A profile of Disability in Canada 2001 - January 2001

Introduction

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Contents

The Participation and Activity Limitation Survey (PALS) is a national survey designed to collect information on adults and children who have a disability, that is, whose everyday activities are limited because of a condition or health problem. Funded by Human Resources Development Canada and conducted by Statistics Canada, PALS provides essential information on the prevalence of various disabilities, the supports for persons with disabilities, their employment profile, their income and their participation in society. This information will be used by all levels of government, associations, researchers and non-government organizations to support the planning of services needed by persons with activity limitations in order to participate fully in society.

Data on persons with disabilities were last collected in 1991, when the Health and Activity Limitation Survey (HALS) was conducted. A new survey was therefore necessary to meet the need for up-to-date, more detailed information that will better reflect the reality of persons with disabilities. This ten-year gap between the two surveys offered an opportunity to review the approach and develop a new survey strategy. Accordingly, to better identify the PALS target population, major changes were made to the structure of the sample and the filter questions identifying persons with disabilities. As a result, comparisons cannot be made between the 1986 and 1991 HALS surveys, and the 2001 PALS. On the other hand, these filter questions may now serve as the standard for identifying persons with disabilities in other Statistics Canada surveys, so that for the first time, it will be possible to compare information on persons with disabilities from one survey to another. For more information on the new survey approach, see the box entitled Identifying Persons with Disabilities.

This article is the first in a series of PALS data releases. It contains survey results on the prevalence, type and severity of disability by age and sex.

Identifying persons with disabilities

This release is based on the Participation and Activity Limitation Survey (PALS). PALS is a post-censal survey which collected information about persons with disabilities whose everyday activities are limited because of a health-related condition or problem. The survey took place between September 2001 to January 2002. PALS is funded by Human Resources Development Canada (HRDC).

PALS is a post-censal survey because it used the 2001 Census as a sampling frame to identify its population. The 2001 Census questionnaire included two general questions on activity limitations. The PALS respondents were selected through the use of the census information on age, geography and the responses to these two general questions.

After the 2001 Census, a sample of individuals who answered YES to the activity limitation questions on the census form was selected. The PALS sample was 43,000, consisting of approximately 35,000 adults and 8,000 children. The interviews were conducted by telephone with the interviewers completing a paper and pencil questionnaire. Two questionnaires were used, one for adults aged 15 and over and one for children under 15. The interviews for the children's questionnaire were conducted with the parent or guardian of the child. The overall response rate was 82.5%.

The population covered by the survey was persons residing in private and some collective households in the ten provinces. Persons living in the Yukon, Northwest Territories and Nunavut, persons living in institutions and on First Nations reserves were excluded from the survey.

PALS followed the groundwork laid by the Health and Activity Limitation Survey (HALS), which was conducted by Statistics Canada about persons with disabilities in 1986 and 1991. However, the data from the HALS and PALS cannot be compared because of significant differences in their sampling plans, the operational definition of their target population and the content of their questionnaires. For more information about the differences between HALS and PALS, please see the report, "A New Approach to Disability Data: Changes between the 1991 Health and Activity Limitation Survey (HALS) and the 2001 Participation and Activity Limitation Survey (PALS)", published in December 2002.

Prevalence of Disability in Canada

In 2001, 3.6 million Canadians living in households reported having activity limitations; this represents a disability rate of 12.4%.

Table 1 - Population with and without disabilities, and disability rate, by province, Canada and provinces, 2001

	Total population	Population without disabilities	Population with disabilities	%
Canada	28,991,770	25,390,510	3,601,270	12.4
Newfoundland and Labrador	492,800	432,310	60,500	12.3
Prince Edward Island	132,850	113,880	18,970	14.3
Nova Scotia	888,900	736,690	152,210	17.1
New Brunswick	712,300	609,440	102,860	14.4
Quebec	7,052,790	6,457,100	595,690	8.4
Ontario	11,192,730	9,678,350	1,514,380	13.5
Manitoba	1,036,270	888,690	147,580	14.2
Saskatchewan	859,080	734,870	124,210	14.5
Alberta	2,830,280	2,475,540	354,740	12.5
British Columbia	3,793,770	3,263,640	530,130	14.0
1The Canada total excludes the Yukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

Table 2 - Population with and without disabilities, and disability rate, by age groups, Canada, 2001

