Disability Studies Quarterly
Summer 2005, Volume 25, No. 3
<www.dsq-sds.org>
Copyright 2005 by the Society
for Disability Studies


BOOK & FILM REVIEWS

Barbara Altman, Sharon Barnartt, Gerry Hendershot and Sheryl Larson. (Editors). Using Survey Data to Study Disability: Results from the National Health Interview Survey on Disability, Volume 3. London: Elsevier, 2003. 362 pages, hardcover, $79, 0762310073.

Reviewed by Linda Long, Brandeis University

Using Survey Data to Study Disability: Results from the National Health Interview Survey on Disability is the third volume in the Research in Social Science and Disability Series published by Elsevier Books, edited by Barbara Altman and Sharon Barnartt. Other volumes have focused on broad topics such as the scope of social sciences research on disability, methodology and theory. With the assistance of guest editors Gerry Hendershot and Sheryl Larson, this book, focused as it is on a particular data set, brings life to some of the issues raised in these earlier volumes.

The chapters are based largely on papers first presented at a conference held on the National Health Interview Survey on Disability (NHIS-D) in June of 2000. The NHIS-D was designed to provide data on a wide array of topics and to permit analysis through a variety of lenses and, to a large extent, that breadth is reflected in this volume. In addition, the editors strike a good balance between a focus on methodology, which is particularly important in dealing with such a large and complicated data set, and content. This volume will be of significant value both to researchers who are grappling with the data set's complexities and to consumers of research who want to better understand the prevalence and correlates of disability in the U.S. population.

The book opens with Altman and Barnartt's thoughtful discussion of the issues that arise when a data set is designed to permit researchers to use multiple and sometimes even inconsistent definitions of disability to address disparate policy objectives. In the chapter that follows, Henderson, Larson, and Lakin echo that theme and provide a brief history of the events leading to the creation of the NHIS-D, along with a concise and illuminating description of its design and implementation. They describe the complexities of the design and issues such as weighting and sampling error with unusual clarity. They also explain how various aspects of implementation ultimately affected issues like interviewing error and sample size. Particularly interesting was the discussion of the disability awareness training that NHIS-D interviewers received, but, the authors note, could not recall a year later, thereby raising questions about their effectiveness. Details such as these sound an important note of caution for researchers using this data set and require their close attention.

The book is then organized into four sections, the first centering on methodological issues. Issues surrounding non-response and, particularly, proxy response are of particular interest to disability researchers and are dealt with quite effectively in the chapter by Henderson, Colpe, and Peter Hunt. This chapter is followed by Fedeyko and Lollar's innovative attempt to apply the International Classification of Functioning (ICF) to this data set. For those interested in issues pertaining to children with disabilities and their families, Witt, Riley and Kasper offer a very helpful chapter outlining an algorithm for linking children to their mothers when this data is otherwise missing.

The book's second section focuses on issues related to work and health among adults with disabilities, one of the most pressing issues in the fields of disability research and policy today. The opening chapter by Loprest and Maag centers on barriers to work for adults with disabilities, particularly job-search and workplace accommodations. Although the result is a smaller sample size, the authors employ a well-reasoned approach to defining their study sample of "work-oriented" adults with disabilities. Their discussion of the need for workplace accommodations, which focuses on the importance of worksite features such as a modified work stations, is very good and would have been even better had they delved more deeply into issues regarding the second-most cited accommodation needed, special work arrangements.

The other two chapters in this section deal with health care related concerns, including a chapter by Jones and Beatty on the use of preventive services among working age-adults with disabilities. Iezzoni, et al. paints a vivid portrait of the health access and insurance status of people with disabilities. As the authors note, public policy changes since the mid-1990s may have altered some aspects of this portrait in the interim, but many of the findings may still ring true. In those areas potentially subject to change, e.g. the use of preexisting condition exclusions in insurance policies, Iezzoni et al.'s findings offer a basis for comparison should similar data become available, thereby presenting a rare opportunity to examine the impact of public policy.

Section 3 of this volume is headed "Development Disabilities" and contains two chapters exploring children's issues. The first chapter by Maag addresses the unmet need for supportive services among children by disability type. A similar chapter on unmet need for supportive services among adults would have been a welcome addition to this volume. The second chapter by Hogan, Park, and Goldscheider focuses on the health status of siblings of children with disabilities, an oft-overlooked population. Amanda Honeycutt, et al. perform an economic analysis of the costs of specific early-onset disabilities, which is noteworthy as much for its analysis of the types of expenditures and differential impact on productivity for each sub-group as for the amount of cost associated with each. The section ends with a helpful chapter by Larson, Lakin, and Anderson who provide prevalence estimates of intellectual and other developmental disabilities, or combinations thereof, at different stages of life.

The fourth section is entitled "Special Populations." Its chapters are primarily descriptive in nature, exploring the prevalence of specific disabilities and the characteristics of individuals with those disabilities in populations that rarely receive such attention. Anderson's chapter on the health status of women aging with developmental disabilities, including mental retardation, is an important contribution to the literature, which usually focuses on these populations only up through the age of 22. Verbrugge's and Yang's article on duration of disability and timing of onset offers interesting comparisons between individuals with early, i.e. childhood, onset, and those with late-onset disabilities. This section ends with Altman and Rasch's stark and compelling portrait of disability and its correlates in the Native American population where relatively young, rather than elderly, people comprise the majority of the population with disabilities.

The volume ends with John Drabek's discussion of actual efforts to use NHIS-D data to influence public policy, along with a proposal for ongoing collection of disability data, and doing so with greater efficiency and precision. One would hope that, having invested such a substantial level of resources in the NHIS-D, public policymakers will not forgo further opportunities to update and build on the knowledge gained. This volume, with the methodological and substantive lessons contained therein, provides a useful springboard for such efforts.