Canadian Survey on Disability, 2012
Pain-related disabilities among Canadians aged 15 years and older, 2012

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by Christine Bizier, Gail Fawcett and Sabrina Gilbert

Release date: July 5, 2016 Correction date: (if required)
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The results presented in this fact sheet are from the 2012 Canadian Survey on Disability (CSD), which surveyed residents of private dwellings who reported an activity limitation and who were aged 15 years and older at the time of the 2011 National Household Survey (NHS).

According to the CSD, respondents are considered to have a disability only if they report a difficulty or impairment due to a long-term condition or health problem and they report that they are limited in their daily activities as a result of their condition. Appendix A describes how the CSD defines pain-related disabilities.

It should be noted that the population living in institutions, including residential care facilities, was not included in the 2012 CSD. Further details are available in the Canadian Survey on Disability, 2012: Concepts and Methods Guide: 89-654-X2014001.

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According to the 2012 Canadian Survey on Disability, 3,775,900 (13.7%) Canadians aged 15 years and older reported some type of disability, and 2,664,200 (9.7% of Canadian adults) were identified as having a pain-related disability that limited them in their daily activities (Table 1). The most prevalent underlying pain-related conditions reported by those with pain-related disabilities were arthritis, dorsalgia, and dorsopathy.

Table 1
Prevalence of disability by type, among adults aged 15 years and older, Canada, 2012
Table summary
This table displays the results of Prevalence of disability by type. The information is grouped by Disability type (appearing as row headers), Population and Percentage (appearing as column headers).
Disability type Population Percentage
Total disability 3,775,900 13.7
Pain-related 2,664,200 9.7
Flexibility 2,078,000 7.6
Mobility 1,971,800 7.2
Mental health-related 1,059,600 3.9
Dexterity 953,100 3.5
Hearing 874,600 3.2
Seeing 756,300 2.8
Memory 628,200 2.3
Learning 622,300 2.3
Developmental 160,500 0.6
Unknown 79,500 0.3

As with disability in general, the likelihood of having a pain-related disability increased notably with age—ranging from a prevalence rate of 1.9% among those aged 15 to 24 to a rate of 22.2% among those aged 65 and older (Chart 1). Women reported a higher rate of pain-related disabilities than men regardless of age, with the biggest gap being in the 65 and older age group, where 24.8% of women reported a pain-related disability compared with 19.1% of men.

Chart 1 Prevalence of pain-related disabilities and total disabilities by age group, aged 15 years and older, Canada, 2012

Data table for Chart 1
Data table for Chart 1
Table summary
This table displays the results of Data table for Chart 1. The information is grouped by Age group (appearing as row headers), Pain-related disabilities and Total disabilities, calculated using percent units of measure (appearing as column headers).
Age group Pain-related disabilities Total disabilities
percent
15 to 24 years 1.9 4.4
25 to 44 years 4.5 6.5
45 to 64 years 12.7 16.1
65 years and older 22.2 33.2

Multiple disabilities

Pain-related disabilities frequently co-occurred with other types of disability: 88.1% of adults with pain-related disabilities also reported at least one other type of disability in 2012. Among those aged 15 to 24 with a pain-related disability, nearly half also had a mental health-related disability and roughly two in five had a mobility or a flexibility disability. Among those in the older age groups, mobility disabilities and flexibility disabilities figured most prominently as additional disability types.

Chart 2 Prevalence of co-occurring disability types among adults with a pain-related disability, by age group, aged 15 years and older, Canada, 2012

Data table for Chart 2
Data table for Chart 2
Table summary
This table displays the results of Data table for Chart 2 Developmental, Learning, Mental health-related, Mobility, Seeing/Hearing, Dexterity, Flexibility and Memory, calculated using percent units of measure (appearing as column headers).
  Developmental Learning Mental health-related Mobility Seeing/Hearing Dexterity Flexibility Memory
percent
15 to 24 years 16.7 37.9 47.6 39.7 22.4 18.0 42.1 24.2
25 to 64 years 3.2 19.8 37.2 57.3 33.0 30.8 65.0 19.7
65 years and older 1.2Note E: Use with caution 11.2 16.6 70.2 39.8 31.7 66.8 17.1