	Total population	Population without disabilities	Population with disabilities	%
Age groups
Total population	28,991,770	25,390,510	3,601,270	12.4
0 -14	5,546,020	5,365,090	180,930	3.3
0-4	1,641,680	1,615,480	26,210	1.6
5-14	3,904,330	3,749,610	154,720	4.0
5-9	1,914,220	1,843,850	70,370	3.7
10-14	1,990,110	1,905,760	84,350	4.2
15 and over	23,445,760	20,025,420	3,420,340	14.6
15-64	19,858,350	17,889,850	1,968,490	9.9
15-24	3,883,690	3,732,670	151,030	3.9
25-44	8,849,090	8,222,480	626,610	7.1
45-64	7,125,570	5,934,710	1,190,850	16.7
65 and over	3,587,410	2,135,560	1,451,840	40.5
65-74	2,082,750	1,433,570	649,180	31.2
75 and over	1,504,660	701,990	802,670	53.3
1The Canada total excludes theYukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

The disability rate increases with age

Survey results confirm that the disability rate gradually increases with age. From 3.3% among children aged 0 to 14, it rises to nearly 10% among adults aged 15 to 64 and climbs to more than 40% among persons aged 65 and over. In fact, more than half (53.3%) of persons 75 and over report having a disability. Within the population aged 15 to 64, this gradual increase is reflected in a rate of about 4% among young adults 15 to 24 years of age, compared to 7.1% among persons aged 25 to 44 and 16.7% among those aged 45 to 64.

In general, the disability rate is higher for women, except in the case of children under 15

The disability rate increases with age for both men and women. Nevertheless, women (13.3%) are generally more likely to report disability than men (11.5%). However, this relationship is reversed among children aged 0 to 14. Boys in this age group are more likely to have activity limitations, with a rate of 4.0% compared to 2.5% for girls. This higher prevalence among boys disappears when they reach their twenties; the disability rate is substantially the same for young men and women aged 15 to 24 years of age. Starting at age 25, the prevalence of disability is slightly higher for women than for men.

Profile of Disability among Children

Some types of disabilities are not identified before age 5

Considering the stages and the rate of children's physical, emotional and intellectual development, it is sometimes difficult to specifically identify some types of disabilities in children aged 0 to 4. Disability in young children can often be described only as a certain delay in development, whether physical, intellectual or other. Thus, for children aged 0 to 4, PALS identifies the following five types of disabilities: hearing, vision, chronic health conditions, developmental delay, and disability of an unknown nature. On the other hand, for children aged 5 and over, PALS identifies 10 types of disabilities, substituting more specific types of disabilities for developmental delay, namely disability related to speech, mobility, dexterity or a psychological condition, as well as learning disabilities and developmental disability. For further information on the different types of disabilities, see the box entitled Type of disability among children.

Table 3 - Type of disabilities among children aged 0 to 14 years with disabilities, by age groups, Canada, 2001

	Age groups
	0-4 years		5-14 years		Total
	Total	%	Total	%	Total	%
Type of disability2
Hearing3	3,160E	12.1	20,590	13.3	23,750	13.1
Seeing3	2,090E	8.0	14,510	9.4	16,600	9.2
Speech4	...	...	66,940	43.3	66,940	43.3
Mobility4	...	...	21,150	13.7	21,150	13.7
Dexterity4	...	...	31,410	20.3	31,410	20.3
Delay5	17,820	68.0	...	...	17,820	68.0
Developmental4	...	...	46,180	29.8	46,180	29.8
Learning4	...	...	100,360	64.9	100,360	64.9
Psychological4	...	...	49,140	31.8	49,140	31.8
Chronic3	16,400	62.6	101,110	65.3	117,510	64.9
Unknown3	2,340E	8.9	4,950	3.2	7,280	4.0
... Not applicable. 1The Canada total excludes theYukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. 2The sum of the categories is greater than the population with disabilities because persons could report more than one type of disability. 3Applies to all children under 15. 4Applies to children aged 5 to 14. 5Applies to children aged 0 to 4. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

Among children aged 0 to 14, the most widespread disability is that related to a chronic health condition such as asthma

A disability due to one or more chronic health conditions affects about 118,000 children aged 0 to 14, representing 65% of children with disabilities (2.1% of all children). Half of children aged 0 to 14 with this type of disability are limited by a single chronic health condition, nearly 30% by two such conditions, and more than 20% by three or more (data not shown). Chronic health conditions that do not cause activity limitations are not considered a disability for the purposes of PALS.

Type of disability among children

The PALS survey questions allow the identification of the following types of disabilities among children under 15:

Hearing*: Difficulty hearing.

Seeing*: Difficulty seeing.

Speech**: Difficulty speaking and/or being understood.

