[Measurement of handicap in the community: a micro survey in a French village].

Handicap is the result of a process initiated by an underlying disease, an accident or an abnormality, which leads to a functional deficit in various situations of everyday life. This definition, derived from the International Classification of Impairments, Disabilities, and Handicaps (ICIDH), reflects the desire of the elderly and the handicapped for social integration. It may also form the conceptual basis for analysis of the capacities of individuals and populations. To this end, a micro-survey was conducted in a homogeneous village community of 532 people aged 1-92 years. This study was of the ergonomic type, accompanied by a questionnaire on perceived restrictions and handicaps, and carried out transversely over a period of one month (94.7% participation). The specific objectives of the study were to obtain a reliable functional representation of the population of the village, comparing self-assessment of functional capacity with observed performance, and analysing the effects of age on capacity. The copious data collected in the areas of locomotion, prehension and communication have provided a detailed functional profile of the population studied. These data may be transposed to particular environments, such as transport, housing, school or work, and may serve as a basis for comparisons. The difficulties encountered by subjects in the tests were closely correlated with the situations simulated by the tests. Subjective estimation of handicap proved to be reliable in comparison with actual performance, especially for tests of mobility and highly demanding situations. Estimation of the presence of a handicap increased with age. The deterioration in performance observed was proportional to age, but can be perceived to begin early, at about 30-40 years. Disability-free life expectancy (DFLE) could be an interesting indicator in so far as it appears to be sensitive to the confrontation of individual functional capacities with the environment. However, it is important that any disability used as a basis for calculation should be measured with maximum precision. A community survey of this kind is thus particularly useful for ergonomic purposes, but is also valuable for the planning of medical and social assistance at the local level in the areas of disability and handicap. The combination of observation and listening to people, with an interview, appears to be fruitful and reliable. Single studies of well-targeted samples of the population, or, alternatively, of larger and more significant populations, would be desirable in public health, since the epidemiological approach to handicap has hitherto been essentially focused on diagnosis and medical evaluation.