In this publication are assembled the most important results of a survey carried out in 1971/1972 by the Central Bureau of Statistics as to the number of physically handicapped in the Netherlands, their social circumstances and the use made of and demand for services and facilities. For the purpose of this survey a sample was drawn from the Netherlands population of 5 years of age and older (both institutionalized and non-institutionalized) registered in the municipal civil registers as of 28th February 1971. In the first instance these persons received a questionnaire by mail. Of those who responded (83%), those who claimed to have physical complaints were approached by means of an interview survey. Co-operation was 95%. In the framework of this survey by physically handicapped is understood: = anyone who has one or more functional disorders to at least a certain degree. Disorders in the following are regarded as functional disorders: function of legs, function of arms/hands, sight, hearing, speech, endurance (heart, lungs), micturition, defecation, balance (including epilepsy), other functions. With respect to each function it was determined to what degree of severity the disorder must at least be present for the individual to be considered physically handicapped. 3 to 4 degrees of severity were distinguished for each functional disorder.
The results of the study are published in Dutch in six parts. The first part, containing the key figures, appeared at the end of 1974. It is expected that parts 2 and 3 will appear in the course of 1976. This part (7) is an English language synopsis of the first three parts. In addition to a general description of definitions and research methods the following subjects are dealt with:
- demographic data (age, sex, degree of urbanization, province, civil status);
- physical data (nature of functional disorder, cause, diagnosis groups, physical defects, location of accident, age at which func
tional disorder became manifest, degree of severity);
- special aids (prostheses, wheel chairs, hearing-aids etc.), use and demand;
- medical services (general practitioner, rehabilitation treatment), use and demand;
- social services, contact and demand.
For each of these subjects some of the most salient results are given.
Of the Netherlands population of 5 years of age and older 8.7% are found to be physically handicapped on the basis of the definition employed in the survey. This is equivalent to over a million persons. The chance of becoming physically handicapped increase sharply with increase of age. Of young people of 5 -24 years of age approximately 2% are handicapped. Among persons of 75 years of age and older this percentage is 35. Till the age of 55 differences between men and women are not large. After this age differentiations are to be found. Differences in mortality patterns and in physical burden are probably responsible for this. The sharp increase among men up to the age of 65 and the decrease after this age is striking. Even when the factor age is eliminated it is found that the percentage of physically handicapped in rural areas is significantly lower than in urban municipalities. After elimination of the age factor, differences between the provinces are found to disappear. Only the province of Limburg, which encompasses the former mining area, is found to have a significantly higher percentage.
Disorders in endurance and in function of legs play a very large role. Of all physically handicapped (of 5 years and older) 21% have only a disorder in endurance and 18% a disorder in function of legs. in addition to this there are a large number of physically handicapped persons with a disorder in endurance and/or function of legs in combination with other functional disorders. This results in there being a disorder in endurance among 45% of all physically handicapped and a disorder in function of legs among 42%. Slightly more than 80% of handicapped persons are handicapped simply as a result of illness (including old age). After this in order of frequency follow "due to accident" and "from birth". In the case of disorders due to accident, traffic is found to account for the largest number, followed closely by accidents at work and at home. In the diagnosis groups heart and vascular diseases and rheumatic conditions are the most widespread.
For the purpose of moving around approximately 56% of persons with disorders in function of legs make use of special aids such as canes and orthopaedic aids, while nearly 10% move around with the assistance of others. It is estimated that 8.9% of all physically handicapped with a disorder in function of legs, or 0.3% of the Netherlands population, makes use of some form of special transport such as a wheel chair, invalid car, push chair etc. Approximately 87% of all physically handicapped had consulted a general practitioner or specialist in the year preceding the survey and 12.3% had at some time received rehabilitation treatment.
Of the physically handicapped of 5 - 64 years of age, 22% had contact with social services in some form.
In conclusion it should be stated that in many instances a lack of information was found to exist as to aids, services and the channels to obtaining these. Though it is possible that resistance and bash fulness play a role it does appear desirable that more attention should be devoted to the aspect "information". more information in general, but in particular to the physically handicapped, to persons in their immediate surroundings and to their potential helpers should be considered.
In view of the fact that a high percentage of the physically handicapped fairly regularly come into contact with some form of medical services, co-operation with this sector to further information and to point the way to the appropriate institutions is to be advocated.