Description | Specific Indicators | Corresponding Mandatory Objectives | Corresponding National Indicators | Data Sources |  Alternative Data Sources | ICD Codes | Analysis Check List | Method of Calculation |  Basic Categories | Indicator Comments | Cross-References to Other Sections | References


Description

• ADL rate
• Basic ADL rate
• Instrumental ADL rate (IADL)

 
Corresponding Mandatory Objectives

• None

• None

  
Data Sources (see Resources: Data Sources)

Numerator & Denominator: 1990 Ontario Health Survey (OHS)
Original source: Ontario MOHLTC
Distributed by:
Health Planning Branch, Ontario MOHLTC
Suggested citation (see Data Citation Notes):
Ontario Health Survey 1990, Health Planning Branch, Ontario MOHLTC

Numerator & Denominator: 1996/97 Ontario Health Survey (OHS)
Original source: Statistics Canada
Distributed by:
1. Health Planning Branch, Ontario MOHLTC
2. Statistics Canada
Suggested citation (see Data Citation Notes):
1. Ontario Health Survey 1996/97, Statistics Canada, Share File, Health Planning Branch, Ontario MOHLTC
2. Ontario Health Survey 1996/97, Statistics Canada, Public Use Microdata File, Statistics Canada

Numerator & Denominator: Canadian Community Health Survey (CCHS)
Original source: Statistics Canada
Distributed by:
1. Health Planning Branch, Ontario MOHLTC
2. Statistics Canada
Suggested citation (see Data Citation Notes):
1. Canadian Community Health Survey [year], Statistics Canada, Share File, Health Planning Branch, Ontario MOHLTC
2. Canadian Community Health Survey [year], Statistics Canada, Public Use Microdata File, Statistics Canada
 

Survey Questions

Answers to these questions are combined into the derived variable "Need for help in series of tasks", variable name racaf6, which is set to yes if the respondent answers ‘yes’ to any of the above questions.

Analysis Check List

• Before releasing and/or publishing these data, users should ensure that the number of sampled respondents who contributed to the estimate is at least 30, regardless of the estimate’s coefficient of variation. For estimates based on sample sizes of 30 or more, determine the coefficient of variation of the rounded weighted estimate and follow the guidelines below:
  • Acceptable (0.0 - 16.5) Estimates can be considered for general unrestricted release. Requires no special notation.
  • Marginal (16.6 - 33.3) Estimates can be considered for general unrestricted release but should be accompanied by a warning cautioning of high sampling variability.
  • Unacceptable (greater than 33.3) Statistics Canada recommends not releasing estimates of unacceptable quality. However, if the user chooses to do so then estimates should be flagged and the following warning should accompany the estimates: "The user is advised that . . .(specify the data) . . . do not meet Statistics Canada’s quality standards for this statistical program. Conclusions based on these data will be unreliable and most likely invalid". These data and any consequent findings should not be published. If the user chooses to publish these data or findings, then this disclaimer must be published with the data.
• The release guidelines for the 1990 OHS are slightly different: No qualification (C.V. less than 16.6), Qualified estimate (C.V. of 16.6 – 25.0), Suppress estimate (C.V. greater than 25.0).

 
Method of Calculation

• Age groups: As the number of people with ADL needs below age 65 is usually very small, one might limit age-specific analyses to <65, 65-74 and 75+.
• Sex: male, female.
• Geographic areas for: CCHS - all 37 Public Health Units and 16 District Health Councils in Ontario; 1996/97 OHS - 23 health areas; 1990 OHS - all 42 Public Health Units and 32 District Health Councils that existed at the time.

Indicator Comments

• The CCHS asks questions about the need for assistance with both both basic (ADL) and instrumental (IADL) activities of daily living. While most people who need assistance with ADL will also need assistance with IADL, the reverse is not necessarily true.
• ADL is generally interpreted as an indicator of moderate to severe disability.
• IADL is generally interpreted as an indicator of mild to moderate disability, often combined with information about activity restriction. See Long-Term Disability and Activity Restriction indicator.
• In some studies, the overall ADL has been calculated excluding the question about heavy household chores, perhaps because this may not be a sensitive measure of need and inclusion may be artificially inflating the rate.
• In the CCHS questions, the need for assistance with ADL must be due to a condition or health problem. How many, if any, cases this excludes is difficult to estimate.
• This indicator gives some sense of the need for assistance among the community-dwelling population. However, the CCHS does not include follow-up questions that ask the respondent if their need for assistance is being met. Other questions in the CCHS that are related to home care services provide the respondent with an opportunity to say whether he or she received personal care or mobility assistance, but the service must have been at least partially paid for by the government to be counted.

Definitions

• Basic activities of daily living refers to personal care (eating, bathing, dressing) or moving about inside the dwelling.

• None

 
References

1. Chen J and Wilkins R. Seniors need for health-related personal assistance. Health Reports 1998; 10(1):39-50.

Date of Last Revision:June 03, 2004.