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Chapter 6 - Conclusions

Released: 15 November 2012 Download PDF

Chapter 6 - Conclusions

This data was revised on April 10th 2014

The LOS Wave Two Report, Part I has highlighted the dynamic nature of the population with impairment. Rather than considering the characteristics and experiences of disabled people at one point in time, the LOS longitudinal data allow the examination of changes associated with impairment onset and offset, as well as changes over time for those who have continually experienced impairments.

In general, analyses in this report have shown similarities between the onset-acquired and offset adults in terms of the impairments and severity of these impairments they had reported, as well as their economic activity status and income over the two waves. On the other hand, adults with impairment at both waves, and those without impairment at both waves can be contrasted against onset-acquired and offset adults in economic activity and income. These comparisons among the four groups are discussed in the following sections. The chapter will conclude with a discussion about Wave Three and the future direction of the LOS.

6.1 Types of impairments

The four most commonly-reported impairment types were identical across adults with impairment at both waves, onset-acquired adults, and offset adults. These four impairment types were long-term pain, chronic health condition, mobility impairment and dexterity impairment. This finding suggests that these four impairments are the most widely experienced by the general population, and therefore the likelihood of acquiring any of these conditions by the onset-acquired group at Wave Two was also high. Additionally, most of the adults who have offset from impairment had previously reported these impairments at Wave One. However, the offset rates by impairment types, which indicate the probability of offsetting from a particular impairment at Wave Two, showed that dexterity and mobility impairments were among those impairments with the lowest offset rates (see section 3.3, Table 3.7).

As illustrated by analyses of the changes of impairment type reported by adults with impairments at both waves (see section 2.3), it is important to bear in mind the dynamic nature of this group in terms of the impairments experienced between the two waves. Specifically, it was clear from the onset rates and offset rates (Tables 2.9 and 2.10) that a substantial proportion of adults with impairments at both waves were reporting new impairments at Wave Two that had not previously been reported at Wave One, and/or were no longer reporting impairments at Wave Two that were previously reported at Wave One. 

6.2 Number of impairments

Most onset-acquired adults and offset adults reported one impairment (at Wave Two and Wave One respectively), with a lower percentage reporting three or more impairments. These findings make intuitive sense as it is unlikely for an individual with no impairments at Wave One to acquire a large number of impairments over the period of one year (the time between Wave One and Wave Two). Conversely, those who have offset from impairment (having at least one impairment at Wave One to no impairments at all at Wave Two), would be more likely to be classified in this group if cessation of only one impairment was required, rather than three or more.

In contrast, those with impairments at both waves showed that just under half of the group reported three or more impairments at Wave Two. The higher proportion of this group reporting two, or three or more impairments meant that it was less likely for these adults to be offset from impairment entirely.

6.3 Severity of impairments

Severity ratings for the four most commonly-reported impairments also showed a similar pattern for onset-acquired and offset adults. For all four impairments, most adults in these two groups reported moderate level of difficulty, and rated the frequency of limitations posed by these impairments as “sometimes”. These findings suggest that recently acquired impairments tend to be less severe, and imply that the onset of impairment experienced, in terms of severity, may be gradual. For the offset adults, the results suggest that having less severe impairments at Wave One led to impairment offset at Wave Two.

The gradual onset of impairments can be seen in the number of adults reporting mild difficulty for an impairment at Wave One, who subsequently reported more severe difficulty at Wave Two and therefore were classified as onset-acquired for that impairment. (Based on the LOS definition, an adult is classified as having a particular impairment if the difficulty experienced is more than “mild”). This was particularly evident for chronic health condition (see table 4.8). On the other hand, using the LOS definition, an adult could be classified as offsetting from an impairment if the level of difficulty rated for that impairment changed from more severe levels to “mild”. This was observed for a proportion of offset adults who reported chronic health condition and sight impairment at Wave One (see table 3.8).

In contrast, adults with impairments at both waves had higher severity ratings for the four most commonly-reported impairment types than seen in the onset-acquired adults and adults who have offset from impairment. Compared with onset-acquired and offset adults, a higher percentage of adults with impairments at both waves rated the level of difficulty experienced for the impairment as “severe” or higher, and the frequency of limitation as “always”.

