

2

3

7

2

58

25

30

29

32

26

27

29

17

343

 

93

2,278

103

118

90

104

76

55

3,451

12

81

11

13

15

11

12

7

233

81

2,197

92

105

75

93

64

48

3,218

67

82

75

109

96

78

77

54

985

33

29

30

35

40

36

34

21

447

17

19

23

19

18

18

16

5

197

being asked about blindness is not dependent on one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent on one’s response (choice) to another question.

a The category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-96.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Annex Table A-2c Sample Size of Noninstitutionalized Working-Age Civilian Women (Ages 25 to 61) in the Random Sample with Various Chronic Impairments, Diseases, and Disorders, 1983-1996a

 

Year

Group

1983

1984

1985

1986

1987

1988

No visual impairments

4,219

4,211

3,657

2,491

5,020

4,929

Visual impairments

118

89

81

65

146

121

Blind in both eyes

5

6

1

4

15

6

Other visual impairments

113

83

80

61

131

115

Vision-related diseases/ disorders

89

75

66

52

101

93

Glaucoma

15

14

21

9

29

25

Cataracts

30

32

30

23

33

44

Color blindness

12

9

4

9

13

11

Other vision-related diseases/disordersa

36

23

14

12

31

22

Other impairments

Hearing impairments

275

263

246

149

304

294

Deaf in both ears

23

11

10

10

18

10

Other hearing impairments

252

252

236

139

286

284

Mental retardation

9

13

6

9

15

15

Paraplegia, hemiplegia, or quadriplegia

1

10

2

3

2

7

Cerebral palsy

2

4

1

2

6

3

Note: In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked about blindness. This one-sixth of the sample is a random sample because

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

1989

1990

1991

1992

1993

1994

1995

1996

Sum

4,750

4,916

4,890

5,256

4,586

4,811

4,267

2,704

60,707

106

110

123

137

118

113

106

71

1,504

6

9

4

12

8

5

16

7

104

100

101

119

125

110

108

90

64

1,400

96

105

102

130

95

103

101

53

1,261

31

25

26

32

22

29

35

13

326

37

42

50

58

41

37

33

27

517

10

13

18

20

9

21

14

5

168

25

31

17

25

28

22

24

12

322

 

265

283

312

330

300

296

238

156

3,711

13

6

10

13

9

10

6

10

159

252

277

302

317

291

286

232

146

3,552

12

23

26

22

10

17

22

16

215

0

6

3

4

6

2

5

4

55

3

4

3

2

4

5

5

7

51

being asked about blindness is not dependent on one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent on one’s response (choice) to another question.

aThe category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

Annex Table A-2d Sample Size of Noninstitutionalized Working-Age Civilian Women (Ages 25 to 61) in the Choice-Based Sample with Various Chronic Impairments, Diseases, and Disorders, 1983-1996

 

Year

Group

1983

1984

1985

1986

1987

1988

No visual impairments

20,934

21,214

18,429

12,658

25,058

25,278

Visual impairments

91

100

85

47

99

84

Blind in both eyes

16

16

14

12

23

11

Other visual impairments

75

84

71

35

76

73

Vision-related diseases/ disorders

98

66

83

45

103

82

Glaucoma

31

17

23

15

39

22

Cataracts

36

22

28

16

28

27

Color blindness

0

0

0

0

0

0

Other vision-related Diseases/disordersa

34

29

37

20

47

39

Other impairments

Hearing impairments

63

58

63

33

77

60

Deaf in both ears

15

6

11

7

18

4

Other hearing impairments

48

52

52

26

59

56

Mental retardation

44

51

37

40

57

66

Paraplegia, hemiplegia, or quadriplegia

12

19

16

5

16

20

Cerebral palsy

8

12

9

5

14

13

Note: In the NHIS, conditions are determined in two ways. First, participants receive one of six condition lists that ask them if they have a specific condition (see Table A-1). Second, participants are asked broad questions to reveal general health and functioning (see Table A-2, top panel). If participants reveal they have health or functioning difficulties, they are then asked what conditions cause these difficulties (see Table A-2, bottom panel). This method misses those with conditions who have no such difficulties, while the first method captures those with conditions that have no health or functioning difficulties. So only one-sixth of the sample is directly asked about blindness. This one-sixth of the sample is a random sample because

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×

 

1989

1990

1991

1992

1993

1994

1995

1996

Sum

24,070

25,056

25,039

26,326

22,980

24,308

21,317

13,300

305,967

94

88

97

133

100

114

88

56

1,276

16

20

17

30

24

25

22

15

261

78

68

80

103

76

89

66

41

1,015

82

93

76

121

82

70

66

50

1,117

27

35

30

40

23

25

31

17

375

27

23

18

47

20

11

10

6

319

0

0

0

2

0

0

0

0

2

36

38

31

39

41

36

27

29

483

 

84

1,150

62

95

87

82

76

38

2,028

11

36

12

22

14

14

13

10

193

73

1,114

50

73

73

68

63

28

1,835

75

66

52

76

66

64

55

38

787

14

15

20

24

7

13

13

8

202

11

17

14

15

17

20

14

7

176

being asked about blindness is not dependent on one’s response to another question. The remaining five-sixths of the sample is choice-based because revealing blindness is dependent on one’s response (choice) to another question.

aThe category other includes conjunctivitis, disorders of the lacrimal system, disorders of binocular eye movements, and diseases of the retina.

Source: Author’s calculations using the National Health Interview Survey, 1983-1996.

Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 275
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 276
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 277
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 278
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 279
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 280
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 281
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 282
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 283
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 284
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 285
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 286
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 287
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 288
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 289
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 290
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 291
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 292
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 293
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 294
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 295
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 296
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 297
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 298
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 299
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 300
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 301
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 302
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 303
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 304
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 305
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 306
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 307
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 308
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 309
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 310
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 311
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 312
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 313
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 314
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 315
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 316
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 317
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 318
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 319
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 320
Suggested Citation:"Appendix A: Employment and Economic Consequences of Visual Impairment." National Research Council. 2002. Visual Impairments: Determining Eligibility for Social Security Benefits. Washington, DC: The National Academies Press. doi: 10.17226/10320.
×
Page 321
Next: Appendix B: Public Forum on Visual Disability Determination Methods and Issues »
Visual Impairments: Determining Eligibility for Social Security Benefits Get This Book
×
Buy Paperback | $67.00 Buy Ebook | $54.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

When children and adults apply for disability benefits and claim that a visual impairment has limited their ability to function, the U.S. Social Security Administration (SSA) is required to determine their eligibility. To ensure that these determinations are made fairly and consistently, SSA has developed criteria for eligibility and a process for assessing each claimant against the criteria. Visual Impairments: Determining Eligibility for Social Security Benefits examines SSA's methods of determining disability for people with visual impairments, recommends changes that could be made now to improve the process and the outcomes, and identifies research needed to develop improved methods for the future. The report assesses tests of visual function, including visual acuity and visual fields whether visual impairments could be measured directly through visual task performance or other means of assessing disability. These other means include job analysis databases, which include information on the importance of vision to job tasks or skills, and measures of health-related quality of life, which take a person-centered approach to assessing visual function testing of infants and children, which differs in important ways from standard adult tests.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!