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DH-18 Data Details

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DH-18 Reduce the proportion of adults with disabilities aged 18 and older who experience serious psychological distress

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Health Interview Survey
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent (age adjusted—see Comments)
Baseline (Year): 
14.4 (2010)
Target: 
13.0
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of people with disabilities aged 18 and over who experienced serious psychological distress

Denominator: 

Number of people with disabilities aged 18 and over

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Questions Used to Obtain the National Baseline Data: 

    From the 2010 National Health Interview Survey:

    [NUMERATOR:]

    During the PAST 30 DAYS, how often did you feel:

    • So sad that nothing could cheer you up?
    • Nervous?
    • Restless or fidgety?
    • Hopeless?
    • That everything was an effort?
    • Worthless?

    (Response categories for the above questions:)

    1. ALL of the time
    2. MOST of the time
    3. SOME of the time
    4. A LITTLE of the time
    5. NONE of the time
    6. Refused/Not ascertained/Don't know

    [NUMERATOR AND DENOMINATOR (DISABILITY IDENTIFIERS):]

    1 year old or older:

    Is this person deaf or do they have serious difficulty hearing?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    Is this person blind or do they have serious difficulty seeing, even when wearing glasses?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    5 years old or older:

    Because of a physical, mental, or emotional condition, does this person have serious difficulty concentrating, remembering, or making decisions?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    Does this person have serious difficulty walking or climbing stairs?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    Does this person have difficulty dressing or bathing?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    15 years old or older:

    Because of a physical, mental, or emotional condition, does this person have difficulty doing errands alone such as visiting a doctor's office or shopping?

    1. Yes
    2. No
    3. Refused
    4. Don't know
Methodology Notes: 

    An adult is considered to have symptoms of psychological distress if they or an adult proxy responds “yes” to ALL of the time or MOST of the time to any of the numerator questions for adults. The six adult questions reflect the Kessler 6 scale which is used internationally to assess feelings of sadness, restlessness, hopelessness, nervousness, worthlessness, and the sense that everything is an effort. Positive responses increase the score. This scale has the sensitivity and specificity to effectively discriminate between cases and non-cases of DSM-IV mood disorders, but it cannot define which specific disorder (such as clinical depression, generalized anxiety disorder) that any given respondent to the survey may have.

    Age Adjustment Notes: 

    This indicator uses Age-Adjustment Groups:

    • Total: 18-24, 25-34, 35-44, 45-64, 65+
    • Sex: 18-24, 25-34, 35-44, 45-64, 65+
    • Race/Ethnicity: 18-24, 25-34, 35-44, 45-64, 65+
    • Educational Attainment: 25-34, 35-44, 45-64, 65+
    • Family Income (percent poverty threshold): 18-24, 25-34, 35-44, 45-64, 65+
    • Family Type: 18-24, 25-34, 35-44, 45-64, 65+
    • Country of Birth: 18-24, 25-34, 35-44, 45-64, 65+
    • Disability Status: 18-24, 25-34, 35-44, 45-64, 65+
    • Geographic Location: 18-24, 25-34, 35-44, 45-64, 65+
    • Health Insurance Status: 18-24, 25-34, 35-44, 45-64
    • Marital Status: 18-24, 25-34, 35-44, 45-64, 65+
Changes Between HP2010 and HP2020: 
The Healthy People 2010 objective with the same operational definition was DSC 06-03 <a href="https://wonder.cdc.gov/data2010/" class="pub_med_link" target="_blank">https://wonder.cdc.gov/data2010/</a>.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2015, DH-18 was moved from developmental to measurable (a baseline and target were established) and was reworded. The objective statement is Reduce the proportion of adults with disabilities aged 18 and older who experience serious psychological distress. The baseline is 13.4 percent in 2010. The target of 12.1 percent was set using the 10 percent improvement target-setting method.

References

Additional resources about the objective

  1. Behavioral risk factor surveillance system. Atlanta (GA): National Center on Chronic Disease Prevention and Health Promotion.
  2. Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand S-LT, Walters EE, Zaslavsky AM. Short screening scales to monitor population prevalences and trends in nonspecific psychological distress. PsycholMed 2002;32:959 – 976.
  3. Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. population. Statistical Notes No. 20. Hyattsville, MD: National Center for Health Statistics. 2001.