In 2022, 66.1% of persons with disabilities in Canada reported at least one unmet need when it came to health care services, prescription medication, assistive aids or devices, or help with everyday activities. An unmet need for support occurs when a service or assistance is required but is not received or does not adequately address the health-related problem or barrier. Services or supports can facilitate accessibility and allow for greater participation in daily activities by persons with disabilities.
The new study, entitled "Factors associated with unmet needs for disability supports, 2022," uses data from the 2022 Canadian Survey on Disability to explore the different characteristics that are associated with having unmet needs for different types of support. The four types of support examined include health care services, prescription medication, assistive aids or devices, and help with everyday activities. This study explores the prevalence of unmet needs for each type of support, while also looking at the association between different characteristics and unmet needs.
Over two-fifths of persons with disabilities have unmet needs for health care services
Health care services (45.7%) was the area with the highest rate of unmet needs in 2022. In terms of specific health-related services or therapies, physiotherapy, massage therapy or chiropractic treatments (28.7%) and counselling services from a psychologist, psychiatrist, psychotherapist or social worker (18.5%) were the most commonly reported unmet needs.
Among persons with disabilities, 13.5% had unmet needs for prescription medication, as they were either unable to purchase medication or took it less often due to cost-related issues. Additionally, among those who used prescription medication, 44.2% had out-of-pocket expenses associated with their medications.
Assistive aids or devices can help persons with disabilities to participate more fully in daily activities. These can include devices with specialized software, walkers, large print reading materials or architectural features in the home such as widened doorways and ramps. Over one-fifth (22.7%) of persons with disabilities had unmet needs for assistive aids or devices.
Persons with disabilities often rely on help from family, friends, neighbours and organizations for everyday activities. Almost one-third (32.7%) of persons with disabilities experienced unmet needs for help with everyday activities. Activities with the highest rates of unmet needs for help included heavy household chores (21.5%), everyday housework (14.4%) and getting to appointments or running errands (10.5%).
Increased disability severity and encountering barriers to accessibility are risk factors for unmet needs across all areas of support
In 2022, persons with very severe disabilities were consistently more likely to have unmet needs for each type of support, compared with their counterparts with milder disabilities. For example, compared with those with mild disabilities, those with very severe disabilities had over two times higher odds of having unmet needs for health care services or prescription medication, while they had almost four times higher odds of having unmet needs for assistive aids or devices or help with daily activities.
Experiencing a higher-than-average number of barriers to accessibility was associated with increased odds of unmet needs in all areas of support. Compared with those who did not experience barriers in their environment, those who faced a high rate of barriers had 3.5 times higher odds of having unmet needs for help with everyday activities and almost twice the odds of having unmet needs for prescription medication. The odds of experiencing unmet needs for health care services or assistive aids or devices were about three times higher for those who encountered a high number of barriers to accessibility than for those who encountered no barriers.
Other common factors associated with unmet needs include lower self-rated health status and loneliness
Some additional patterns emerged in 2022 across other disability and health-related or wellbeing characteristics in relation to unmet needs for the different areas of support. Lower self-rated health was associated with higher odds of unmet needs for health care services, prescription medication and help with everyday activities. Feelings of loneliness were also associated with higher odds of unmet needs for these same three areas.
Those who considered themselves housebound, defined as those who cannot leave their home environment due to their condition, were at greater risk of experiencing unmet needs for health care services and for help with everyday activities, compared with those who were not housebound.
Older Canadians with disabilities are more likely to have unmet needs for assistive aids or devices as well as for help with everyday activities
Age and gender were factors in the likelihood of having unmet needs for all types of support in 2022. Compared with youth aged 15 to 24 years, those aged 65 years and older had greater odds of unmet needs for assistive aids or devices or help with everyday activities, but lower odds of unmet needs for health care services or prescription medication. The odds of having unmet needs for health care services, prescription medication or help with everyday activities were greater for women than men. Conversely, women had lower odds than men of having unmet needs for assistive aids or devices.
Note to readers
The Canadian Survey on Disability (CSD) is the official source of data on persons with disabilities aged 15 years and older in Canada. The survey population for the 2022 CSD was comprised of Canadians aged 15 years and older as of the date of the 2021 Census of Population (May 2021) who were living in private dwellings. For methodological details see Surveys and statistical programs - Canadian Survey on Disability (CSD).
In this study, descriptive statistics were used to estimate the prevalence of experiencing unmet needs for each disability support among persons with disabilities aged 15 years and older. Logistic regression modeling was used to identify the key factors associated with higher or lower odds of having unmet needs, while controlling for the effects of other disability-related and sociodemographic covariates at the same time.
In this analysis, a two-category gender variable is used to facilitate historical comparison and to protect the confidentiality of non-binary persons, given the relatively small size of this population in Canada. For 2022 data, the category of "men" includes cisgender and transgender men (and/or boys), as well as some non-binary persons, while "women" includes cisgender and transgender women (and/or girls), as well as some non-binary persons. Although sex and gender refer to two different concepts, the introduction of gender is not expected to have a significant impact on data analysis and historical comparability, given the small size of the transgender and non-binary populations.
A global severity score was developed for the CSD, which was calculated for each person using: a) the number of disability types that a person has, b) the level of difficulty experienced in performing certain tasks, and c) the frequency of activity limitations. To simplify the concept of severity, four severity classes were established: mild, moderate, severe, and very severe. "Mild" and "moderate" classes were collapsed into "milder", while "severe" and "very severe" classes were collapsed into "more severe". Note that the name assigned to each class is intended to facilitate use of a severity score and is not a label or judgement concerning the person's level of disability. For more information, see the Canadian Survey on Disability, 2022: Concepts and Methods Guide.
Health care services include the following therapies or services: physiotherapy, massage therapy or chiropractic treatments; speech therapy, occupational therapy; counselling services from a psychologist, psychiatrist, psychotherapist or social worker; support group services, drop-in centre services or telephone information or support lines; life sustaining therapies or specialized medical care; addiction services; life skills program or services; naturopathic, homeopathic or osteopathic treatments; acupuncture; nutrition or dietary services; specialized vision care from an ophthalmologist, optometrist, or optician; or other therapy or service.
For prescription medication, respondents were asked if they were ever unable to purchase required medication or took their medication less often because of cost, within the 12 months prior to the survey. It is important to note that respondents were specifically asked about cost as the reason for each behaviour within the question, whereas the other need areas examined in this report did not specify the reason within the questions but instead had follow up questions on reasons, with cost as one of several possible reasons listed.
Questions on assistive aids or devices were asked for specific disability types, with modules for seeing aids, hearing aids, physical aids (includes mobility, dexterity or flexibility disabilities) and cognitive aids (includes developmental or learning disabilities), as well as one module that was asked of persons with all disability types.
Help with everyday activities includes the following activities: preparing meals, everyday housework, heavy household chores, getting to appointments or running errands, looking after personal finances, personal care, basic medical care at home, moving around inside their residence, or other types of help.
Reference
Definitions, data sources and methods: survey number 3251.
Contact information
For more information, or to enquire about the concepts, methods or data quality of this release, contact us (toll-free 1-800-263-1136; 514-283-8300; infostats@statcan.gc.ca) or Media Relations (statcan.mediahotline-ligneinfomedias.statcan@statcan.gc.ca).