Mobility**: Difficulty walking. This means walking on a flat firm surface, such as a sidewalk or floor.

Dexterity**: Difficulty using hands or fingers to grasp or hold small objects, such as a pencil or scissors.

Learning**: Difficulty learning due to the presence of a condition, such as attention problems, hyperactivity or dyslexia, whether or not the condition was diagnosed by a teacher, doctor or other health professional.

Developmental delay***: Child has a delay in his/her development, either a physical, intellectual or another type of delay.

Developmental disability or disorder**: Cognitive limitations due to the presence of a developmental disability or disorder, such as Down syndrome, autism or mental impairment caused by a lack of oxygen at birth.

Psychological**: Limited in the amount or kind of activities that one can do due to the presence of an emotional, psychological or behavioural condition.

Chronic condition*: Limited in the amount or kind of activities that one can do due to the presence of one or more chronic health conditions that have lasted or are expected to last six months or more and that have been diagnosed by a health professional. Examples of chronic conditions are asthma or severe allergies, heart condition or disease, kidney condition or disease, cancer, epilepsy, cerebral palsy, Spina Bifida, Cystic Fibrosis, Muscular Dystrophy, Fetal Alcohol Syndrome, etc.

Unknown*: The type of disability is unknown if the respondent answered YES to the general questions on activity limitations, but did not provide any YES to the questions about type of disability that followed.

* Applicable to all children under 15.
** Applicable to children aged 5 to 14.
*** Applicable to children under 5.

In the 0 to 4 age group, chronic health conditions cause activity limitations for nearly 16,000 children, or 62.6% of young children with disabilities. As for children aged 5 to 14, activity limitations caused by such conditions affect roughly 101,000 children, or 65.3% of those with disabilities. Asthma or severe allergies, complex medical care needs, cerebral palsy, migraines, autism, heart condition or disease, and attention deficit disorders with or without hyperactivity (ADD/ADHD) are only a few examples of the chronic health conditions identified in PALS. However, it should be noted that more than a third of chronic health conditions were reported in the category "Other long-term condition".

Developmental delay is the most common disability in children aged 0 to 4

Among children aged 0 to 4, developmental delay is the most common disability. In 2001, nearly 18,000 children with a disability, or 68%, had a developmental delay, representing 1.1% of all children aged 0 to 4. In this group, 59% had a delay in their intellectual development, 54% a delay in their physical development and 38%, another type of delay such as speech difficulties (data not shown). It is important to note that developmental delay is identified by the child's parent/guardian and is not necessarily diagnosed by a health care professional. The identification of the disability is therefore based on the parent's perception of his/her child's development.

Among school-age children (aged 5 to 14), learning disabilities are one of the two most often-reported disabilities

Learning disabilities are almost as common as activity limitations related to chronic health conditions in children aged 5 to 14. In 2001, over 100,000 children aged 5 to 14, or 2.6% of all children in that age group, were reported to have learning disabilities. This represented 64.9% of children with disabilities in the 5 to 14 age group. Among these school-age children with disabilities, boys were more likely to have a learning disability than girls (68.9% and 58.0% respectively).

Speech difficulties affect a significant number of school-age children

Hearing and vision difficulties affect nearly 24,000 and 17,000 children aged 0 to 14 respectively, or 13.1% and 9.2% of children with disabilities. Speech difficulties may have been identified by parents as a delay in development for children aged 0 to 4 but are categorized as being a specific disability for children aged 5 to 14. Speech-related disability affects about 67,000 children aged 5 to 14 (43.3% of children with disabilities). Boys are more likely to have this disability than girls (46.6% compared with 37.6%).

Disabilities related to mobility and dexterity are reported in just over 21,000 children and nearly 31,000 children aged 5 to 14 respectively, or 13.7% and 20.3% of those with disabilities. While a larger proportion of boys experience dexterity problems, girls are more likely to have mobility problems.

Nearly 32% of children aged 5 to 14 with disabilities, or roughly 49,000 children, were identified by their parent as having emotional, psychological or behavioural conditions that limit their activities. Developmental disability affects nearly 46,000 children aged 5 to 14, or 29.8% of children with disabilities.

Among children with disabilities, disability of an unknown nature is more often observed in those aged 0 to 4 (8.9%) than in those aged 5 to14 (3.2%). Indeed, it is more difficult to specifically identify the type of disability in younger children.

