An Executive Summary, Life Opportunities Survey - Wave Two Report, Part 1

Part of Life Opportunities Survey, Wave Two, Part I Release

Released: 15 November 2012 Download PDF

Executive Summary

The Life Opportunities Survey (LOS) is a large scale longitudinal survey of disability in Great Britain. It is the first major social survey in Great Britain to explore disability in terms of the social barriers to participation that people experience. The LOS compares the experiences of people with and without impairments across a range of areas, including education and training, employment, transport, leisure, social and cultural activities, and social contact.

The survey is wholly funded by the Department for Work and Pensions (DWP) and is carried out by the Office for National Statistics (ONS).

The LOS does not equate having an impairment with being disabled. A person may have some form of impairment without it limiting their activities, and they may not be considered or consider themselves to be disabled. Following the social model, disability is understood as the disadvantage people with impairments experience due to barriers that restrict their participation in different areas of life. To meet the social model definition of disability, as used in the LOS, people must have an impairment and have experienced barriers to participation.

The LOS is a longitudinal survey in that it follows respondents over time and collects information on changes in the respondents’ situations and experiences. Respondents were interviewed for the first time in Wave One, which took place between June 2009 and March 2011. Wave Two began in June 2010 and finished in March 2012, with respondents followed up approximately one year after their initial interview.

Aim of this Report and Definitions

Aim of this report

The LOS Wave Two Report, Part I is based on data collected from both Wave One and Wave Two of the survey. The report primarily focuses on the changes reported by adults between the two waves. Part II of the LOS Wave Two Report, due for publication in 2013, will provide further analyses on these changes, as well as cross-sectional results for Wave Two of the survey.

This report looks at the following respondents:

Adults aged 16 and over who have ‘impairments at both waves’, that is, they reported at least one impairment at both Wave One and Wave Two.
Adults aged 16 and over who have ‘offset from impairments’, that is, they reported at least one impairment at Wave One, but did not report any impairment at Wave Two.
Adults aged 16 and over who are ‘onset-acquired’, that is, they did not report any impairment at Wave One, but reported at least one impairment at Wave Two.

Analysis of the control group has not been included in this report but will appear in the Part II report.

Definition of impairment and impairment severity

In this report, an adult is defined as having an impairment if they indicated that:

They experience moderate, severe or complete difficulty within at least one area of physical or mental functioning, and
Certain activities are limited in any way as a result. ‘Activities’ refer to different areas of physical or mental functioning, such as walking, climbing stairs or reading a newspaper.

The severity of the impairment can be thought of in terms of:

The level of difficulty imposed by the impairment – greater than ‘mild’ (‘moderate’, ‘severe’, ‘cannot do’)¹.
The frequency of limitation imposed by the impairment – more frequent than ‘never’ (‘rarely’, ‘sometimes’, ‘often’ or ‘always’).

Participation Restriction in Life Areas

An adult has a participation restriction if he/she experiences a social barrier to taking part in a life area. Eight life areas are considered on the LOS: education and training, work, economic life (household’s ability to afford things and make ends meet), transport, leisure activities, accessibility inside the home, accessibility outside the home, and social contact.

Notes for Aim of this Report and Definitions

Response categories for level of difficulty: 1. “No Difficulty”; 2. “Mild Difficulty”; 3. Moderate Difficulty 4; “Severe Difficulty”; and 5. “Cannot Do”; For some impairment types (chronic condition, breathing, learning, intellectual, behavioural, memory, and mental health impairments), the levels range from 1 to 4. For pain, the level of pain is measured by the intensity of the pain experienced: 1.”Mild”; 2.”Moderate”; 3. “Severe”.

Key Findings

Of all adults with at least one impairment at Wave One, 34 per cent were found to have offset from impairment, that is, they no longer reported any impairment at Wave Two.
Of all adults with at least one impairment at Wave One, 66 per cent reported at least one impairment at Wave Two. However, there was a great deal of change in the types of impairments these adults reported at Wave One and at Wave Two.
Of all adults without an impairment at Wave One, 8 per cent were found to have acquired at least one impairment at Wave Two.

Notes for Key Findings

Due to the longitudinal design of the survey, there may be a downward bias in the onset rate reported. The onset rate here therefore provides a lower-bound estimate of the true onset rate. For more detail, please refer to section 4.1.

Adults with impairment at both waves

Number and types of impairments reported

The number of impairments reported by these adults has changed little between the two waves and therefore only the number of impairments reported at Wave Two have been included in this analysis. At Wave Two:

Thirty-three per cent reported only one impairment, 23 per cent two impairments, and 44 per cent three or more impairments
Those aged 65 or over were more likely to report three or more impairments (50 per cent), and less likely to report only one impairment (26 per cent), than those of working age (where 41 per cent reported three or more impairments, versus 37 per cent reporting only one impairment).
At both Wave One and Two, the most commonly-reported impairments for adults with impairment at both waves, were long term pain and chronic health condition¹, followed by mobility and dexterity impairment.