Education

Educational attainment

Working-age adults (aged 15 to 64) with pain-related disabilitiesNote 1 had overall lower levels of educational attainment than those who did not have any type of disability. For example, adults aged 15 to 64 who were not in school and who reported a pain-related disability were more likely than those without any type of disability to have not completed high school (20.6% versus 13.1%). This pattern was particularly pronounced among the two younger age groups: individuals with pain-related disabilities were slightly less than twice as likely to have not completed high school, compared with their counterparts without any type of disability (46.6% versus 25.4% for the 15 to 24 age group and 17.2% versus 9.5% for the 25 to 44 age group).

Similarly, those aged 15 to 64 with a pain-related disability were also less likely (51.1%) than their counterparts without any disability (61.1%) to have completed postsecondary qualifications.Note 2

Chart 3 Proportion of the population with a pain-related disability compared to those without any disability by highest level of education, aged 15 to 64 years, Canada, 2012

Data table for Chart 3
Data table for Chart 3
Table summary
This table displays the results of Data table for Chart 3. The information is grouped by Level of education (appearing as row headers), With a pain-related disability and Without any disability, calculated using percent units of measure (appearing as column headers).
Level of education With a pain-related disability Without any disability
percent
Less than high school 20.6 13.1
High school 28.2 25.8
Postsecondary 51.1 61.1

Educational experiences

In the 2012 CSD (Canadian Survey on Disability), adults with a disability who were currently or had recentlyNote 3 been in school were asked a series of questions about their educational experiences and how their condition(s) may have affected these experiences.Note 4 More than half of adults with a pain-related disability reported that their condition(s) had influenced their choice of courses or careers. Similarly, roughly two in five indicated that, due to their disability, they took fewer courses, took longer to achieve their current level of education, or had their education interrupted (Table 2). Many individuals reported multiple impacts of disability on their educational experiences.

Table 2
Effect of disability on educational experiences of adults with a pain-related disability, aged 15 years and older, Canada, 2012
Table summary
This table displays the results of Effect of disability on educational experiences of adults with a pain-related disability. The information is grouped by Effect of disability (appearing as row headers), Percentage (appearing as column headers).
Effect of disability Percentage
Choice of courses/career influenced by disability 53.3
Took fewer courses due to disability 42.2
Took longer to achieve current level due to disability 39.2
Education interrupted due to disability 37.7
Went back to school for retraining due to disability 36.7
Changed course of studies due to disability 33.4
Discontinued education due to disability 30.3
People avoided/excluded you in school due to disability 27.3

Employment

Labour force status

Nearly half (47.3%) of adults aged 15 to 64 with a pain-related disability were not in the labour force, another 6.7% were unemployed, and fewer than half (46.0%) were employed.Note 5

In fact, the employment rate of working-age adults who did not have any type of disability was about one and a half times that of those with a pain-related disability (73.6% versus 46.0%), and this pattern was evident within each age group (Chart 4).

Chart 4 Employment rates of adults with a pain-related disability and adults without any disability, by age group, aged 15 to 64 years, Canada, 2012

Data table for Chart 4
Data table for Chart 4
Table summary
This table displays the results of Data table for Chart 4 15 to 24, 25 to 34 years, 35 to 44 years, 45 to 54 years and 55 to 64 years, calculated using percent units of measure (appearing as column headers).
  15 to 24 years 25 to 34 years 35 to 44 years 45 to 54 years 55 to 64 years
percent
With a pain-related disability 38.7 56.2 53.7 51.8 36.9
Without any disability 51.9 81.9 84.0 83.6 64.0

Disability in the workplace

Nearly a quarter (24.6%) of employed adults with a pain-related disability indicated that their employer was unaware of their condition(s).