The transition from home to school: a key factor in identifying certain types of disability in children

While proportions of some types of disability, such as activity limitations related to chronic health conditions and learning disabilities, increase with the age of the child, others such as speech difficulties and dexterity problems, decrease with age. The transition from home to school may explain some of this variation. For example, learning disabilities are often not apparent until the child begins to attend school; as well, these difficulties are more easily detected within the school context. At the same time, the school system can provide specialized resources and services that might tend to reduce some activity limitations, such as those associated with speech difficulties.

Some children have several disabilities

While survey results show more than half of children with disabilities aged 0 to 4 have only one type of limitation, almost 40% have two, and just under 10%^E have three or more. Of children aged 5 to 14 with disabilities, 28.1% have only one disability, 36.5% have two or three and 24.8% have four or five. More than 10% of school-age children with disabilities have six or more. It should be noted that for a sizable proportion of children with only one disability, the nature of the disability was not identified. As well, children may be limited by more than one chronic health condition, but these count for only one disability.

Table 4 - Number of disabilities reported for children aged 0 to 4 years with disabilities, Canada, 2001

	Number	%
Number of disabilities
Total	26,210	100.0
One	13,350	50.9
Two	10,420	39.8
Three or more	2,440E	9.3
1 The Canada total excludes the Yukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

Table 5 - Number of disabilities reported for children aged 5 to 14 years with disabilities, Canada, 2001

	Number	%
Number of disabilities
Total	154,720	100.0
One	43,550	28.1
Two or three	56,500	36.5
Four or five	38,430	24.8
Six or more	16,250	10.5
1 The Canada total excludes the Yukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

The number of disabilities influences the degree of severity associated to a person's disability. In other words, the severity of overall disability depends not only on the severity of each type of disability but also the number of disabilities that an individual has. For further information on the development of the severity scale, see the box entitled Severity of Disability.

Severity of disability

An index measuring the severity of the disability was constructed based on the answers to the survey questions. Points were given according to the intensity and the frequency of the activity limitations reported by the respondent. A single score was computed for each type of disability. Each score was then standardized in order to have a value between 0 and 1. The final score is the average of the scores for each type of disability.

Since the survey questions differ depending on the age of the respondent, a different scale was constructed for adults (15 years and over), for children under 5 and for children aged 5 to 14. Each scale was then divided into different severity levels. The scale for adults and for children aged 5 to 14 was divided into four groups(that is, mild, moderate, severe and very severe ), while the scale for children under 5 was divided into two groups(that is, mild to moderate and severe to very severe ).

Among children aged 0 to 14 in Canada, 1.4% have a severe or very severe disability

Of the 181,000 children with disabilities aged 0 to 14, 57.4% experienced a mild to moderate disability and 42.6%, a severe to very severe disability. Thus, at the national level, 1.4% of children aged 0 to 14 had a severe or even very severe disability. The severity of disability among children varies little with age. The severity scale for children aged 5 to 14 can be disaggregated to obtain a more precise profile. Of these children, 32.1% had a mild disability, while at the other end of the scale, 17.2% had a very severe disability. The proportions of moderate and severe disabilities were relatively the same.

The level of severity of activity limitations is different for boys and girls aged 5 to 14. Boys appear more likely to experience a very severe disability (19.1%), compared to girls (13.9%) of the same age group. Girls, for their part, seem more likely to have mild activity limitations (36.8%) than boys (29.4%).

Table 6 - Severity of disability among children aged 0 to 14 years with disabilities, by age groups, Canada, 2001

	Age groups
	Total		0-4 years2		5-14 years
	Number	%	Number	%	Number	%
Degree of severity
Mild to moderate	103,770F	57.4	15,080	57.5	88,690	57.3
Mild	...	...	...	...	49,730	32.1
Moderate	...	...	...	...	38,960	25.2
Severe to very severe	77,160F	42.6	11,130	42.5	66,030	42.7
Severe	...	...	...	...	39,480	25.5
Very severe	...	...	...	...	26,550	17.2
... Not applicable. 1The Canada total excludes theYukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. 2The severity scale for children aged 0 to 4 is divided into only two groups, mild to moderate and severe to very severe . Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

Profile of Disability among Adults

Disability related to mobility affects the greatest number of adults

Mobility problems are the type of disability most often reported by adults aged 15 and over. In 2001, nearly 2.5 million or 10.5% of Canadians had difficulty walking, climbing stairs, carrying an object for a short distance, standing in line for 20 minutes or moving about from one room to another. For all age groups, women were more likely to have mobility problems than men. Indeed, among adults aged 15 and over, there was a significant difference in the overall proportion of women (12.2%) and men (8.6%) with a mobility-related disability. Also with respect to motor skills, activity limitations related to agility affect a substantial number of persons aged 15 and over. In all, 2.3 million or 9.7% of adults reported having difficulty with everyday activities that require these skills, such as bending down to pick up an object, getting dressed or undressed, or cutting one's food. For further information on the different types of disabilities, see the box entitled Type of disability among adults.

