Skip to content
GSS > Policy and guidance hub > Impairment

Impairment

Policy details

Metadata item Details
Publication date:1 May 2019
Author:William Perks
Approver:Harmonisation
Who this is for:Members of the Government Statistical Service
Contact:

william.perks@ons.gov.uk

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

The Harmonisation team reviewed this principle with stakeholders in February 2019 and concluded that no updates are needed.

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

Impairments associated with any long-lasting physical or mental health conditions or illnesses reported above (Standard version)

One question designed to provide a measure of impairment and co-impairment for use in social surveys and suitable for data collection using Computer Assisted Personal interviewing (CAPI) and Computer Assisted Telephone Interviewing (CATI). This question should not be used in paper-based and online self-completion forms until further testing has been completed.

The purpose of this question is to add detail; whether the reported health condition or illness affects functioning in specified areas. There is a deliberate distinction drawn here between impairments and specific health conditions, illnesses or diseases: This question focuses on the capture of impairment, not the type of health condition By ‘impairment’ we mean the functions that the individual cannot either perform or has difficulty performing because of their health condition (for example, glaucoma is a condition, being unable to see or being partially sighted is an impairment). These categories enable the outcomes for disabled people to be disaggregated by impairment type.

This question collects data using a show card which the interviewer reads out before handing it to the respondent to select which categories apply. There are 9 substantive categories and a free text category to record other impairments not included on the list. Up to 10 categories can be coded.

 

To ask respondents who are aged 16 and over, proxy for those under 16 and those not fit to respond and responds ‘yes’ to question on any long-lasting physical or mental health conditions or illnesses.

 

Do any of these conditions or illnesses affect you in any of the following areas?

Show card

  1. Vision (for example blindness or partial sight)
  2. Hearing (for example deafness or partial hearing)
  3. Mobility (for example walking short distances or climbing stairs)
  4. Dexterity (for example lifting and carrying objects, using a keyboard)
  5. Learning or understanding or concentrating
  6. Memory
  7. Mental health
  8. Stamina or breathing or fatigue
  9. Socially or behaviourally (for example associated with autism, attention deficit disorder or Asperger’s syndrome)
  1. Other (please specify)

Spontaneous only:

  1. None of the above
  2. Refusal

Interviewer note:

The purpose of this question is to establish the type of impairment(s) you experience currently as a result of your health condition or illness. In answering this question, you should consider whether you are affected in any of these areas whilst receiving any treatment or medication or using devices to help you such as a hearing aid for example.

Guidance can be given regarding the category response or responses where clarification is requested. Respondents can select as many responses that apply to them. Interviewers should steer respondents to using the pre-defined categories wherever possible, and avoid collecting precise conditions such as obstructive pulmonary disease, which would code to the category stamina or breathing or fatigue.

Spontaneous responses should not appear on the show card, but refusals or a response that none of the categories apply should be coded.

If respondents are too ill to respond on their own behalf, and if present, proxy responses from a family member or friend can be recorded. For those not able to speak English, translators should be used to assist with the data collection.

This is an additional question, not intended to replace existing questions.

Impairments associated with any long-lasting physical or mental health conditions or illnesses, whether reported in the previous question or not (Optional alternative version)

One question designed to provide a measure of impairment and co-impairment for use in social surveys and suitable for data collection using CAPI and CATI. This question should not be used in paper-based and online self completion forms until further testing has been completed.

The question collects data using a show card which the interviewer reads out to the respondent before handing it to them to select which categories apply. There are 9 substantive categories, a free text category to record other impairments not included on the list, and a category to code no impairment. Up to 10 categories can be coded.

Do you have any health conditions or illnesses which affect you in any of the following areas?

Show card and code all that apply asking the respondent to read out which apply to him\her:

  1. Vision (for example blindness or partial sight)
  2. Hearing (for example deafness or partial hearing)
  3. Mobility (for example walking short distances or climbing stairs)
  4. Dexterity (for example lifting and carrying objects, using a keyboard)
  5. Learning or understanding or concentrating
  6. Memory
  7. Mental health
  8. Stamina or breathing or fatigue
  9. Socially or behaviourally (for example associated with autism, attention deficit disorder or Asperger’s syndrome)
  10. Other (please specify)
  11. None of the above

Spontaneous only:

  1. Refusal

Interviewer note:

The purpose of this question is to ask you about any impairment(s) you have. In answering this question, you should consider whether you are affected in any of these areas whilst receiving any treatment or medication or using devices to help you such as a hearing aid for example.

Guidance can be given regarding the category response or responses where clarification is requested. Respondents can select as many responses that apply to them. Interviewers should steer respondents to using

the pre-defined categories wherever possible, and avoid collecting precise conditions such as obstructive pulmonary disease, which would code to the category stamina or breathing or fatigue.

A spontaneous response of refusal should not appear on the show card but should be coded.

If respondents are too ill to respond on their own behalf, and if present, proxy responses from a family member or friend can be recorded. For those not able to speak English, translators should be used to assist with the data collection.

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

The following table shows the output categories for impairments. Coding of these categories should comply with the specific coding conventions applied in the specific survey source. ONS is not prescribing a code but an example is given in the table. These data are independent and therefore more than one category can apply to a record, up to a maximum of 10. Data output files will need 10 variables to cover this item, 9 numeric and 1 string free text variable up to 255 characters in length.

