Study: The dynamics of disability: Progressive, recurrent or fluctuating limitations
The conventional view of disability is a limitation that remains more or less permanent and unchanged over time. However, many disabilities may not follow this relatively stable pattern. In fact, of the 6.2 million Canadians adults with disabilities in 2017, 3.8 million (61%) experienced limitations that changed in some way (otherwise known as disability dynamics), while 2.4 million (39%) experienced continuous limitations that tended to be more stable over time. To mark the International Day of Persons with Disabilities, Statistics Canada is releasing four new products based on findings from the 2017 Canadian Survey on Disability.
Many Canadians with a disability have periods of good health interrupted by periods of limitations (on-again/off-again episodes), or have limitations that change over time (worsening, improving or fluctuating). These changing or fluctuating limitations may be characterized as disability dynamics, as opposed to continuous disabilities or limitations, which tend to be more stable over time. Thus, Canadians with disability dynamics may differ from those with continuous disabilities. From a program and policy perspective, this is an important distinction because persons with disability dynamics may have changing requirements for employment supports, programs and services over time, even though the same underlying condition remains present.
The paper "The Dynamics of Disability: Progressive, Recurrent or Fluctuating Limitations" profiles four groups of Canadians with different disability dynamics based on data from the 2017 Canadian Survey on Disability. Each group has its own unique demographic, employment and workplace accommodation profile based on the length of time between the periods of limitations, as well as on changes in limitations over time.
3.8 million Canadians experience some type of disability dynamic
Despite the conventional belief that disability is fairly continuous, is permanent and changes very little over time, three in five persons with disabilities do not fit this definition. In fact, of the 6.2 million persons with disabilities aged 15 years and older, 2.4 million (39%) experienced continuous limitations, while 3.8 million (61%) experienced some type of disability dynamic.
Of the 3.8 million persons with disability dynamics, nearly 1.4 million (37%) experienced limitations that worsened over time ("progressive"), over 1.5 million (41%) sometimes had periods of a month or more without experiencing limitations ("recurrent"); and over 0.8 million (22%) experienced fluctuations in limitations over shorter periods ("fluctuating").
Persons with progressive limitations have the greatest number of disability types
Among persons with disabilities, women (16%) were more likely than men (10%) to experience fluctuating limitations, whereas men (43%) were more likely than women (36%) to experience continuous limitations.
Since persons with different disability dynamics are asked to consider the impact of their underlying conditions or disabilities when assessing their limitations, it is useful to understand how many different types of disabilities they may have. Persons with progressive limitations had the greatest number of disability types, with an average of four. Persons with fluctuating or continuous limitations averaged about three types, and those with recurrent limitations averaged about two. For instance, persons with progressive limitations were more likely to have physical (i.e., mobility, flexibility or dexterity), pain-related, sensory (i.e., hearing or seeing) or cognitive (i.e., learning, memory or developmental) disabilities than any of the other three disability dynamic groups. Conversely, persons with fluctuating limitations were more likely to have disabilities related to mental health than those with progressive limitations.
Employment rate highest for those with recurrent limitations
The opportunity to seek meaningful employment and have access to all required workplace accommodations is key to creating an accessible and inclusive work environment for persons with disabilities.
The employment rate was highest for those with recurrent limitations (65%) and lowest for those with progressive limitations (40%). For those with fluctuating or continuous limitations, employment rates were in the middle range, at 53% and 59%, respectively.
Among employed men, those with recurrent limitations (93%) had the highest rate of full-time employment, while those with progressive limitations had the lowest (78%). Among employed women, those with continuous limitations had the highest rate of full-time employment (79%), while those with progressive limitations had the lowest (67%).
Around half of employed persons with either progressive or fluctuating limitations required workplace accommodations
At around half of their respective populations, employed persons with progressive (56%) or fluctuating (49%) limitations were the most likely to require workplace accommodations. In comparison, less than one-third (31%) of employed persons with recurrent or continuous limitations required workplace accommodations. With the exception of those with progressive limitations, employed women were more likely than men to require accommodations in the workplace.
Note to readers
The 2017 Canadian Survey on Disability (CSD) provides comprehensive data on persons with disabilities by province and territory and age group, as well as disability types and severity of the disability. The survey population comprised Canadians aged 15 years and older as of the 2016 Census of Population (May 10, 2016) and living in private dwellings.
The CSD definition of disability includes anyone who reported being "sometimes," "often" or "always" limited in their daily activities because of a long-term condition or health problem, as well as anyone who reported being "rarely" limited if they were also unable to do certain tasks or could only do them with a lot of difficulty.
The paper "The Dynamics of Disability: Progressive, Recurrent or Fluctuating Limitations" is now available as part of the publication Canadian Survey on Disability Reports (89-654-X).
The infographic "Canadians with a pain-related disability" is now available as part of the Statistics Canada — Infographics (11-627-M) series.
The data visualization product "Canadian Survey on Disability, 2017: Data Visualization Tool" is now available as part of Statistics Canada — Data Visualization Products (71-607-X).
For more information, or to enquire about the concepts, methods or data quality of this release, contact us (toll-free 1-800-263-1136; 514-283-8300; STATCAN.infostats-infostats.STATCAN@canada.ca) or Media Relations (613-951-4636; STATCAN.mediahotline-ligneinfomedias.STATCAN@canada.ca).
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