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Definition

A person’s functioning or disability is conceived as a dynamic interaction between health conditions and environmental and personal factors (WHO 2001:6 and see Figure 1). Functioning and disability are both multidimensional concepts.

Disability is the umbrella term for any or all of: an impairment of body structure or function, a limitation in activities, or a restriction in participation.

Key definitions of components are:

  • Body functions are the physiological functions of body systems (including psychological functions).
  • Body structures are anatomical parts of the body such as organs, limbs and their components.
  • Impairments are problems in body function and structure such as significant deviation or loss. Activity is the execution of a task or action by an individual. Participation is involvement in a life situation.
  • Activity limitations are difficulties an individual may have in executing activities.
  • Participation restrictions are problems an individual may experience in involvement in life situations.
  • Environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives. These are either barriers to or facilitators of the person’s functioning.

Comments

Many different 'definitions' of disability are used in Australia, both in administrative data collections and in Acts of Parliament. The consistent identification of disability in national data collections has been recommended in a number of reports, for instance to enable:

  • the monitoring of access to generic services by people with disability
  • the collection of more consistent data on disability support and related services, including data on service use by different groups
  • population data and service data to be related, thereby improving the nation's analytical capacity in relation to the need for and supply of services
  • improved understanding of the relationship between disability, health conditions and other health outcomes.

Defining disability makes it possible to determine the number of people who are accessing services, both disability specific and generic, and also those with a disability in the general population with unmet need. Better definition of disability will aid better targeting of resources to those in need.

Disability arises from the interaction between health conditions and environmental and personal factors. A health condition may be a disease (acute or chronic), disorder, injury or trauma. Environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives. Personal factors relate to the individual, such as age, sex and Indigenous status.

The concept 'Disability' can be described using a combination of related metadata items as building blocks.

The metadata items selected may vary depending on the definition of disability used. For example, in hospital rehabilitation, the focus may be on the impairment and activity dimensions and in community-based care the focus may be primarily on participation. Some applications may require a broad scope for inclusion (e.g. discrimination legislation). Data collections relating to services will select combinations of the data elements, which best reflect the eligibility criteria for the service.

This glossary item is based on the International Classification of Functioning, Disability and Health (ICF). The ICF was endorsed by the World Health Assembly in 2001 as a reference member of the WHO Family of International Classifications and of the Australian Family of Health and Related Classifications (endorsed by the National Health Information Management Group in 2002).

The ICF provides a framework for the description of human functioning and disability. The components of ICF are defined in relation to a health condition. A health condition is an ‘umbrella term for disease (acute or chronic), disorder, injury or trauma’ (WHO 2001). A health condition may be recorded, for example, as Episode of care principal diagnosis, code (ICD-10-AM 3rd Edn) ANN.NN and Episode of care additional diagnosis, code (ICD-10-AM 3rd Edn) ANN.NN.

Origin

https://www.aihw.gov.au/reports/disability/icf-disability-health/summary

(AIHW) Disability Data Briefing, Number 20, June 2002 - https://www.aihw.gov.au/getmedia/2055456b-aa8a-44a9-80c0-d5c9a8adc87c/ddb20.pdf.aspx

References

Bickenbach JE, Chatterji S, Badley EM & Ustun TB 1999. Models of disablement, universalism and the international classification of impairments, disabilities and handicaps. Social Science & Medicine 48:1173–87.

World Health Organization 2001. International Classification of Functioning, Disability and Health. Geneva: WHO.

Australian Institute of Health and Welfare 2002. History of the International Classification of Functioning, Disability and Health (ICF) Disability Data Briefing Number 21.

Further information on the ICF can be found in the ICF itself and the ICF Australian User Guide (AIHW 2003) and the following websites

  • The Australian ICF site is at: www.aihw.gov.au/disability/icf/ index.htm
  • The WHO ICF site is at: www3.who.int/icf/icftemplate.cfm | http://www.who.int/classifications/icf/en

Related content

Relation Count
Data Element Concepts implementing this Conceptual Domain 9
Value Domains Concepts implementing this Conceptual Domain 7