Among those with a pain-related disability who were either currently in the labour market or had been within the previous five years, 46.0% reported that they believed their employer considered them disadvantaged in employment and 44.3% reported that they felt disadvantaged in employment (Chart 5). With respect to more specific indicators of disadvantage in the labour market, 12.5% believed that they had been refused a job, 8.6% felt they had been refused a promotion, and 8.2% believed they had been refused a job interview—all due to their disability or disabilities. It is important to remember that this is based on the impact of all disability types these individuals with a pain-related disability may have had.

Chart 5 Perceived employment discrimination or disadvantage among adults with a pain-related disability, aged 15 years and older, Canada, 2012

Data table for Chart 5
Data table for Chart 5
Table summary
This table displays the results of Data table for Chart 5. The information is grouped by Perceived discrimination or disadvantage (appearing as row headers), Percent (appearing as column headers).
Perceived discrimination or disadvantage Percent
Feels employer considers them disadvantaged 46.0
Feels disadvantaged 44.3
Refused a job 12.5
Refused a job promotion 8.6
Refused a job interview 8.2

Job modifications

Overall, 47.9% of adults with a pain-related disability who were or had been recently employedNote 6 stated that they needed at least one type of job accommodation such as modified work hours (26.8%), special back supports (21.0%), modified duties (17.1%), a modified work station (14.5%) and other job accommodations. Of those requiring modifications, 50.8% reported that all of their needs had been met, while 24.7% indicated that some needs had been met. Another 24.5% reported that none of their needs had been met. Given the high rate of co-occurrence with other types of disabilities, some of these accommodations may have been for disabilities other than pain-related disabilities.

Hours worked

Employed working-age adults, aged 15 to 64, with a pain-related disability worked an average of 34 hours per week,Note 7 which is less than the average number of hours worked per week by those without any reported type of disability (37 hours).Note 8

Not in the labour force

Among those with a pain-related disability, aged 15 to 64, who were not in the labour force, the majority (77.2%) reported that their condition(s) prevented them from working. Of these individuals, 18.4% indicated that some type of accommodation would allow them to work. As well, 27.2% indicated that they would look for work in the next 12 months. Respondents who planned to look for work were asked why they intended to do so:

Many of those who were not in the labour force encountered barriers that discouraged them from looking for work. Some of the most commonly reported job search barriers for those with a pain-related disability were the lack of available local jobs (25.4%) and inadequate training or experience (23.8%) (Chart 6).

Chart 6 Prevalence of job search barriers among adults with a pain-related disability who were not in the labour force, aged 15 to 64 years, Canada, 2012

Data table for Chart 6
Data table for Chart 6
Table summary
This table displays the results of Data table for Chart 6. The information is grouped by Job search barriers (appearing as row headers), Percent (appearing as column headers).
Job search barriers Percent
Few jobs available locally 25.4
Training/experience not adequate 23.8
Past attempts were unsuccessful 22.2
Would lose additional supports (e.g., drug/housing) 15.2

Supports

Overall, four in five (79.3%) adults with a pain-related disability indicated that they required help with some type of everyday activity, and about three in five (61.8%) of these reported having some level of unmet need for at least one of these support requirements.

While nearly three-quarters (72.6%) of all adults with a pain-related disability reported receiving help with at least one type of everyday activity, there was unmet need for various specific types of supports, as summarized in Chart 7. For example, about a third (34.4%) of all adults with a pain-related disability had an unmet need for help with heavy household chores, while around 1 in 20 had an unmet need for help with activities such as medical care at home and moving around the home.

