New Standard for Assessing Health Status of People with Disabilities

International Classification of Functioning, Disability, and Health

The United States currently determines disability status in various ways depending on the reason for making such distinction. For example, qualification for civil rights claims, work disability compensation, or public-funded programs such as childhood early intervention programs, special education, and Medicaid or supplemental income. While such claims or programs are important, not everyone considered to have a disability utilizes them leaving some people with disabilities unrecognized.  

Public health science has been built on strong case definitions by classification systems developed over the past 150 years such as the International Classification of Diseases, now maintained by the World Health Organization. When primary prevention is the main emphasis, this system works quite well. 

However, In 1997, a useful companion to the International Classification of Diseases emerged heralding a new disability paradigm. In 2001, after 20 years of refinement, the World Health Organization General Assembly adopted the International Classification of Functioning, Disability, and Health. http://www.who.int

The Disability and Health Team undertook a two-year cooperative agreement with the World Health Organization to develop the environmental component and to test the framework of this new classification system. For the first time in history, academics, researchers and clinicians are considering that people with a "disabling" condition can be healthy regardless of the body part involved. The new classification system helps understand why two people with the same diagnosed condition have a very different disabling experience. Moving away from using a disabling condition as a health status measure, disability and health researchers have begun using the International Classification for Functioning, Disability and Health (2001, World Health Organization) to closely assess:

• health status outside of the disabling condition; 

• the relationship between activity limitations and barriers encountered in the environment or the use of facilitative assistive technology; and

• participation and inclusion in society as a critical part of one's health.  

The conceptual framework established within the new classification helps define and gather information about various conditions, individual needs, and long-term consequences of disease, injuries or disorders. The framework: 

• provides a scientific basis for understanding and studying the functional states associated with health conditions;

• establishes common language for describing functional states associated with health conditions in order to improve the communications among health care workers, other sectors, and people with disabilities;

• permits comparison of data across countries, health care disciplines, services and time:

• provides a systematic coding scheme for health information systems

Both the classification system and the conceptual framework provide a sound basis for the CDC disability science. Information derived through the classification framework will improve our understanding of health disparities between people with and without disabilities; and facilitate developing interventions towards preventing diseases or secondary conditions and mitigating environmental and societal barriers to health.  

  Conferences on Functioning, Disability, and Health

2004, June 1-4. CIHI and NCHS will host the 10th Annual NACC Conference on ICF: Developing a Research Agenda for ICF at the Westin Nova Scotian Hotel in Halifax, Nova Scotia, Canada to exchange knowledge on key ICF topics and initiatives with peers from around the world. For more information go to www.icfconference.com.

2001, October 17. 8th National Disability Statistics and Policy Forum: Who counts as having a disability? For a copy of the proceedings, call the Disability Statistics Center at the University of California, San Francisco or the National Institute on Disability and Rehabilitation Research (NIDRR) at 415/502-5216 or TTY 415/502-5216.

2001, June 4-6. United Nations International Seminar on Measurement of Disability. For a copy of the proceedings, contact Ms. Angela Me at me@un.org

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This page was last updated August 05, 2004

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National Center on Birth Defects and Developmental Disabilities

The National Center on Birth Defects and Developmental Disabilities (NCBDDD) promotes the health of babies, children, and adults, and enhances the potential for full, productive living.  Our work includes identifying the causes of birth defects and developmental disabilities, helping children to develop and reach their full potential, and promoting health and well-being among people of all ages with disabilities.