Severity of impairments

Most of adults with impairment at both waves (between 64 to 66 per cent) experienced moderate difficulty for the four most commonly-reported impairment types.
For both long-term pain and chronic health condition, those aged 65 or over were more likely than those of working age to rate the frequency of limitation as ‘always’. Among adults who reported long-term pain, a higher percentage of those aged 65 and over (35 per cent) than those of working age (28 per cent) rated the frequency of limitation as ‘always’. This pattern was also found among adults who reported a chronic health condition: 53 per cent of those aged 65 or over and 45 per cent of those of working age rated the frequency limitation as always.
Most of those with impairment at both waves did not report a change between the two waves in both the level of difficulty and in the frequency of limitation, for long-term pain, chronic health condition, mobility and dexterity impairments.

Notes for Adults with impairment at both waves

Chronic Conditions are defined as long-term conditions that have lasted or are expected to last 12 months or more and that have been diagnosed by a health professional. These include but are not limited to: Asthma or severe allergies; Heart condition or disease; Kidney condition or disease; Cancer; Diabetes; Epilepsy; Cerebral Palsy; Spina Bifida; Cystic Fibrosis; Muscular Dystrophy; Migraines; Arthritis or rheumatism; Multiple Sclerosis (MS) ; Paralysis of any kind; and Depression;

Adults who have offset from impairment

Offset rates: Likelihood of offsetting from impairment

The offset rate is calculated as the percentage of adults with impairments at Wave One but not at Wave Two, out of all adults with impairments at Wave One. Overall, the offset rate of adults at Wave Two was 34 per cent, which means that approximately a third of all adults who reported at least one impairment at Wave One, did not report any impairment at Wave Two.

The offset rate was similar for both men (35 per cent) and women (33 per cent).
However, offset rates seemed to decrease with age. Nearly half (49 per cent) of all adults aged 16 to 24 who reported an impairment at Wave One no longer reported any impairment at Wave Two. The corresponding offset rate for those aged 75 and over was 21 per cent.

Number and types of impairments reported at Wave One by adults who have offset from impairment

Of all adults who have offset from impairment at Wave Two, the majority (70 per cent) reported only one impairment at Wave One. Nineteen per cent reported two impairments, and only 11 per cent reported three or more impairments at Wave One.
For adults who have offset from impairment, the most commonly-reported impairments at Wave One were long-term pain (54 per cent), chronic health condition (27 per cent), mobility (10 per cent) and dexterity (eight per cent).
An offset rate can also be calculated for each impairment type, this gives the percentage of offset adults who reported this impairment at Wave One, but no longer reported it at Wave Two. The offset rate was highest for learning impairment (31 per cent), followed by long-term pain (29 per cent), sight impairment (28 per cent) and hearing impairment (26 per cent).

Severity of impairments reported at Wave One: Offset from impairment adults

For adults who have offset from impairment, the severity experienced, for the most commonly-reported impairments, tended to be moderate rather than severe. For example:

For those with long-term pain at Wave One, the level of pain was rated as ‘moderate’ by 77 per cent of these adults. Also, 52 per cent rated the frequency of the limitation due to pain as ‘sometimes’, and 27 per cent rated it as ‘rarely’.
Over 80 per cent of those who had reported chronic health condition, mobility and dexterity impairments at Wave One rated the level of difficulty associated with the impairment as ‘moderate’. Around 50 per cent rated the frequency of limitation imposed by these impairments as ‘rarely’ or ‘sometimes’.

Onset-acquired adults

Onset rates: Likelihood of acquiring at least one impairment

The likelihood of acquiring an impairment is measured by the onset rate. The onset rate is calculated as the percentage of adults who reported at least one impairment at Wave Two out of all adults who did not report any impairment at Wave One. Overall, the onset rate for adults at Wave Two was 8 per cent, which means that approximately one in twelve adults, who did not report an impairment at Wave One, reported an impairment at Wave Two.

The onset rate was not significantly different for men (seven per cent) and women (eight per cent).
However, the onset rate was found to vary by age. More than one in five (23 per cent) adults aged 75 and over had acquired at least one impairment at Wave Two. This compared with 9 per cent of those aged 45 to 64, 4 per cent of those aged 25 to 44, and 3 per cent of those aged 16 to 24.

Number and types of impairments reported at Wave Two by onset-acquired adults

Of the onset-acquired adults, most (69 per cent) reported acquiring one impairment at Wave Two. This compared with 19 per cent reporting two impairments, and 12 per cent reporting three or more impairments.
Those aged 65 or over were more likely to report acquiring three or more impairments than those of working age (17 per cent compared with 9 per cent).
The four most commonly-reported impairments among onset-acquired adults at Wave Two were: long-term pain (52 per cent), chronic health condition (32 per cent), mobility (13 per cent) and dexterity impairment (9 per cent).
Therefore the onset rate was also highest for long-term pain (3.9 per cent), chronic health condition (2.4 per cent), mobility impairment (1.0 per cent) and dexterity impairment (0.7 per cent).
For most impairment types, the onset rate was higher for onset-acquired adults aged 65 or over than for those of working age. The difference by age was particularly evident for long-term pain, chronic health condition and mobility impairment.