Chart 7 Met and unmet needs for help with everyday activities among adults with a pain-related disability, aged 15 years and older, Canada, 2012

Data table for Chart 7
Data table for Chart 7
Table summary
This table displays the results of Data table for Chart 7. The information is grouped by Help with everyday activities (appearing as row headers), Needed help, not received and Needed help, received, calculated using percent units of measure (appearing as column headers).
Help with everyday activities Needed help, not received Needed help, received
percent
Heavy household chores 34.4 31.1
Housework 24.9 24.1
Getting to appointment and running errands 19.6 24.0
Preparing meals 12.2 18.2
Personal finances 7.6 13.6
Personal care 6.6 9.5
Medical care 5.1 7.6
Moving around 5.1 6.0
Childcare 1.6 1.1

Help with everyday activities was most likely to have come from family members, particularly those in the same household. For example, among those receiving assistance with such activities, 65.6% of those with pain-related disabilities received some help from family members living with them and 42.2% received some help from family members who were not living with them. Help with everyday activities came from other sources as well. For example, among adults who received some assistance with everyday activities, 27.8% of those with a pain-related disability also indicated receiving help from a friend or neighbour, 20.8% paid an individual or organization for help, and 12.3% reported receiving help from an organization free of charge. Clearly, individuals needing help often received that assistance from multiple sources.

Income

Personal income for working-age adults

The median personal income (before taxes) of working-age adults aged 15 to 64 with a pain-related disabilityNote 9 was $21,400—about 70% of the median personal income of those without any reported type of disability ($31,200).Note 10 Working-age men with pain-related disabilities had a higher median personal income than their female counterparts ($26,200 versus $17,700).

Those with a pain-related disability were also more likely to be reliant on government transfersNote 11 as their major source of income (48.2%) compared with those without any reported type of disability (18.7%). Furthermore, it was found that employed working-age adults with a pain-related disability had a lower median employment incomeNote 12 than those without any reported type of disability ($26,400 versus $34,100 respectively). Employed men with pain-related disabilities had a higher median employment income than their female counterparts ($32,600 versus $22,400).

Conclusion

Adults with a pain-related disability face many challenges. Co-occurrence with other disability types was high. In particular, the majority of individuals with a pain-related disability also had a mobility and/or a flexibility disability, and this was observed across all age groups. Yet, among young adults aged 15 to 24, the highest rate of co-occurrence for those with a pain-related disability was with mental health-related disabilities. At the same time, educational attainment and employment levels among those with a pain-related disability were lower than for those who did not report any disability. Even when employed, those with a pain-related disability had lower levels of employment income. Consequently, it is not surprising that working-age adults with a pain-related disability were also more likely than those without any disability to rely on government transfers as their major source of income. Four in five adults with a pain-related disability required some type of help with everyday activities (in particular, the more physically demanding activities such as heavy household chores and housework), and about three in five of these had some level of unmet need.

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Appendix A

Identification of adults with a pain-related disability

The 2012 Canadian Survey on Disability (CSD) identified adults with a pain-related disability as those whose daily activities are limited because of difficulties caused by constant and/or recurrent pain. The survey used the newly developed Disability Screening Questions (DSQ) to identify disability. The initial step in identifying a pain-related disability was to establish the existence of pain that is “always present” and/or pain that “reoccurs from time to time.” This was done using the following questions:

DSQ_21
Do you have pain that is always present?

DSQ_22
Do you have periods of pain that reoccur from time to time?

For those who said “yes” to either or both of these questions, indicating constant and/or recurrent pain, another question was asked to determine how often this difficulty limited their daily activities:

DSQ_23
How often does this pain limit your daily activities?

  • Never
  • Rarely
  • Sometimes
  • Often
  • Always

Those who reported being limited at least rarely were asked a follow-up question to determine the degree of difficulty:

DSQ_24
When you are experiencing this pain, how much difficulty do you have with your daily activities?

  • No difficulty
  • Some (difficulty)
  • A lot (of difficulty)
  • You cannot do most activities

A pain-related disability was identified when respondents reported being limited at least sometimes, regardless of degree of difficulty. If they reported being limited rarely, they were considered to have a pain-related disability if they also indicated having a lot of difficulty or being unable to do most activities when being limited.

An estimated 3,897,400 Canadian adults reported having constant and/or recurrent pain. Of these, 1,233,100 (4.5% of the adult population) were identified as not being limited by their pain, and 2,664,200 (9.7%) were identified as having a pain-related disability, based on the methodology described above.

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