Limits...
Using GIS in a first national mapping of functional disability among older American Indians and Alaska Natives from the 2000 census.

Moss MP, Schell MC, Goins RT - Int J Health Geogr (2006)

Bottom Line: The significance of this study is that gerontologic programs and policies are data-driven, yet there is a lack of reliable national level data from US health systems on functional disability among American Indians and Alaska Natives.One study limitation was that Census questions regarding disability differed from traditional measures of activities of daily living and instrumental activities of daily living.An immediate policy recommendation would be to incorporate standard activities of daily living and instrumental activities of daily living language into future Census for a comprehensive, linked database for the future.

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Minnesota, School of Nursing, 308 Harvard Street, 6-138 Weaver-Densford Hall, Minneapolis, MN 55455, USA. mossx015@umn.edu

ABSTRACT

Background: Geographical information systems (GIS) have been used mainly in understanding infectious diseases and environmental threats in health research. Here, GIS was used to examine patterns of functional disability as one impact of chronic disease in American Indians and Alaska Natives. The study purpose was to create the first national mapping of functional disability for AIANs using the 2000 U.S. Census.

Results: American Indians and Alaska Natives over age 65 reported disability at a rate of 57.6% versus 41.9% for all people over 65 (P < or = 0.0001). Regional differences in levels and type of disability were evident.

Conclusion: Maps help visualize those who might otherwise be 'lost' from the data. The significance of this study is that gerontologic programs and policies are data-driven, yet there is a lack of reliable national level data from US health systems on functional disability among American Indians and Alaska Natives. One study limitation was that Census questions regarding disability differed from traditional measures of activities of daily living and instrumental activities of daily living. An immediate policy recommendation would be to incorporate standard activities of daily living and instrumental activities of daily living language into future Census for a comprehensive, linked database for the future.

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Geographic distribution of disability among AIANs 65 years and older showing urban vs. rural differences.
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Figure 5: Geographic distribution of disability among AIANs 65 years and older showing urban vs. rural differences.

Mentions: In the Census questionnaire, ADL targeted queries are worded differently than are standard ADL and IADL items. Standard ADL items often ask whether the participant needs no assistance, some assistance, or complete assistance with the standard measures of walking, bathing, etc. The U.S Census uses "yes" and "no" as the choices for whether one experiences functional limitations. According to McBride, one or more ADL limitations are disabling and two or more are severely disabling [30]. One limitation of census disability data is that it reports counts of each disability within a unit of geography, so it is not possible to determine whether the same individual is appearing in the same counts. It is therefore not possible to address issues related to more than one disability. However, the census data does include one derived disability count, which is the total number of individuals responding affirmatively to any one or more of the disability questions. This derived count is utilized in Figures 2 and 5 of the analysis.


Using GIS in a first national mapping of functional disability among older American Indians and Alaska Natives from the 2000 census.

Moss MP, Schell MC, Goins RT - Int J Health Geogr (2006)

Geographic distribution of disability among AIANs 65 years and older showing urban vs. rural differences.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1590018&req=5

Figure 5: Geographic distribution of disability among AIANs 65 years and older showing urban vs. rural differences.
Mentions: In the Census questionnaire, ADL targeted queries are worded differently than are standard ADL and IADL items. Standard ADL items often ask whether the participant needs no assistance, some assistance, or complete assistance with the standard measures of walking, bathing, etc. The U.S Census uses "yes" and "no" as the choices for whether one experiences functional limitations. According to McBride, one or more ADL limitations are disabling and two or more are severely disabling [30]. One limitation of census disability data is that it reports counts of each disability within a unit of geography, so it is not possible to determine whether the same individual is appearing in the same counts. It is therefore not possible to address issues related to more than one disability. However, the census data does include one derived disability count, which is the total number of individuals responding affirmatively to any one or more of the disability questions. This derived count is utilized in Figures 2 and 5 of the analysis.

Bottom Line: The significance of this study is that gerontologic programs and policies are data-driven, yet there is a lack of reliable national level data from US health systems on functional disability among American Indians and Alaska Natives.One study limitation was that Census questions regarding disability differed from traditional measures of activities of daily living and instrumental activities of daily living.An immediate policy recommendation would be to incorporate standard activities of daily living and instrumental activities of daily living language into future Census for a comprehensive, linked database for the future.

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Minnesota, School of Nursing, 308 Harvard Street, 6-138 Weaver-Densford Hall, Minneapolis, MN 55455, USA. mossx015@umn.edu

ABSTRACT

Background: Geographical information systems (GIS) have been used mainly in understanding infectious diseases and environmental threats in health research. Here, GIS was used to examine patterns of functional disability as one impact of chronic disease in American Indians and Alaska Natives. The study purpose was to create the first national mapping of functional disability for AIANs using the 2000 U.S. Census.

Results: American Indians and Alaska Natives over age 65 reported disability at a rate of 57.6% versus 41.9% for all people over 65 (P < or = 0.0001). Regional differences in levels and type of disability were evident.

Conclusion: Maps help visualize those who might otherwise be 'lost' from the data. The significance of this study is that gerontologic programs and policies are data-driven, yet there is a lack of reliable national level data from US health systems on functional disability among American Indians and Alaska Natives. One study limitation was that Census questions regarding disability differed from traditional measures of activities of daily living and instrumental activities of daily living. An immediate policy recommendation would be to incorporate standard activities of daily living and instrumental activities of daily living language into future Census for a comprehensive, linked database for the future.

Show MeSH
Related in: MedlinePlus