BACKGROUND

The independent living movement in America stresses the empowerment of people with disabilities. The mission of the Idaho State Independent Living Council is to "promote a philosophy of independent living. " The goal inherent in the mission statement is to maximize opportunities and to incorporate people with disabilities into all walks of American life. In order to realize its goal, the Idaho State Independent Living Council must obtain detailed information on the prevalence, needs, and concerns of Idahoans with disabilities. This information is crucial for developing an effective strategic plan. On September 28, 1994, the Idaho State Independent Living Council awarded a contract, funded jointly by the federal government (90 percent) and the state government (10 percent) to the Survey Research Center at Boise State University to conduct a statewide needs assessment survey of Idahoans with disabilities. This monograph presents the results of the Center's work.

OBJECTIVES

The Idaho State Independent Living Council sought to conduct a statewide needs assessment survey of Idahoans with disabilities in order to identify the greatest unmet needs for its three-year strategic plan. To achieve this goal, the Council developed several objectives for the survey. Most importantly, the Council desired a survey based on probability sampling that would be statistically valid. The Council also wanted to reach those Idahoans with disabilities that were not currently receiving services in order to assess unmet need. In addition, the Council strongly desired that the survey provide information that was not already known. Further, the Council sought to ensure that the needs of individuals with communication-related disabilities were well- represented among the respondents. Finally, the Council sought to ensure that minority populations were represented among the respondents. The Council was interested primarily in the detailed, unknown needs of Idahoans with disabilities. However, the Council also recognized the need for accurate information about the magnitude of problems that are already well-known at a general level, such as the lack of adequate transportation.

METHODOLOGY

The Center used a statewide probability sample of all Idaho telephone numbers (a random digit dialing telephone survey), stratified by county and region, to conduct interviews with 635 Idahoans who answered "yes" to one or more of the questions that were designed to identify people who would be likely to qualify as having disabilities under the Americans with Disabilities Act and other relevant legislation. The Center worked with the Council to develop a questionnaire that addressed the unknown and unmet needs of Idahoans with disabilities. The Center also developed methods for interviewing respondents with communication-related disabilities (including mail versions of the questionnaire and the use of other household members as translators or proxy respondents). The Center used Spanish speaking interviewers to ensure that Hispanics (Idaho's largest minority group) who speak only Spanish could be included in the survey results. The survey was conducted during late February and early March of 1995, using the fully-networked, computer-assisted telephone survey laboratory at the Center.

KEY FINDINGS

Prevalence of Idahoans with Disabilities

Twenty-nine screening questions were used to identify those people who would be likely to qualify as having a disability under the Americans with Disabilities Act and other relevant legislation. Based on the survey results, the Center estimates that approximately 260,394 (44.8 percent) of Idaho's estimated 581,245 households contain at least one person that would qualify under one or more of the screening questions. In each qualifying household, there are approximately 1.13 qualified residents. Accordingly, the Center estimates that there are approximately 294,263 Idahoans living in residential households that would qualify under one or more of the screening questions. This number represents (18.74 percent) of the total 1,570,413 estimated number of Idahoans. The survey did not attempt to obtain information from Idahoans who do not live in residential households, such as those who live in nursing homes. Had these Idahoans been included, the percentage of Idahoans with potential disabilities would have been higher.

The Center compared the results of the 17 screening questions developed by the Center and the Council with the results from the four U.S. Census questions that ask about disabilities. Only 29.11 percent of the respondents that qualified under one or more of the Center's screening questions also qualified under one or more of the Census questions. Thus, the Census questions may significantly undercount people who qualify as having a disability under relevant legislation.

Overall Needs and Concerns

Overall, the Idahoans who qualified for the survey had a positive outlook about the extent to which their needs are met. As expected, few of the Idahoans interviewed had visited Centers for Independent Living, but those who had were quite satisfied. Only one-third of the respondents indicated that they had a high interest in attending support groups with other people with disabilities. The need for increased independence and personal financial resources were the most frequently reported "most important" problems facing the respondents, while the respondents most frequently reported that increased independence and social understanding or respect were the "most important" problems for people with disabilities in general.

No specific area of need stands out as a particularly strong statewide concern. However, a consistent minority, ranging between 20 and 30 percent of respondents disagreed that their needs were met. One possible exception was the availability of transportation services, identified as inadequate by nearly one-third of respondents. However, less than five percent reported transportation as the most important problem. Whereas most respondents agreed that public access was adequate, 45 percent of respondents disagreed that laws establishing designated parking for people with disabilities were adequately enforced.

Independence, Self-Efficacy, and Significance of Condition

Important factors did distinguish among respondents with more or less positive outlooks about the extent to which their needs are met. The degree to which respondents believe they live independently was strongly related to the extent of positive outlook. Independence was also strongly related to the significance of the reported condition and to the degree to which respondents believed themselves to be self-efficacious, which also were related to outlook. Generally, people who believe themselves to be independent and self-efficacious are more likely, for example, to believe that there is adequate parking, that parking laws are enforced, that the streets are safe and accessible, that they receive adequate job training, and so forth.

Other Demographic Differences

The analysis of demographic factors helps to provide a detailed understanding of the needs and concerns of specific types of Idahoans with disabilities. For example, the survey showed that the region of the state in which a respondent lives was not consistently related to attitudes about the degree of unmet need. There was no consistent effect of the rural to urban dimension, and there were no regions of the state that contained respondents who exhibited a consistently less positive outlook than other regions.

On the other hand, the Center's initial analysis of other demographic variables found strong effects for race, gender, employment status, and type of insurance. These factors are associated with unmet need in several important, although widely divergent, areas. With respect to employment status, for example, people who were employed full-time were more likely than others to believe that they receive adequate job training, whereas women were more likely than men to report visiting a health care practitioner and less likely than men to believe they had recreational opportunities available.

Conclusions: Idahoans with the Greatest Needs

The survey results suggest that, while there are no strikingly severe areas of unmet need for all Idahoans; with disabilities, some disabled Idahoans have substantially greater degrees of unmet need than others. Disabled Idahoans with the most unmet needs include those with more significant disabilities, those with lower perceived independence and self-efficacy, those lacking private health insurance, minorities and women, and unemployed and underemployed Idahoans. The survey results suggest that, in many ways, the needs and concerns of Idahoans with disabilities parallel those of Idahoans in general.

In order to collect additional data on relatively rare types of Idahoans, the four Centers for Independent Living together completed 103 supplemental interviews. These interviews do not represent a statistically valid sample. Their purpose was to provide additional qualitative information about Idahoans with relatively rare characteristics. A comparison of the results of these interviews with those of the general population survey showed that the general population survey was highly successful. Every type of Idahoan represented in the 103 supplemental interviews was found in the general population survey, with the exception that the general population survey did not identify anyone who reported tribal or Indian health services as their first reported type of insurance. In the 103 supplemental interviews, two respondents reported tribal or Indian health services as their first type of insurance.