Severity of impairments reported at Wave Two: Onset-acquired adults

For adults who became onset-acquired at Wave Two, the severity of the most commonly-acquired impairments was moderate. For example:

Around 80 per cent of onset-acquired adults who reported long-term pain, chronic health condition, mobility or dexterity impairments rated the level of difficulty imposed by these conditions as ‘moderate’.
For each of the four most commonly-acquired impairments at Wave Two, between 43 per cent and 52 per cent of the onset-acquired adults rated the frequency of limitation imposed by these impairments as ‘sometimes’.

Changes experienced between Wave One and Wave Two

The LOS collects information on economic activity status, income and participation restriction at each wave, in order to measure changes in these areas over time.

Changes in economic activity

For all working age adults with impairment at both waves, there has been little change in their economic activity status, with most adults either remaining employed (39 per cent) at both waves, or economically inactive (around 46 per cent) at both waves.
For adults who have offset from impairment, most were employed at both waves (61 per cent) or economically inactive at both waves (22 per cent). Approximately 7 per cent were employed at Wave Two, after being either unemployed or economically inactive at Wave One.
For onset-acquired adults, the majority were either employed at both waves (62 per cent) or were inactive at both waves (20 per cent). Approximately 8 per cent of onset-acquired adults became either unemployed or economically inactive at Wave Two, after being employed at Wave One.
These findings are against a background of a rising unemployment rate, lower employment and a variable but falling inactivity rate

Changes in income

For all adults (impairment at both waves, offset from impairment, and onset-acquired), there has been little change in the income distributions across the two waves.
The general absence of change could be due to the one year gap between waves, which may be too short to allow substantial changes to be observed. Additionally, the lack of change in income between waves is consistent with the stability seen in the economic activity status of working age adults.
Over the same period wage growth has been small, and more than offset by inflation. At the lower end income from benefits has fallen only slightly in real terms during this time
At Wave Two, more than half (54 per cent) of adults with impairments at both waves had an individual weekly income of £200 or less, compared with 40 per cent of adults who have offset from impairment, and 44 per cent of onset-acquired adults.

Changes in participation restriction

Adults who have offset from impairments experienced barriers in fewer life areas at Wave Two (average of 2.3 life areas) than at Wave One (2.7 life areas).
Onset-acquired adults experienced barriers in more life areas at Wave Two (average of 2.6 life areas) than at Wave One (2.3 life areas).
On average, adults with impairment at both waves experienced a barrier in 3.3 life areas at both waves. Moreover, a higher percentage of offset adults (46 per cent) experienced a barrier in fewer life areas at Wave Two than at Wave One, compared with 27 per cent of onset-acquired adults. For adults with impairment at both waves, 35 per cent experienced a barrier in fewer life areas at Wave Two than at Wave One.
In contrast, 27 per cent of offset adults experienced a barrier in more life areas at Wave Two than at Wave One, compared with 40 per cent of onset-acquired adults. The corresponding figure for adults with impairment at both waves was 35 per cent.
The most commonly-cited life areas in which a barrier was experienced were transport and leisure activities. This was true for both waves and for all adults (impairment at both waves, offset from impairment or onset-acquired).
Adults with impairment at both waves were more likely to experience a barrier in the life area of ‘work’, than offset adults or onset-acquired adults. In Wave One and Wave Two over two-thirds of adults with impairment at both waves experienced a barrier in this life area (68 per cent and 67 per cent respectively) compared to around two-fifths of offset adults (42 per cent at Wave One, 37 per cent at Wave Two) and onset-acquired adults (34 per cent at Wave One, 40 per cent at Wave Two).

Conclusions

This report has provided strong evidence for the dynamic nature of the population reporting impairments. While some people continue to experience the same impairment over time some people experience onset of impairment and others experience offset. Wave Three of LOS will allow us to look at this dynamic nature of the population of adults with impairment over a longer period of time.

It is important to bear in mind that the population covered by the LOS form a very diverse group with respect to the impairments and the severity of these impairments they report. Hence, a simple picture that covers all impairments is unlikely to appear. This diversity and the dynamic nature of impairments mean that personal perception is also likely to play a key role in how impairments are experienced. Indeed, previous research on people with disabilities has found that only 48 per cent of those registered as ‘disabled’ actually considered themselves as disabled¹.

This report has not examined the specific barriers experienced by adults at Wave One and Two, or any changes in the reasons for the barrier. Similarly, analyses on reasons why changes have occurred in the impairment reported between waves, and any effect of these changes on the experience of barriers have not been explored in this report.

Wave Three of the LOS will look at these questions about the reasons why respondents experience a change in their impairments and/or participation restrictions. Findings from the LOS should further be considered in the context of other research on disability to inform policy development.

The LOS Wave Two Report, Part II, is planned for publication in 2013. The report will provide prevalence estimates of impairments in the general population at Wave Two. The report will also include further longitudinal analyses on participation restrictions, and changes experienced by those adults who did not report any impairment at both waves of the survey.

Notes for Conclusions

DWP 2002 ‘Disabled for Life? Attitudes towards and experiences of, disability in Britain’

Background notes

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