The Prevalence and Correlates of Disability in Singapore: Results from a Nationwide Cross-Sectional Survey.

Mythily Subramaniam,Saleha Shafie,Yen Sin Koh,Eng Sing Lee,Fiona Devi,Peizhi Wang,Chee Fang Sum,Siow Ann Chong,Edimansyah Abdin,Janhavi Ajit Vaingankar,P V Asharani

doi:10.3390/ijerph182413090

Abstract

Objective: The study aims to estimate the prevalence of disability and the association of disability with socio-demographic correlates and health outcomes among the Singapore population. Methods: Face-to-face interviews were conducted with a representative sample of Singapore’s population. Using the Washington Group’s questionnaire, disability was defined using both the ‘standard’ (a lot of difficulty or higher in one or more domains) and the ‘wider’ threshold (of ‘some’ or greater difficulty). Data on socio-demographic correlates, self-reported lifestyle, physical activity, chronic conditions, and health-related quality of life were also collected. Results: The prevalence of any disability using the standard threshold was 3.1% (95% CI: 2.4–4.1). When separated by disability type, mobility (1.8%) was the most prevalent, followed by vision (0.8%), cognition (0.5%), hearing (0.3%), and self-care (0.2). In the adjusted regression analysis, lower education and unemployed and economically inactive status (versus employed) were significantly associated with disability. Conclusions: Although this prevalence is lower than other countries, it is a significant finding in terms of actual numbers and impact at both the individual and the societal levels. Our findings also highlight the need to strengthen health services and preventive interventions targeting older adults and those who are physically inactive to reduce the burden of disability in these groups.

Highlights

The International Classification of Functioning, Disability and Health (ICF) defines disability as ‘impairments in body functions and structures, activity limitations, and participation restriction’
Using data from the World Health Survey to compare the prevalence of disability and socioeconomic inequalities in disability, Hosseinpoor et al [25] found that low and lower-middle-income countries had a higher prevalence of age- and sexstandardised disability than upper-middle- and high-income countries
Future prevalence studies in Singapore should consider using a clinical screen on those reporting ‘some difficulty’ to identify a sub-population that would need services. This approach would ensure a better allocation of resources and provision of services for those with functional limitations. Considering this in Singapore, our findings suggest that using a self-reported method in isolation may be overly restrictive at the threshold of “a lot”

Summary

Introduction

The International Classification of Functioning, Disability and Health (ICF) defines disability as ‘impairments in body functions and structures, activity limitations, and participation restriction’. Disabilities (UNCRPD) defines persons with a disability as ‘those with long-term physical, mental, intellectual or sensory impairments. These impairments in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others’ [2]. In a retrospective analysis from the World Health Survey (WHS) of non-institutionalised populations in 54 countries, the age and sex standardised disability prevalence among adults was estimated to be 14%. It varied significantly between countries ranging from less than 1% to 30% across countries [3]

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