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GSS > Policy Store Items > Activity restriction

Activity restriction

The following guidance sets out how to collect and report statistics about activity restriction to ensure statistics about this topic are as comparable as possible across the Government Statistical Service (GSS).

Questions

This section provides guidance on the survey questions to use when collecting information about activity restriction.

Does your condition or illness/do any of your conditions or illnesses reduce your ability to carry-out day-to-day activities?

  1. Yes, a lot
  2. Yes, a little
  3. Not at all

 

Interviewer Instructions:

  • To be asked to all respondents aged 16 and over, those asked by proxy if under 16 and those asked by proxy if not fit to respond who: responds ‘yes’ to question about any long-lasting physical or mental health conditions or illnesses.
  • As an introduction to the question, the interviewer should state – This question asks about whether your health condition or illness currently affects your ability to carry-out normal day-to-day activities, either a lot or a little or not at all. In answering this question, you should consider whether you are affected whilst receiving any treatment or medication for your condition or illness and/or using any devices such as a hearing aid, for example.
  • Normal day to day activities can include; washing and dressing, household cleaning, cooking, shopping for essentials, using public or private transport, walking a defined distance, climbing stairs, remembering to pay bills, and lifting objects from the ground or a work surface in the kitchen, moderate manual tasks such as gardening, gripping objects such as cutlery and hearing and speaking in a noisy room.
  • The respondents should answer on the basis of their current extent of activity restriction, taking account of any treatment, medication or other devices such as a hearing aid they may receive or use.

 

Family Resource Survey

Does this physical or mental illness or disability (Do any of these physical or mental illnesses or disabilities) limit your activities in any way?

  1. Yes
  2. No

 

Does this/Do these health problem(s) or disability(ies) mean that you have substantial difficulties with any of these areas of your life?

  1. Moving                   Mobility (moving about)
  2. Lifting                     Lifting, carrying or moving objects
  3. Hands                     Manual dexterity (using your hands to carry out everyday tasks)
  4. Bladder                   Continence (bladder and bowel control)
  5. Speech                   Communication (speech, hearing or eyesight)
  6. Learn                      Memory or ability to concentrate, learn or understand
  7. Danger                    Recognising when you are in physical danger
  8. Balance                  Your physical co-ordination (eg: balance)
  9. Other                      Other health problem or disability
  10. None                     None of these

 

Annual Population Survey

Do these health problems or disabilities, when taken singly or together, substantially limit your ability to carry out normal day to day activities? If you are receiving medication or treatment, please consider what the situation would be without the medication or treatment.

  1. Yes
  2. No

 

Integrated Household Survey (general lifestyle module)/ Continuous Household Survey/ Health Survey for England 

Does this illness or disability (Do any of these illnesses or disabilities) limit your activities in any way?

  1. Yes
  2. No

 

Would you say your activities are limited or strongly limited?

  1. Limited
  2. Strongly limited

 

Does this illness or disability limit your activities in any way?

  1. Yes
  2. No

 

Life Opportunities Survey

Does this/Do these health problem(s) or disability(ies) mean that you have substantial difficulties with any of these areas of your life?

  1. Moving                   Mobility (moving about)
  2. Lifting                     Lifting, carrying or moving objects
  3. Hands                     Manual dexterity (using your hands to carry out everyday tasks)
  4. Bladder                   Continence (bladder and bowel control)
  5. Speech                   Communication (speech, hearing or eyesight)
  6. Learn                      Memory or ability to concentrate, learn or understand
  7. Danger                    Recognising when you are in physical danger
  8. Balance                  Your physical co-ordination (eg: balance)
  9. Other                      Other health problem or disability
  10. None                     None of these

 

Interviewer Instructions:

  • To be asked to all respondents aged 16 and over, those asked by proxy if under 16 and those asked by proxy if not fit to respond who:
  • responds ‘yes’ to question about any long-lasting physical or mental health conditions or illnesses and responds ‘yes, a lot’ or ‘yes, a little’ to the activity restriction question.

 

For how long has your ability to carry-out day-to-day activities been reduced?

  1. Less than six months
  2. Between six months and 12 months
  3. 12 months or more

 

Presentation of outputs

This section provides guidance for outputting the survey questions to use when collecting information about activity restriction.