Table 7 - Prevalence of disability among adults aged 15 years and over, by type of disability, Canada, 2001

	Number of Adults	%
Type of disability2
Hearing	1,038,140	4.4
Seeing	594,350	2.5
Speech	362,720	1.5
Mobility	2,451,570	10.5
Agility	2,276,980	9.7
Pain	2,376,730	10.1
Learning	451,420	1.9
Memory	420,750	1.8
Developmental	120,140	0.5
Psychological	522,950	2.2
Unknown	96,180	0.4
1 The Canada total excludes the Yukon, Northwest Territories number of persons aged 15 and over. In all, and Nunavut. The sum of the values for each category may differ from the total due to rounding. 2 The sum of the categories is greater than the population with difficulty with everyday activities that require disabilities because persons could report more than one type of disability. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

More than 10% of adults have activity limitations related to pain or discomfort

Rather surprisingly, adults report pain-related disability almost as frequently as mobility-related disability. Some 2.4 million persons aged 15 and over (10.1%) reported having activity limitations related to chronic pain. Pain-related disability is more prevalent among women (11.4%) than among men (8.8%). This may reflect, in part, some reluctance among men to report this type of limitation. It is important to note here that for the purposes of PALS, persons who reported having pain but did not associate it with any activity limitation were not considered to have a pain-related disability. In fact, some 3.2 million adults reported having pain, with or without limitations (data not shown).

One million persons aged 15 and over report having a hearing-related disability

Regarding sensory-type activity limitations, just over one million adults (4.4%) reported having a hearing-related disability, about 600,000 (2.5%) had vision difficulties, and some 360,000 or 1.5% of persons aged 15 and over reported a speech-related disability. While a larger proportion of women (3.1%) than of men (2.0%) reported having vision difficulties, activity limitations related to hearing were more common among men (5.0%) than women (3.8%). Men aged 15 and over were also slightly more likely than women to have a speech-related disability.

Type of disability among adults

The PALS survey questions allow the identification of the following types of disabilities among adults aged 15 and over:

Hearing: Difficulty hearing what is being said in a conversation with one other person, in a conversation with three or more persons or in a telephone conversation.

Seeing: Difficulty seeing ordinary newsprint or clearly seeing the face of someone from 4 metres (12 feet).

Speech: Difficulty speaking and/or being understood.

Mobility: Difficulty walking half a kilometre or up and down a flight of stairs, about 12 steps without resting, moving from one room to another, carrying an object of 5 kg (10 pounds) for 10 metres (30 feet) or standing for long periods.

Agility: Difficulty bending, dressing or undressing oneself, getting into and out of bed, cutting own toenails, using fingers to grasp or handling objects, reaching in any direction (for example, above one's head) or cutting own food.

Pain: Limited in the amount or kind of activities that one can do because of a long-term pain that is constant or reoccurs from time to time, for example, recurrent back pain.

Learning: Difficulty learning because of a condition, such as attention problems, hyperactivity or dyslexia, whether or not the condition was diagnosed by a teacher, doctor or other health professional.

Memory: Limited in the amount or kind of activities that one can do due to frequent periods of confusion or difficulty remembering things. These difficulties may be associated with Alzheimer's disease, brain injuries or other similar conditions.

Developmental: Cognitive limitations due to the presence of a developmental disability or disorder, such as Down syndrome, autism or mental impairment caused by a lack of oxygen at birth.

Psychological: Limited in the amount or kind of activities that one can do due to the presence of an emotional, psychological or psychiatric condition, such as phobias, depression, schizophrenia, drinking or drug problems.

Unknown: The type of disability is unknown if the respondent answered YES to the general questions on activity limitations, but did not provide any YES to the questions about type of disability that followed.

A good number of adults have less visible disabilities

The 2001 PALS also sought to distinguish certain types of less visible disabilities, such as limitations related to psychological conditions or memory problems, learning difficulties and developmental disability. This distinction in no way ignores the close relationship that exists between some of these disabilities; as well, identification is always subjective, based on the respondent's perception. Nevertheless, more than half a million persons aged 15 and over (2.2%) reported having activity limitations due to emotional, psychological or psychiatric conditions. Similarly, more than 450,000 adults reported having learning disabilities, representing a proportion of 1.9%. A similar proportion of adults (1.8%) had activity limitations due to frequent memory problems or periods of confusion. Nearly 120,000 persons aged 15 and over had a developmental disability.

