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Advancing the Inclusion of People with Disabilities 2009

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Chapter 5: Health and well-being

This chapter explores health and well-being among Canadians with disabilities. Because disability is often interrelated with health and well-being difficulties, health and access to well-being supports are important elements to consider in ensuring that people with disabilities have the opportunity to participate as fully as possible in society. This chapter focuses on the self-rated health status of people with disabilities and the interrelation of health and factors such as stress, employment and income.

Health and well-being are fundamental to a full life and full participation in society. Physical, mental and emotional health affects virtually all aspects of people’s lives. Health and well-being are linked to outcomes such as level of education, employment and income, and participation in the community.

Health is often described as the presence or absence of physical limitations. However, the World Health Organization (WHO) provides a broad definition of health that takes physical and mental well-being, lifestyle, and social interactions into account. According to WHO, health is a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

While seniors with disabilities report poorer health than in 2001, more working-age adults with disabilities are reporting that they have good to excellent health. Physical activity, social relationships, good income, education and employment are some of the factors that influenced a stronger health rating. Access to health care remains an issue for people with disabilities.

Self-rated health status

In 2006, just over half (54.0%) of adults with disabilities rated their health as good, very good or excellent, and one quarter (24.8%) rated their health as fair. Another 12.9% rated their health as poor.

Chart 5.1 — Self-rated health status for adults aged 15 and over, 2001 and 2006

1. The chart uses 2006 data that is comparable to 2001 data.
2. The sum of the values for each category may differ from the total due to rounding.
3. Applicable to adults 15 years of age and over.

Source: Participation and Activity Limitation Survey, 2001 and 2006.

[Chart 5.1 Description …]

In general, men with disabilities are more likely than women to rate their health as very good or excellent (26.5% versus 22.0%). This trend is similar across age groups. When asked to rate their satisfaction with their health out of ten, women reported slightly lower ratings than men (6.0 versus 6.3).

The overall percentage of seniors with disabilities who rated their health as excellent, very good or good decreased slightly, from 56.4% in 2001 to 53.0% in 2006. A small gender gap in self-rated health is seen among seniors with disabilities: from 2001 to 2006, the percentage of senior women who rated their health as excellent, very good or good decreased slightly, from 55.7% to 53.3%, while the percentage of senior men reporting one of those ratings decreased from 57.5% to 52.6%.

Chart 5.2 — Self-rated health status by age, 2001 and 2006

Health status	2001				2006
	Age 15 to 64		Age 65 and over		Age 15 to 64		Age 65 and over
	Number	%	Number	%	Number	%	Number	%
Total	1 968 490	100.0	1 451 850	100.0	2 437 610	100.0	1 725 090	100.0
Excellent	127 640	6.5	69 490	4.8	167 110	6.9	87 720	5.1
Very good	354 910	18.0	251 620	17.3	451 550	18.5	294 360	17.1
Good	583 270	29.6	498 310	34.3	715 120	29.3	532 750	30.9
Fair	492 980	25.0	413 870	28.5	576 230	23.6	456 150	26.4
Poor	296 990	15.1	152 230	10.5	309 630	12.7	226 390	13.1

1. The table uses 2006 data that is comparable to 2001 data.
2. The sum of values for each category may differ from the total due to rounding.
3. Applicable to adults 15 years of age and over.

Source: Participation and Activity Limitation Survey, 2001 and 2006.

There is a relationship between severity of disability and self-rated health. Seven out of ten adults with mild to moderate disabilities rate their health as good, very good or excellent, whereas only three out of ten adults with severe to very severe disabilities report one of those ratings. In addition, 26.2% of adults with severe or very severe disabilities rate their health as poor, in comparison to 4.1% of adults with mild to moderate disabilities.

When asked to rate their satisfaction with various life factors such as health and work out of 10, adults with disabilities rate their satisfaction with relationships as 8.3 but their satisfaction with health as 6.2. Furthermore, severity of disability affected the response regarding satisfaction with health: people with mild to moderate disabilities reported an average rating of 6.9, whereas people with severe to very severe disabilities reported an average rating of 4.7.

Impact of stress

Stress has negative effects on health and can have even more harmful effects on the health of people with disabilities. As people age, their main sources of stress change.

Work is the most common source of stress for working-age adults with disabilities aged 15 to 64 (main source for 24.5%), whereas health is the most common source of stress for seniors (main source for 37.4%). When looking at gender, health is the most common source of stress for working-age women (24.6%) whereas work is the most common source of stress for working-age men (28.9%).

People with severe to very severe disabilities are most likely to identify health as their main source of stress (43.0%). In contrast, people with mild to moderate disabilities identify a larger variety of main causes of stress, with the most common cause of stress being work (26.0%).

