The Canterbury studies of disablement in the community: prevalence, needs and attitudes.

The Health Services Research Unit at the University of Kent at Canterbury was set up in 1971, with financial support from the Central Government's Department of Health and Social Security. One area of major concern has been the study of the number and needs of disabled people living at home and of services provided to meet those needs. In a City-wide survey of the whole population, it was found that about 5 per cent of the people living at home had significant impairments, about half of whom had or required some support. Registers of disabled people and records of services helping them were found to be an inadequate source of data for estimating total numbers and needs. A separate study validated the broad clinical information given by the respondents. The original population of impaired people were revisited years after the first survey. 13 per cent had died, mortality being highest among those with the severer degrees of dependency; 25 per cent had had at least one episode of serious illness; and 61 per cent reported more difficulties overall than they had in the initial survey. Although 75 per cent of the needs expressed in the initial survey had been met or ameliorated. Other studies have examined means of detecting visual disability, the value of domiciliary physiotherapy, and occupational therapy and the need for special dental services for some disabled people. Inevitably some biases are introduced into the design of population-wide surveys of disabled people. Important among these are the definitions used of 'impairment', 'disability' and 'handicap'; the orientation of the questions asked (which tend define 'need' in terms of the perceptions of the provider of services rather than of the disabled person); and, in the measures used to quantify the data collected. Further areas of research needed are discussed at the end of the paper.