The prevalence of most types of disabilities increases with age

According to the most widely held view, the prevalence of any form of disability rises increasingly with age. The PALS findings confirm that this is true for disabilities related to mobility, agility, hearing, vision and pain. For example, while fewer than 2% of young adults aged 15 to 24 have a mobility-related disability, the rate reaches 31.5% for persons aged 65 and over. This increase in prevalence with age is also observed, although to a lesser degree, for other problems more closely associated with aging, such as memory and speech problems.

Activity limitations related to emotional, psychological or psychiatric conditions are relatively frequent in persons aged 45 to 64

However, there are some exceptions to the rule. Thus, persons aged 45 to 64 (3.3%) were more likely to have a disability related to psychological problems than persons aged 65 to 74 (2.0%), although the rate resumed its rise to 3.6% for persons 75 and over. The same is true for learning disabilities, with adults aged 45 to 64 (2.3%) showing a rate higher than among adults aged 65 to 74 (1.5%), but lower than that of seniors 75 years and over (2.8%). With respect to developmental disability, prevalence varies between 0.2%^F and 0.7%^E according to age, with young adults aged 15 to 24 showing the highest rate, and persons 65 to 74, the lowest. In this regard, it is important to note that a sizable proportion of older adults with a developmental disability are institutional residents and are therefore excluded from the survey population. Younger adults are more likely to live at home and therefore be included in PALS due to the de-institutionalization that has been taking place in Canada for about 25 years.

The strong predominance of some types of disabilities becomes even more obvious when we look at the proportion of persons with disabilities who have these particular types of disabilities. More than seven of every ten persons with disabilities have difficulties related to mobility, and almost as many have pain-related disabilities. Activity limitations related to agility are also very frequent, with two-thirds of persons with disabilities reporting them. More than 30% of adults with disabilities have a hearing-related disability and 17% have vision difficulties.

The results of the 2001 PALS also show how an important proportion of adults with disabilities have activity limitations related to psychological conditions, namely over 15%. Furthermore, some 13% of persons with disabilities aged 15 and over reported having a learning disability, with more than half (54.1%) of them having been diagnosed with learning disabilities by a teacher, a physician or another health care professional. The approximately 420,000 persons with a disability related to memory account for 12% of all persons with disabilities. Speech difficulties, which affect at least one in ten persons with disabilities, and developmental disability (3.5%) complete the PALS profile of persons with activity limitations. However, for just under 100,000 persons reporting a disability, the type of disability could not be identified.

Table 8 - Types of disabilities reported by adults aged 15 years and over with disabilities, Canada, 2001

	%
Type of disability
Mobility	71.7
Pain	69.5
Agility	66.6
Hearing	30.4
Seeing	17.4
Psychological	15.3
Learning	13.2
Memory	12.3
Speech	10.6
Developmental	3.5
Unknown	2.8
1 The Canada total excludes the Yukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

Table 9 - Number of disabilities reported by adults aged 15 years and over with disabilities, Canada, 2001

	Number of adults	%
Number of disabilities
One	621,270	18.2
Two	595,520	17.4
Three	992,360	29.0
Four or five	945,850	27.7
Six or more	265,340	7.8
1 The Canada total excludes the Yukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.;

A large majority of persons with disabilities aged 15 and over have more than one disability

The 2001 PALS distinctly recognizes, along with physical and sensory disabilities, the various types of less visible disabilities (pain, psychological problems, memory, learning and developmental disability). As a result, the survey provides a detailed profile reflecting the complexity of disability in adults aged 15 and over. The number of disabilities reported is ample evidence to that effect. Only 18.2% of persons with disabilities reported having only one disability, whereas a sizable proportion of them reported three (29.0%) or even four or five (27.7%). Indeed, just under 8% of persons with disabilities had six or more.

Severity of disability in 2001: mild, moderate, severe or very severe

A profile of disability in Canada would not be complete if it did not consider the degree of severity of disabilities reported. Among the 3.4 million adults with disabilities, the 2001 PALS distinguishes four levels of severity: mild, moderate, severe and very severe. Firstly, the level of severity depends on the frequency and intensity of limitations associated with each type of disability. For example, a person who has no difficulty walking and climbing stairs but cannot stand in line for more than 20 minutes, would have a mild mobility-related disability. A person who can only move around in a wheelchair would have their mobility more severely limited, and one who is bedridden for a long term period would have a very severe mobility-related disability. The number of disabilities also has an impact on the overall level of severity. The PALS distinguishes 10 types of disabilities among adults and the level of severity will increase with the number of disabilities affecting each individual. For further information on the development of the severity scale, see the box entitled Severity of disability.