  • Restriction (limitation) carrying out normal day to day activities

The following table shows the output categories for activity restriction:

Suggested variable name: REDACT

Does your condition or illness/do any of your conditions or illnesses reduce your ability to carry-out day-to-day activities? Example Code      
Nominal scale
Yes, a lot Numeric 1
Yes, a little Numeric 2
No, not at all Numeric 3
Equality Act: Core currently disabled population 1 or 2
Equality Act: Not core currently disabled 3
EU-SILC: Not severely hampered in daily activities 3
EU-SILC: Not hampered in daily activities to some extent 3

  • Duration of restriction (limitation) carrying out normal day to day activities

The following table shows the output categories for duration of activity restriction:

Suggested variable name: DURREDACT

For how long has your ability to carry-out day-to-day activities been reduced? Example Code
Nominal scale
Less than 6 months Numeric 1
Between six months and 12 months Numeric 2
12 months or more Numeric 3
EU-SILC: Severely hampered in daily activities 2 OR 3 AND REDACT 1
EU-SILC Hampered in daily activities to some extent 2 OR 3 AND REDACT 2
EU-SILC Not severely hampered in daily activities 1
EU-SILC Not hampered in daily activities to some extent 1

The purpose of capturing information on restriction carrying-out day-to-day activities is to enable the operationalisation of the core definition of currently disabled people made statute in the Equality Act 2010; but also have functionality to capture data required by the European Union’s Statistics on Income and Living Conditions (EU-SILC).

The Equality Act generally defines a disabled person as someone who has a physical or mental health condition or impairment that has a substantial and long-term adverse effect on the person’s ability to carry out normal day-to-day activities. This differs from the definition previously stipulated in the Disability Discrimination Act 1995, which also required the disabled person to show that their normal day-to-day activities produced a substantial adverse effect in one or more of one specified capacities such as mobility, speech, or memory. The current EU-SILC regulation variable guideline requires capturing data on limitation carrying-out daily activities people usually do for the past six months by extent of limitation.

The term ‘day-to-day activities’ was generally taken by respondents to refer to routine activities; cooking, shopping, dressing, bathing and gardening, difficulty crossing the road, lifting items above the head and walking a defined distance were some of the functional difficulties identified in cognitive testing.

The capture of the extent to which daily activities are affected was deemed beneficial in consultations; but required testing to examine any relationship with the term substantial used in the Equality Act and the term ‘severely’ limited used in the European Health Interview Survey which the EU-SILC data were required to harmonise with. The use of the responses categories ‘limited a lot’ and ‘limited a little’ in the Census 2011 question on disability and the preference for response categories containing the plain English terms ‘a lot’ and ‘a little’ was adopted in the field testing of these questions.

It was also agreed that activity restriction would only be captured among the sub-sample of respondents with a physical or mental health condition or illness lasting or expected to last a year or more, to ensure compatibility with the Equality Act definition.

Field testing of this question had three principal objectives:

a) To establish the level of coherence with other data sources capturing similar data

b) To determine the relationship between the terms ‘substantial long-term effect’ used in the FRS and LOS, ‘limited’ and ‘strongly limited’ used in the GLF, ‘limited a lot’ and ‘limited a little’ used in the Census 2011 question, and the terms ‘a lot’ of reduced ability and ‘a little’ reduced ability used in the field test question.

c) To assess whether the prevalence of activity restriction is artefactually inflated by capturing extent compared with simple dichotomised responses of ‘Yes’ or ‘No’.

Two questions providing a measure of restriction carrying-out day-to-day activities by extent and duration. These can be used in social surveys and suitable for data collection using CAPI, CATI. These questions can also be used with paper-based and online self-completion forms too.

These can be used to establish whether a person with a long-lasting physical or mental health condition or illness is restricted in carrying-out normal day-to-day activities.

There was a good level of agreement between the estimate derived from the FRS criterion of substantial difficulty in one or more capacity domains and the estimates from both the field test conflated categories of ‘Yes, a lot’ or ‘Yes, a little’ reduced ability carrying-out day-to-day activities and the field tested 2011 Census question’s conflated categories of ‘Yes, limited a lot’ and ‘Yes, limited a little’. This suggests the term ‘substantial’ concurs with the combined plain English response categories used in the harmonised question and the 2011 Census question. Table 1 shows the comparative prevalence calculated from each external source together with the field test stage 2 estimates.

