Health and health care; personal characteristics

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Description topics

Functional limitations

Functional limitations (physical) are observed by means of 3 groups of questions:
a. The OECD indicator for persons in the age category of 12 years or older.
b. The ADL (Activities of Daily Living) indicator for persons in the age category of 55 years or older.
c. Temporary activity limitations and bed-days for persons of all ages.
Besides, a general question about the functional limitations (GALI-indicator) is asked.

GALI limitation, 4 years or older

Percentage of persons that for at least the past 6 months are limited because of a health problem in activities people/children usually do. This internationally used and adjusted indicator for health limitations is called the GALI, which stands for Global Activity Limitation Indicator. This indicator is calculated for all persons 4 years and older.
In 2014, this indicator was calculated by use of 2 questions, in 2015 both questions are combined in 1 question. This had no effect on the outcome.

Limitations OECD, 12 years or older

The OECD indicator (Organisation for Economic Cooperation and Development) in this table is based on 7 questions on abilities that people normally can perform, if necessary with glasses or a hearing aid. It does not deal with temporary problems.
1. Can you follow a conversation in a group of three or more persons? (with hearing aid, if needed)
2. Can you have a conversation with one other person? (with hearing aid, if needed)
3. Can you read the small print in the newspaper? (with glasses or contact lenses, if needed)
4. Can you recognise somebody's face at a distance of 4 metres? (with glasses or contact lenses, if needed)
5. Can you carry an object of 5 kilogrammes, for instance a shopping bag, over a distance of 10 metres?
6. Can you bend down from an upright position and pick up something from the floor?
7. Can you walk 400 metres without stopping? (with stick, if needed)
Answer categories to these questions are: 'without difficulty', 'with some difficulty', 'with a lot of difficulty', 'impossible'. The indicator scores 'yes' if the answer to at least 1 of the 7 questions is: 'with a lot of difficulty' or 'impossible'. The respondents are persons in the age category 12 years or older.

Persons with at least 1 limitation

Percentage of persons with at least 1 OECD limitation. A respondent has a limitation if he or she answers ꞌwith a lot of difficultyꞌ or ꞌimpossibleꞌ to at least 1 of the 7 OECD questions.

Limitations per person

The average number of OECD limitations per person in the population of 12 years or older, measured by the OECD indicator.

Limitations per person with limitation

The average number of OECD limitations per person of 12 years or older with at least 1 limitation, measured by the OECD indicator.

Persons with hearing limitation

Percentage of persons of 12 years or older who answered ꞌyes, with a lot of difficultyꞌ or ꞌno, impossibleꞌ to at least 1 of the 2 questions on hearing (according to the OECD indicator).

Persons with visual limitation

Percentage of persons of 12 years or older who answered ꞌyes, with a lot of difficultyꞌ or ꞌno, impossibleꞌ to at least 1 of the 2 questions on eyesight (according to the OECD indicator).

Persons with mobility limitation

Percentage of persons of 12 years or older who answered ꞌyes, with a lot of difficultyꞌ or ꞌno, impossibleꞌ to at least 1 of the 3 questions on mobility limitation (according to the OECD indicator).

Limitations ADL, 55 years or older

The ADL indicator (Activities of Daily Living) is based upon questions on the following 11 activities:
1. Sitting down in and rising from a chair
2. Getting into and out of bed
3. Walk up and down stairs
4. Eating and drinking
5. Dressing and undressing
6. Washing face and hands
7. Washing whole body
8. Utilizing toilet
9. Moving to another room on the same floor
10. Leaving and entering the house
11. Moving outdoors
The 4 possible answers to these questions are: 'without difficulty', 'with some difficulty', 'with a lot of difficulty’, 'only with the help of others'. The first 3 questions have a fifth answer: 'not even with the help of others'. The indicator scores 'yes' if at least one of the answers to the above 10 questions is: 'with a lot of difficulty' or 'only with the help of others'. The questions were put to persons aged 55 years or older.