In 2001, one-third (34.1%) of adults with disabilities had a mild degree of disability. At the other end of the scale, at least one in four persons with disabilities (26.9%) experienced severe activity limitations and 14.0% reported having a very severe disability. Men (36.4%) were more likely than women (32.2%) to report a mild degree of limitation. Conversely, a larger proportion of women than of men with disabilities reported a severe level of activity limitation (28.3% compared with 25.1%). However, the proportion of very severe disabilities was relatively the same for the two sexes.

Table 10 - Severity of disability among adults aged 15 years and over with disabilities, by sex, Canada, 2001

	Both sexes		Men		Women
	Number	%	Number	%	Number	%
Severity of disability
Total	3,420,340	100.0	1,526,900	100.0	1,893,440	100.0
Mild	1,165,470	34.1	555,110	36.4	610,360	32.2
Moderate	855,330	25.0	375,380	24.6	479,950	25.3
Severe	919,310	26.9	383,570	25.1	535,740	28.3
Very severe	480,220	14.0	212,830	13.9	267,390	14.1
1 The Canada total excludes theYukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

Nearly 6% of Canadians aged 15 and over have a severe or very severe disability

In terms of the total population aged 15 and over, 5.0% of Canadians had a mild disability, 3.6% a moderate disability and 3.9% a severe disability. Again at the national level, more than 480,000 persons aged 15 and over (2.0%) reported a very severe level of disability.

Severity of disability increases gradually until age 65 and then declines slightly among the 65 and over population. In this regard, it is important to note the significant prevalence of less visible disabilities among the working-age population, which increases the number of disabilities reported for these adults aged 15 to 64. As well, it is generally recognized that a person is more likely to experience the highest level of activity and the widest scope of activities during these working years (home, work, school, leisure); a person would therefore be just as likely to experience during those years, a high level of limitation in these same activities. At the same time, a sizable proportion of elderly persons likely to have a severe or very severe disability reside in an institution and are therefore not included in the PALS population.

Table 11 - Disability rate for adults aged 15 years and over, by severity of disability, Canada, 2001

	%
Severity of disability
Mild	5.0
Moderate	3.6
Severe	3.9
Very severe	2.0
The Canada total excludes the Yukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

Disability among Working-age Adults (Aged 15 to 64)

Activity limitations related to pain: the most common form of disability among working-age adults

Within the working-age population, activity limitations related to pain or discomfort are the most widespread, having been reported by nearly 1.5 million persons aged 15 to 64. Thus, 7.5% of all working-age persons are limited in their activities due to pain or discomfort. This type of disability affects 3 out of every 4 persons with disabilities aged 15 to 64.

Women more likely to report activity limitations due to pain

Working-age women are particularly affected by this less visible type of disability, 8.3% of them stating that they were limited in their activities because of pain or discomfort. By comparison, 6.7% of men aged 15 to 64 reported pain-related limitations.

Table 12 - Prevalence of pain-related disability among adults aged 15 to 64 years, by age groups and sex, Canada, 2001

	Adults 15-64 years of age		With pain-related disability
	Total	%	Total	%
Sex and age groups
Both sexes	19,858,350	100.0	1,489,460	7.5
15-24	3,883,690	100.0	76,870	2.0
25-44	8,849,090	100.0	476,110	5.4
45-64	7,125,560	100.0	936,490	13.1
Men	9,821,720	100.0	656,770	6.7
15-24	1,980,020	100.0	31,730	1.6
25-44	4,340,320	100.0	202,340	4.7
45-64	3,501,380	100.0	422,690	12.1
Women	10,036,630	100.0	832,700	8.3
15-24	1,903,680	100.0	45,140	2.4
25-44	4,508,770	100.0	273,760	6.1
45-64	3,624,190	100.0	513,800	14.2
The Canada total excludes theYukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

Pain is constant for 70% and recurrent for 30% of persons affected

The PALS questions covered not only constant pain, but also pain that reoccurs periodically, such as migraines or backache. In fact, nearly 70% of working-age persons who have pain-related limitations experience pain constantly, while recurrent periods of pain affect about 30% of them (data not shown).