Chart 5.3 — Main source of stress for adults aged 15 and over by severity of disability, 2006

1. The chart uses 2006 data that is comparable to 2001 data.
2. The sum of the values for each category may differ from the total due to rounding.
3. Applicable to adults 15 years of age and over.

Source: Participation and Activity Limitation Survey, 2006.

[Chart 5.3 Description …]

Physical activity

Regular physical activity is an important component of good health. It can prevent or delay the onset of certain disease such as diabetes. The majority of adults with disabilities who engaged in physical activity in their homes over the past 12 months rated their health as either good or fair. In addition, the percentage of people who exercised in their homes who rated their health as very good or excellent rose from 27.4% in 2001 to 30.6% in 2006.

In 2006, 33.5% of men with disabilities who exercised at home in the past year rated their health as excellent or very good, compared to 28.3% of women. This percentage has increased significantly since 2001 for men (from 27.7%), but only slightly for women (from 27.2%).

The gap by severity of disability was much larger: 39.3% of people with mild to moderate disabilities who exercised rated their health as excellent or very good, compared to only 13.7% of people with severe to very severe disabilities. Since 2001, these figures increased only slightly for people with mild to moderate disabilities (from 36.3%) and did not change much for people with severe to very severe disabilities (was 13.2%).

In 2006, 31.5% of working-age adults with disabilities who exercised at home rated their health as very good or excellent, up from 27.9% in 2001. In addition, 29.2% of seniors with disabilities who exercised at home rated their health as very good or excellent, up from 25.9%.

Income, employment and education

Income levels, employment and education are associated with health status. These three factors play an important role in determining a person’s quality of life and ability to contribute to his or her family and community.

The percentage of adults with disabilities living in low-income families who rated their health as poor decreased slightly between 2001 and 2006 (from 22.7% to 21.4%). Adults with disabilities who do not live in low-income families remain less likely to rate their health as poor: 12.8% did so in 2006.

Chart 5.4 — Self-rated health status by level of family income, 2001 and 2006

Health rating	2001		2006
	Number	%	Number	%
Member of low income economic family
Total	498 890	100.0	540 350	100.0
Excellent or Very Good	86 200	17.3	98 800	81.3
Good or Fair	299 450	60.0	326 150	60.4
Poor	113 250	22.7	115 420	21.4
Member of non-low income economic family
Total	1 348 540	100.0	3 265 030	100.0
Excellent or Very Good	393 950	29.2	899 550	27.6
Good or Fair	772 260	57.3	1 945 930	59.6
Poor	182 330	13.5	419 540	12.8

In terms of employment and self-rated health, 37.2% of employed working-age adults rate their health as very good or excellent, in comparison to 25.1% of unemployed working-age adults.

Education, which is closely related to employment opportunities and income levels, is also associated with perception of health. Of people with disabilities who reported having fair to good health, 57.9% had a post-secondary education. This number has increased slightly from 2001 (56.1%).

Access to health care

Having access to health care is an important component of a person’s health care status. Of adults with disabilities who need health care or social services, 13.9% feel they do not receive them. Women are more likely than men to report an unmet need for health care or social services (15.8% versus 11.7%). Similar results were reported in 2001.

There are various reasons why health care needs are not met. These include expense, not having insurance coverage, or lack of availability. Cost is the most common reason. In 2006, 47.1% of those who felt they did not receive needed health care claimed expense as the most common reason their needs were unmet, whereas 21.5% did not know where or how to obtain the health care they required.

Chart 5.5 — Reasons for not receiving needed health care, adults aged 15 and over, 2001 and 2006

1. The chart uses 2006 data that is comparable to 2001 data.
2. The sum of the values for each category may differ from the total due to rounding.
3. Applicable to adults 15 years of age and over.

Source: Participation and Activity Limitation Survey, 2001 and 2006.

[Chart 5.5 Description …]

Social contacts

In 2006, 25.9% of adults with disabilities had at least three close social contacts they were comfortable talking to and relying on for help. However, 281 930 adults with disabilities (6.8%) said they had no close friends they could confide in or depend on for help.

Women with disabilities were more likely than men to report having close friendships. However, men were more likely to have larger social networks (11 or more close friends).

Chart 5.6 — Number of close friendships by gender, 2006

Number of close friendships	Men		Women
	Number	%	Number	%
Total	1 872 290	100.0	2 290 410	100.0
None	144 760	7.7	137 170	6.0
1 to 2	290 310	15.5	417 470	18.2
3 to 5	433 400	23.1	642 830	28.1
6 to 10	287 520	15.4	365 380	16.0
11 to 20	141 870	7.6	130 030	5.7
More than 20	128 960	6.9	95 980	4.2

A total of 28.4% of adults with mild to moderate disabilities had three to five close friendships, compared to 22.0% of adults with severe to very severe disabilities.

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Date Modified:

2011-08-06