Suggested variable names: IMPCAT_1 THRU IMPCAT_10

Do any of these conditions or illnesses affect you in any of the following areas ? Example Code
Nominal scale
Has a Vision impairment Numeric 1
Has a Hearing impairment Numeric 2
Has a Mobility impairment Numeric 3
Has a dexterity impairment Numeric 4
Has a Learning impairment Numeric 5
Has a Memory impairment Numeric 6
Has a Mental Health impairment Numeric 7
Has a Stamina, Breathing or Fatigue impairment Numeric 8
Has a Developmental impairment Numeric 9
Text
Has other type of impairment String (255)
Nominal scale
None of the above -8
Refusal -9

 

Output categories: Impairments (alternative version)

The following table shows the output categories for impairments using the alternative version for comprehensive sample coverage. Coding of these categories should comply with the specific coding conventions applied in the specific survey source. ONS is not prescribing a code but an example is given in the table. These data are independent and therefore more than one category can apply to a record, up to a maximum of 10. Data output files will need 11 variables to cover this item, 10 numerical and 1 string free text variable up to 255 characters in length. A code of ‘None of the above’ in the alternative version is a substantive category.

Suggested variable names: IMPCAT_1 THRU IMPCAT_11

 

Do you have any health conditions or illnesses which affect you in any of the following areas? Example Code
Nominal scale
Has a Vision impairment Numeric 1
Has a Hearing impairment Numeric 2
Has a Mobility impairment Numeric 3
Has a Dexterity impairment Numeric 4
Has a Learning impairment Numeric 5
Has a Memory impairment Numeric 6
Has a Mental Health impairment Numeric 7
Has a Stamina, Breathing or Fatigue impairment Numeric 8
Has a Developmental impairment Numeric 9
Text
Has other type of impairment String 255
Nominal Scale
None of the Above Numeric 10
Refusal Numeric -9

The harmonised principles are designed to be consistent with a conceptual framework of disability that encompasses medical, individual and societal factors as documented in the International Classification of Functioning (ICF), the World Health Organisation’s definition of disability and the disablement process.

This approach is consistent with the collection of traditional data on activity restriction, long-standing illness and impairment, as well as data on the importance of aspects of society which restrict the participation of people with impairments relative to those without impairments.

The GSS Harmonised Principles applies to the collection of data on health conditions or illnesses of a long-lasting nature (see separate principle), the type of impairment associated with the condition(s), and the impact on day-to-day activities. It also covers the data inputs and outputs to measure participation in key areas of life and the importance of social barriers, such as building design and transport inadequacies, affecting participation differentially among people who either have impairments or do not.

This principle takes account of the needs of national and European administrations for data continuity and the definitions and guidelines contained in UK and EU legislation, including the Equality Act and the EU-SILC regulation. The questions are intended as a suite, not all of which has to be used in every situation.

The usefulness of collecting information on the type of impairment was emphasised in consultations and harmonisation group deliberations as it fits the ICF framework and disablement process and enables the identification of the type of functional deficit experienced by the person reporting a long-lasting health condition or illness, for example a mobility deficit.

The prescribed sample coverage for this principle is to restrict coverage to those reporting a long-lasting health condition or illness, approximately a third of the sampled population. Stage 1 field testing had shown that while the prevalence of impairment itself is somewhat lower in the routed sample, there was no evidence of a knock-on effect for measures of activity restriction (that is disability), suggesting the additional impairments captured by non-routeing are not associated with activity restriction. As it is the impaired population with activity restriction that is the most useful for policy, the additional costs incurred by administrating the impairment question across the whole sample is unjustified. However, for those wanting to capture impairment comprehensively, an alternative version of this question is available for use which excludes routeing.

The content of the independent category list of this question made reference to a number of sources including the DDA list of capacities used to estimate the population prevalence of disability for FRS publications, the Scottish Health Conditions 2011 Census question and the impairment categories captured on the Life Opportunities Survey. While the DDA had specified a list of capacities for disability classification purposes, the Equality Act, which replaces it, does not, which provided greater flexibility in what to include.

The stages 1 and 2 field test findings and further consultation with stakeholders refined this list further:

  1. the addition of the word ‘Fatigue’ to the ‘Stamina and Breathing’ category
  2. the expansion of the mobility category into a mobility-specific category, which encompasses an ability to walk short distances and climb stairs; and a dexterity category, which involves moving and carrying objects and using work related devices such as a keyboard.

The latter change improves consistency with the Life Opportunities Survey categories and takes account of the different policy needs presented by mobility and dexterity impairment for care and fitness for work.

This version is for those surveys wanting to capture impairment type among the general population with or without a long-lasting physical or mental health condition or illness. This is to mitigate any perceived risk of under-reporting of impairment because the respondent does not believe they have a long-lasting physical or mental health condition or illness, but does have an impairment to achieve this differing need, the routeing rule is dispensed with; but this will add to survey costs and the evidence from field testing suggests it is unnecessary.

The Equalities Data Review, published in 2007 identified a need to improve the co-ordination, comparability, quality, accessibility and presentation of disability statistics through developing and applying a principled approach to data collection and its propagation. ONS and ODI were tasked to develop harmonised principles to meet this need and began deliberating in 2008 to this end. The objectives of the project were to:

  1. establish a conceptual framework for disability definition
  2. develop questions to measure disability in accordance with the definitions
  3. test the performance of these questions in terms of interpretability and coherence with established sources
  4. recommend an implementation across social survey sources to harmonise data collection and the presentation of disability statistics.

Review frequency:

This guidance is reviewed every two years.

Updates

Date Changes
1 May 2019

The Harmonisation team reviewed this principle with stakeholders in February 2019 and concluded that no updates are needed.

Documents

File

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

Download