Pain-related disability affects half of young adults aged 15 to 24 who have a disability

Pain-related disability increases gradually from age 15 to 64, with prevalence within the total population rising from 2.0% for 15-to-24-year-olds to 5.4% for persons 25 to 44 and 13.1% for those aged 45 to 64. However, while the proportion of young adults reporting pain-related disability is quite small, this type of limitation is nevertheless reported by more than half (50.9%) of young adults aged 15 to 24 with disabilities. The gap between the sexes is also more pronounced in this age group, young women with disabilities being much more likely to have pain-related limitations (59.0%) than their male counterparts (42.6%).

Moreover, these findings raise a number of questions about the impact this less visible type of disability has on the types of supports and adaptations, in the workplace and elsewhere, that will be needed to ensure that persons affected make an effective transition from school to the labour market and participate fully in all spheres of social activity.

Disability among Persons Aged 65 and Over

Mobility problems affect eight in ten seniors with disabilities

Mobility problems affect more than 1,1 million persons aged 65 and over, or nearly eight persons in ten with disabilities. Nationally, 23.3% of adults aged 65 to 74 reported having mobility problems, and the rate climbed to 42.9% for those 75 and over.

Table 13 - Prevalence of mobility-related disability among adults aged 65 years and over, by age groups and sex, Canada, 2001

	Adults 65 years of age and over		With mobility-related disability
	Number	%	Number	%
Sex and age groups
Both sexes	3,587,410	100.0	1,131,400	31.5
65-74	2,082,750	100.0	485,840	23.3
75-84	1,219,840	100.0	481,310	39.5
85 and over	284,820	100.0	164,250	57.7
Men	1,573,970	100.0	423,070	26.9
65-74	980,210	100.0	198,500	20.3
75-84	498,150	100.0	178,740	35.9
85 and over	95,620	100.0	45,830	47.9
Women	2,013,430	100.0	708,330	35.2
65-74	1,102,540	100.0	287,340	26.1
75-84	721,690	100.0	302,570	41.9
85 and over	189,200	100.0	118,420	62.6
The Canada total excludes theYukon, Northwest Territories and Nunavut. The sum of the values for each category may differ from the total due to rounding. Source: Statistics Canada, Participation and Activity Limitation Survey, 2001.

Mobility problems more common among women 65 and over

Women are more likely to have mobility difficulties. Among those with a disability, nearly 84% had difficulty moving about. By comparison, 70% of men with disabilities aged 65 and over reported having mobility problems. Notwithstanding the fact that the average age of women is certainly greater than that of men in that same age group, there is a substantial difference between the sexes.

Memory problems: the less visible disability most widespread among adults aged 65 and over

Activity limitations related to memory problems are often associated with aging. Among adults aged 65 and over, 153,000 persons reported being limited by memory problems or periods of confusion, representing 4.3% of Canadian seniors. Among seniors with disabilities, one person in ten reported having limitations in everyday activities related to memory problems. The proportion of persons with this disability increases with age up to age 85. From that point on, PALS results show a slight decline in activity limitations due to memory problems but this drop is not significant.

Men more likely than women to be limited by memory problems

Men with disabilities aged 65 and over are more likely to be limited in their activities by memory problems (12.5%), compared to women with disabilities in the same age group (9.1%). However, the difference between the sexes was not significant among adults aged 85 and over.

Upcoming PALS Releases

In 2003, other PALS data will be made available. They will include information on:

• the need for and use of disability supports (at home, at school, at work or elsewhere), such as
  • technical equipment,
  • human support,
  • medications,
  • accessible transportation,
  • specialized features and accommodations,
• a profile of education and employment among adults with disabilities,
• income level and sources,
• costs associated with disability,
• conditions or health problems inherent in disability and their causes, and
• the impact of a child's disability on the family.

Definitions

Disability

The Participation and Activity Limitation Survey uses the World Health Organization's (WHO) framework of disability provided by the International Classification of Functioning (ICF). This framework defines disability as the relationship between body structures and functions, daily activities and social participation, while recognizing the role of environmental factors.

For the purpose of PALS, persons with disabilities are those who reported difficulties with daily living activities, or who indicated that a physical, mental condition or health problem reduced the kind or amount of activities they could do.

The respondents' answers to the disability questions represent their perception of the situation and are therefore subjective.

Disability rate

Refers to the total number of persons who reported activity limitations expressed as a percentage of the population. For example, the calculation of the disability rate for the population aged 15 to 64 in Ontario is as follows: (Number of persons with disabilities aged 15-64 in Ontario/Total population aged 15-64 in Ontario)*100.

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