Table 1 Per Cent prevalence of activity restriction by extent, persons aged 16 years and over

Source Per Cent
Field test harmonised principle question – Opinions 2010
Does your condition or illness\do any of your conditions or illnesses reduce your ability to carry-out day-to-day activities
‘Yes a lot’ or ‘Yes a little’?
21.9
‘Yes, a lot’ 10.3
‘Yes, a little’ 11.7
FRS question – 2008–09
Does this\do these health problems or disabilities mean that you have substantial difficulties with any of these areas of your life? Mobility; lifting; manual dexterity; continence; communication; memory, concentrate, understand or learn; physical danger; balance; other
21.4
FRS question – 2009–10
Does this\do these health problems or disabilities mean that you have substantial difficulties with any of these areas of your life? Mobility; lifting; manual dexterity; continence; communication; memory, concentrate, understand or learn; physical danger; balance; other
21.3
LOS question 2009–10 interim results
Does this\do these health problems or disabilities mean that you have substantial difficulties with any of these areas of your life? Mobility; lifting; manual dexterity; continence; communication; memory, concentrate, understand or learn; physical danger; balance; other
25.9
GLF question 2009
Does this illness(es) or disability(ies) limit your activities in any way?
Limited or strongly limited
21.2
Strongly limited 8.7
Field Test of 2011 Census question – Opinions 2010
Are your day-to-day activities limited because of a health problem or disability which has lasted or is expected to last 12 months or more
Yes, limited a lot or yes limited a little
21.9
Yes, limited a lot 10.7
Yes, limited a little 11.2

The term ‘strongly limited’ asked in the 2009 GLF question is lower than both the field test question and Census 2011 question estimates of ‘Yes, (limited) a lot’ by 1.2 percentage points. The GLF currently supplies estimates of the UK’s prevalence of ‘severely hampered in daily activities’ used in the EU-SILC data tables available on the Eurostat website:

http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_silc_12&lang=en.

There was no evidence in the field testing that the capture of extent produced an artefactual inflation in prevalence by conflating extent categories compared with questions using dichotomised ‘Yes’ or ‘No’ responses.

The need for a follow-up question which captured duration for use in a classification of disability was deemed beneficial to improve compliance with the EU-SILC variable concept. The following categories were tested: ‘less than six months’, ‘between 6 months and 12 months’, and ‘12 months or more’.

The field test results demonstrated the effect of using the duration filter question to classify a case of disability is to reduce prevalence estimates; a 12-month or more time filter reduced prevalence of activity restriction to 18.8 per cent, while a 6 month or more time filter reduced prevalence to 20.7 per cent. Consequently, the application of this filter for use in the UK Equality Act classification will cause a discontinuity from FRS estimates and additionally be incoherent with the Census 2011 question. However, it will provide a conservative estimate of Equality Act disability.

However, application of the time filter improves comparability with EU-SILC historical estimates; the estimate of ‘severely hampered in daily activities’ using the field test question’s category ‘Yes, a lot’ and filtering using the categories between 6 months and 12 months and 12 months or more is 9.9 per cent, while the estimate of ‘hampered in daily activities to some extent’ using the field test question’s category ‘Yes, a little’ and the same duration categories is 11.0 per cent, which compares favourably with the UK estimates published on the Eurostat website for 2009.

Table 2 shows the estimates derived from the harmonised principle questions in the field test with those currently published on the Eurostat website for the UK in 2009.

 

Table 2 EU-SILC derived and published disability: per cent prevalence, persons aged 16 years and over

Source Per Cent 95% confidence limits
Field test question – Opinions 2010
For how long has your ability to carry-out day-to-day activities been reduced?
Less than six months or between 6 and 12 months or 12 months or more
21.9 20.0 – 23.9
Less than six months 1.3 0.7 – 1.8
Between 6 months and 12 months 1.8 1.2 – 2.5
12 months or more 18.8 17.0 – 20.7
Revised EU-SILC estimate taking account of duration 20.7 18.8 – 22.6
Revised EU-SILC estimate of ‘Severely hampered in daily activities’ using the activity restriction category ‘Yes, a Lot’ and the duration categories ‘between six months and 12 months’ and ‘12 months or more’ 9.9 8.5–11.3
Revised EU-SILC estimate of ‘Hampered in daily activities to some extent’ using the activity restriction category ‘Yes, a little’ and the duration categories ‘between six months and 12 months’ and ’12 months or more’ 10.8 9.3–12.2
EU-SILC 2009 estimate on Eurostat website – conflated categories ‘Severely hampered in daily activities’ and ‘Hampered in daily activities to some extent’ 20.8
EU-SILC 2009 estimate on Eurostat website – ‘Severely hampered in daily activities’ 9.1
EU-SILC 2009 estimate on Eurostat website – ‘Hampered in daily activities to some extent’ 11.7

Sources: ONS Opinions Survey 2010; Eurostat

Further information on the field testing of these questions can be found in the field test reports which will be published on the ONS website during the autumn 2011, and links to these reports will be added to this document following their publication.

 

Further information on the harmonisation project can be accessed in two Health Statistics Quarterly articles published in Issue 51 in August 2011.

Documents

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Activity restriction, Impairment and Long lasting illness (PDF , 0.21MB)

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