Under the conceptual framework of disability described by the Institute of Medicine (IOM) and the International Classification of Functioning, Disability, and Health (ICF), disability is defined as the product of interactions among individuals' bodies; their physical, emotional, and mental health; and the physical and social environment in which they live, work, or play. Disability exists where this interaction results in limitations of activities and restrictions to full participation at school, at work, at home, or in the community. For example, disability may exist where a person is limited in their ability to work due to job discrimination against persons with specific health conditions; or, disability may exist where a child has difficulty learning because the school cannot accommodate the child's deafness.

Furthermore, disability is a dynamic concept that changes over time as one's health improves or declines, as technology advances, and as social structures adapt. As such, disability is a continuum in which the degree of difficulty may also increase or decrease. Because disability exists along a continuum, various cut-offs are used to allow for a simpler understanding of the concept, the most common of which is the dichotomous "With a disability"/"no disability" differential.

Measuring this complex concept of disability with a short set of six questions is difficult. Because of the multitude of possible functional limitations that may present as disabilities, and in the absence of information on external factors that influence disability, surveys like the ACS are limited to capturing difficulty with only selected activities. As such, people identified by the ACS as having a disability are, in fact, those who exhibit difficulty with specific functions and may, in the absence of accommodation, have a disability. While this definition is different from the one described by the IOM and ICF conceptual frameworks, it relates to the programmatic definitions used in most Federal and state legislation.

In an attempt to capture a variety of characteristics that encompass the definition of disability, the ACS identifies serious difficulty with four basic areas of functioning - hearing, vision, cognition, and ambulation. These functional limitations are supplemented by questions about difficulties with selected activities from the Katz Activities of Daily Living (ADL) and Lawton Instrumental Activities of Daily Living (IADL) scales, namely difficulty bathing and dressing, and difficulty performing errands such as shopping. Overall, the ACS attempts to capture six aspects of disability, which can be used together to create an overall disability measure, or independently to identify populations with specific disability types.

Information on disability is used by a number of federal agencies to distribute funds and develop programs for people with disabilities. For example, data about the size, distribution, and needs of the population with a disability are essential for developing disability employment policy. For the Americans with Disabilities Act, data about functional limitations are important to ensure that comparable public transportation services are available for all segments of the population. Federal grants are awarded, under the Older Americans Act, based on the number of elderly people with physical and mental disabilities.

Question/Concept History

In the 2018 American Community Survey, disability concepts were asked in questions 17 through 19. Question 17 had two subparts and was asked of all persons regardless of age. Question 18 had three subparts and was asked of people age 5 years and older. Question 19 was asked of people age 15 years and older.