6.4 Onset and offset rates

In Chapters 3 and 4, the onset rates for onset-acquired adults and the offset rates of offset adults were examined across a selection of demographic characteristics. Onset rates were found to vary across age groups (see table 4.1), with older adults more likely than younger adults to report an impairment at Wave Two. The situation was reversed for offset rates, where the likelihood of offsetting completely from impairments was higher for younger than older adults (see table 3.1).

Offset and onset rates were also found to vary within other demographic characteristics such as highest qualifications attained and its related characteristic, socio-economic classification (based on occupation). Specifically, offset rates tended to increase with higher levels of qualifications and socio-economic classification. In contrast, the onset rates were higher for people in lower supervisory and technical occupations, and semi-routine and routine occupations, than it was for people in higher managerial, administrative and professional occupations, and higher for those with no formal qualifications than those with degree level qualifications. These findings are consistent with existing research showing a relationship between good general health and higher levels of qualifications.

6.5 Economic activity status and income

The similarity between onset-acquired and offset adults, and their distinction from adults with impairments at both waves were again seen in their economic activity status1 and income distributions. Most onset-acquired and offset adults were found to be employed at both waves, with a smaller proportion being economically inactive at both waves. These groups could be contrasted with adults with impairment at both waves, where a lower proportion of the group were employed at both waves, and a larger proportion were economically inactive at both waves. Finally, compared with the other three groups who reported impairment at one or both waves, adults without impairment at both waves had the highest proportion who were employed at both waves, and lowest proportion who were inactive at both waves.

Onset-acquired and offset working age adults showed similar income distributions. Compared with these groups, a higher proportion of working age adults with impairment at both waves had an income of £200 or less per week. In contrast, working age adults without impairment at both waves were least likely to fall into the lowest category of weekly income. These findings are consistent with the patterns seen in the economic activity data. Adults with impairment at both waves were least likely to be employed at both waves, whereas adults without impairment at both waves were most likely, with onset-acquired and offset adults falling in between these two groups in terms of likelihood of being employed at both waves.

Overall, there has been a large degree of stability across the two waves in both economic activity status and income distributions for all groups examined in this report. The lack of change could partly be due to the short gap (of one year) between the two waves.

Notes for 6.5 Economic activity status and income

  1. Analysis was based on working age adults only.

6.6 Wave Three and future directions

Data from Wave Three of the LOS will further our understanding of the dynamic nature of the population with impairment over a longer period of time. It will help us understand the movements in and out of impairment. It will allow us to explore whether or not the onset-acquired adults continue to experience impairment and how the severity of these impairments changes; also whether adults who experienced an offset of impairment remain without impairment or whether they will move back into impairment.

Evidence from Australia has shown that over a five year period 38% of the overall population fluctuated between the disabled and non-disabled populations1.

However, it is important to note at this juncture that the population covered by the LOS form a very diverse group with respect to the impairments they report and the severity of those impairments, and a simple picture that covers all impairments is unlikely to appear. This diversity, and the dynamic nature of impairments experienced mean that personal perception is also likely to play a key role in how impairments are reported. Earlier research found that only 48% of disabled people actually consider themselves to be disabled2.

We also note that this report has not examined in detail the specific barriers experienced by adults at Wave One and Two, or any changes in the reasons causing the barrier. Similarly, analyses on reasons why changes have occurred in the types of impairments reported between waves, and the effect of these changes on the experience of barriers have not been explored in this report. The LOS Wave Three questionnaire will look at the reasons why respondents experience changes in their impairments and/or participation restrictions.

Findings from the LOS should further be considered in conjunction with research from the wider field of disability, and together these could help identify successful interventions and the effectiveness of these interventions in terms of people’s perception about their impairment and the barriers experienced.

The LOS Wave Two Report, Part II, is planned for publication in 2014. The report will provide longitudinal analyses on participation restriction focusing on changes experienced between the two waves in the life areas of work, education and training, and transport. 

Notes for 6.6 Wave Three and future directions

  1. Emerson E  ‘Disability Transitions: Some preliminary data from Australia’.
  2. DWP 2002 ‘Disabled for Life? Attitudes towards and experiences of disability in Britain’.

Background notes

  1. Details of the policy governing the release of new data are available by visiting www.statisticsauthority.gov.uk/assessment/code-of-practice/index.html or from the Media Relations Office email: media.relations@ons.gsi.gov.uk

Get all the tables for this publication in the data section of this publication .
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