Background Representative national data on disability are becoming increasingly important in helping policymakers decide on public health strategies.
Objectives We assessed the respective contribution of chronic health conditions, including musculoskeletal diseases, to disability for three age groups (≤40, 40–65, and >65 years old) using data from the 2008–2009 Disability-Health Survey in France.
Methods Data on 12 chronic conditions and on disability for 24 682 adults living in householdswere extracted from the Disability-Health Survey results. A weighting factor was applied to obtain representative estimates for the French population.We considered three disability categories: functional disability which was defined as at least one restriction in activities of daily living (ADL), severe disability as the inability to perform at least one ADL alone, and self-reported disability as a general feeling of being disabled. To account for co-morbidities, we assessed the contribution of each chronic disorder to disability by using the average attributable fraction (AAF).
Results Weestimatedthat 38.8 million people in France (81.7% [80.9;82.6]) had a chronic condition (13.7 millions (28.7% [27.9;29.5]) reported musculoskeletal diseases): 14.3% [14.0;14.6] considered themselves disabled, 4.6% [4.4;4.9] were restricted in ADL and 1.7% [1.5;1.8] were severely disabled.Musculoskeletal disorders contributed the most to self-reported disability (AAF 15.4%) and had the second largest impact on functional disability (AAF 16.4% versus 17.4% for neurological conditions). Their contribution to severe disability was almost nil (AAF 0.0%). These estimates vary according to the age group. Psychiatric diseases contributed the most to disability categories for patients 40 years old and younger (AAF 23.8%–40.3%).
Conclusions Musculoskeletal, neurological and cardiovascular chronic disorders mainly contribute to disability in France. Musculoskeletal diseases have the largest impact on self-reported disability. Results vary according to the age group. These findings should help policymakers define priorities for health-service delivery in France and perhaps other developed countries.
Disclosure of Interest C. Palazzo Grant/Research support from: We received grant from Pfizer France, which had no role in study design, data collection and analysis, J.-F. Ravaud: None Declared, L. Trinquart: None Declared, M. Dalichampt: None Declared, P. Ravaud: None Declared, S. Poiraudeau Consultant for: received fees from Pfizer for consultancy.
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