Knowledge Translation‎ > ‎Education‎ > ‎

Statement of Need and Benefit

Mobility Device Users

As the U.S. population ages, and as more individuals survive with physically disabling diseases and paralyzing or disabling injuries, the use of assistive technology, and specifically mobility devices, is key to maintaining independence and functional in society. Manton et al. report that assistive technology is likely responsible for improved levels of activity in the elderly (Manton, 1993). Mobility devices, including wheelchairs, make up a significant portion of the assistive technology in use today.

Approximately 6.8 million non-institutionalized Americans utilize mobility assist devices, including wheelchairs, scooters, walkers and canes (Kaye, 2000). The number of wheelchair and walker users has roughly doubled between 1980 and 1990 (LaPlante, 1996). Nearly 1.7 million persons are either wheelchair or scooter users. A breakdown of wheeled mobility device usage by type of device and age are shown in the table below.

Mobility Device Usage in the United States (reported in 1000's)

DeviceAll personsUnder 1818-6465 & over
All Wheelchairs1,59988614897
Manual WCs1,50379560864
Powered WCs155189047
Scooters14207864

(Kaye, 2000)

The medical conditions associated with wheelchair or scooter usage are shown in the table below. In the 18-64 age group, multiple sclerosis, paraplegia and cerebrovascular disease are the leading conditions (Kaye, 2000). In the elderly population, age 65 and older, osteoarthritis and cerebrovascular disease are the leading causes of wheelchair or scooter use.

Wheelchair & Scooter Use Based Upon Condition (Age 18-64)

Condition# Persons in 1000’s
Multiple Sclerosis58
Paraplegia48
Cerebrovascular Disease45
Quadriplegia44
Osteoarthritis32
Loss of lower extremity31
Cerebral Palsy29
Rheumatoid Arthritis or Polyarthropathies21
Diabetes21
Orthopedic impairment of back/neck21
All Conditions635

(Kaye, 2000)

Relationship Between Mobility Usage and Quality of Life

In recognition of the importance for people with disabilities to function in society, in 1990 the US Congress enacted the Americans with Disabilities Act (ADA) prohibiting discrimination against people with disabilities in employment practices, public accommodations and telecommunication services (ATBCB, 1991). Transportation services, by legislative definition, fall within the public accommodation category. Therefore, public transportation service providers must accommodate persons seated in their wheelchairs who wish to travel. More recently, the 2001 New Freedom Initiative cited integration of persons with disabilities in the workforce and the community as a priority, specifically noting “transportation” as a critical factor in meeting this priority (Whitehouse.gov, 2001).

In support of this Initiative, the Director of Project Action reinforced the need for persons with disabilities to use public transportation systems, indicating that one third of the 25 million transit-dependent people with disabilities report inadequate transportation as a significant barrier to successful integration into society. The National Institute on Disability and Rehabilitation Research (NIDRR) has further reported that 82% of wheelchair users indicate difficulty in using public transportation systems and nearly 39% report wheelchair access problems (Kaye, 2000).

The NIDRR Disability Statistics Report on Mobility Device Use in the United States further highlights the lack of integration of wheelchair users into society and the workplace, indicating that mobility device users are less likely to be employed than those not using mobility devices (Kaye, 2000). Roughly 25% of mobility device users are employed as compared to approximately 75% in the non-using population. The study found an unemployment rate of 4.3 percent in those who do not use a mobility device as compared to 14.4 percent in those that use a mobility device; a 10.3 percent difference.

This high rate of unemployment among wheeled mobility users further translates into lower economic status. Among all mobility device users (including wheelchairs, walkers, canes and crutches), roughly 21% live in poverty as compared to 13% of the non-user population. When comparing the working-age population, the report indicates that mobility device users are 2.5 times as likely to live in poverty than non-users.

Educational attainment levels, which are correlated with socioeconomic status and associated with mobility device usage rates, also varied across users (Kaye, 2000). The rate of mobility device usage in those with eight years or less total education is six times greater than those who have sixteen years or more total education. In working age mobility device users, the same comparison yields a four-fold difference. Directly related to educational attainment, family income of mobility device users is also lower compared to non-users. Kaye reports that “a person whose family income is less than $10,000 is 4.6 times as likely to be a wheelchair user as a person whose family income is $35,000 or greater.”

Although there are no reliable statistics on the proportion of wheelchair users who remain seated in their wheelchairs when using private, public, and school transportation systems, it is likely that the proportion is high and that the numbers are increasing. The RERC on WTS efforts to increase safety and independence of motor vehicle transportation for wheelchair users have benefited many of the 1.7 million people who use wheelchairs.

Even though many wheelchair users will generally transfer to a vehicle seat, in some transport situations, they will choose to remain seated in their wheelchair. For example, a wheelchair user may choose to transfer to a vehicle seat in his or her personal vehicle, but ride seated in his or her wheelchair when using public transportation. Therefore, the potential benefit of providing safe and independent wheelchair transport is likely to affect a significant portion of the 1.7 million wheelchair users. With increased safety and independence in using motor vehicle transportation for all wheelchair users, the beneficial effects can be expected to include improved integration into society, increased employment, and increased educational attainment. In summary, access to safe public and private transportation services can be vital to providing wheelchair users access to work, education, and recreational environments – all essential to attaining equality of life style in the U.S.

In addition to consumers, caregivers, clinicians, and transporters who provide assistance to wheelchair users will also realize beneficial effects of providing safe and independent transportation to wheelchair users. They have an interest because the independence provided to wheelchair users during motor vehicle transportation should reduce the level of assistance needed by wheelchair users.

Finally, the RERC on WTS have benefited wheelchair manufacturers and companies that produce wheelchair tiedown and occupant restraint systems (WTORS). By translating the results of the research and testing conducted in the RERC on WTS into voluntary industry standards, manufacturers will be provided with clear design and performance targets for products that provide improved safety and crash protection for wheelchair-seated drivers and passengers. Voluntary industry standards are associated with reduced liability and increased incentive to develop and market products that offer wheelchair users a safer ride in motor vehicles. More information about Wheelchair Transportation Safety Standards can be found on this website.

References

ATBCB, 1991. Americans with Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles, 36 CFR Part 1192, Federal Register Vol 56, No. 173.

Kaye, HS, Kang, T, LaPlante, MP. Disability Statistics Report – Mobility Device Use in the United States, June 2000. Washington, DC: US Dept. of Education, National Institute of Disability and Rehabilitation Research.

LaPlante, MP, Carlson, D. Disability in the United States: Prevalence and Causes, 1992. Washington, DC: US Dept. of Education, National Institute of Disability and Rehabilitation Research.

Manton, KG, Corder, LS, Stallard, E. Changes in the Use of Personal Assistance and Special Equipment from 1982 to 1989: Results from the 1982 and 1989 NLTCS, Gerontology 33(2), p. 168-176.