Persons with at least 1 limitation

Percentage of persons of 55 years or older with at least 1 ADL limitation. A respondent is considered to have a limitation if he or she answers at least one of the 11 questions with 'impossible', 'with great difficulty' or 'not even with the help of others.

Limitations per person

The average number of ADL limitations per person aged 55 years or older, measured with the aid of the ADL indicator.

Limitations per person with limitation

The average number of ADL limitations per person of 55 years or older with at least 1 limitation, measured with the aid of the ADL indicator.

Limitations IADL, 55 years or older

IADL (Instrumental Activities of Daily Living) inquires after domestic activities that may cause executional problems as a consequence of health problems. The IADL indicator is based upon questions on the following 7 performances:
1. Preparing meals
2. Telephoning
3. Shopping
4. Taking the right medicines in time
5. Light domestic work
6. Heavy domestic work
7. Keeping money matters and daily financial records
The 5 answer categories to these questions are: 'without difficulty'; 'with some difficulty'; 'with a lot of difficulty’; 'unable to do so'; 'not applicable / I never did or had to do this'. These questions are posed to persons of 55 years or older.

Persons with at least 1 limitation

Percentage of persons of 55 years or older with at least 1 IADL limitation. A respondent is considered to have a limitation if he or she answers at least one of the 7 questions with 'impossible' or 'with great difficulty.

Limitations per person

The average number of IADL limitations per person of 55 years or older, measured with the aid of the IADL indicator.

Limitations per person with limitation

The average number of IADL limitations per person of 55 years or older with at least 1 limitation, measured with the aid of the IADL indicator.

SF-12 health measure, 12 plus

The 'Short Format 12' or SF-12 questionnaire is a selection of 12 questions from the SF-36 (Ware et al., 1995 *). The SF-12 is a widely used international standard of a generic health measure. The SF-12 measures eight health aspects, namely physical functioning, role limitations due to physical health problems, physical pain, general health, vitality (energy / fatigue), social functioning, role limitations due to emotional problems and mental health. Based on the 12 questions, two partial scales can be calculated; a summary measure for physical health (norm score physical) and a summary measure for psychological health (norm score psychological).
These norm scores are calculated for people aged 12 or older.
*Ware J.E., Kosinski M., Keller S.D. SF-12: How to score the SF-12 Physical and Mental Health Summary Scales. Boston, MA: The Health Institute, New England Medical Center, Second Edition, 1995.

Norm score physical

Standard score physical is determined for persons 12 years of age or older. The standard score physical is a summary physical health measure, which is calculated by means of the answers to the SF-12 questionnaire. The American population was used as the reference group in the development of the norm scores. In 1995, the physical health score for the American population was exactly 50. Mean values below 50 indicate less good physical health than in that standard population (American population 1995) and values above 50 indicate better health. For the Dutch population, the average of the physical norm score is slightly higher than 50.

Separate items

Physical health: less accomplished

The following question was asked to respondents aged 12 or older: When you think about your work or other daily activities, has your physical health helped you achieve less than you would like?
1.Yes
2. No.

Yes

The percentage of people aged 12 or older who answered ‘yes’ to the question ‘When you think about your work or other daily activities, have you accomplished less than you would like because of your physical health?’

No

The percentage of people aged 12 or older who answered ‘no’ to the question ‘When you think about your work or other daily activities, have you accomplished less than you would like because of your physical health?’

Physical health: limited work

The following question was asked to respondents aged 12 or older:
When thinking about your work or other daily activities, were you limited by your physical health in the type of work or activities?
1.Yes
2. No.

Yes

The percentage of people aged 12 or older who answered ‘yes’ to the question ‘When thinking about your work or other daily activities, were you limited by your physical health in the type of work or activities?’

No

The percentage of people aged 12 or older who answered ‘no’ to the question ‘When thinking about your work or other daily activities, were you limited by your physical health in the type of work or activities?’