Abstract:

Overshadowing all other policy implications of disability related to elderly people in the US are two stark realities: (a) the direct and indirect costs associated with disability and rehabilitation in the total population approximate $300 billion per year, and (b) the increasing numbers of persons 85 years and older whi stand at greatest risk for disabilities. The costs associated with disability amount to more than 4% of gross national domestic product, a substantial outlay that will almost certainly increase in the future unless the USA takes an aggressive and definitive action. A recent report by the Institute of Medicine indicates that annual expenditures for research on disabilities amounts to only about $7 per disabled person, whereas the annual costs in healthcare and lost productivity are approximately $7,500 per person. Although disability in America exerts profound social and fiscal burdens, the research cited by Ostir et al (Ostr, GV et al 1999) demonstrates the complexity and lack of universal agreement concerning the physical or psychological problem. Adding to the potential for confusion is the number of contrasting ways of measuring disability. In this article, the authors review several perspectives and associated methodologies and consider their implications for public policy research and practice. It concludes with some recommendations for public policy.