Disability overview

Disability overview

In the Equality Act 2010, disability is defined as “a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities.”

‘Substantial’ is defined as more than minor or trivial, e.g., it takes much longer than it would usually to complete a daily task, like getting dressed. ‘Long-term’ is defined as a condition lasting 12 months or longer.

These conditions may be cognitive, developmental, intellectual, mental, physical, sensory, or a combination of multiple factors. Conditions causing disability may be present from birth or occur during life or may even come and go.

Hidden disabilities

Invisible disabilities are those that are not immediately apparent to others. These can include neurodiversity, a mental health condition as well as mobility, sensory loss or a physical disability that causes pain, fatigue or impacts on movement. People who experience neurodiversity, interact with, and interpret the world in unique ways. Neurodiversity can include autism, dyslexia, dyscalculia, epilepsy, hyperlexia, dyspraxia, ADHD, obsessive-compulsive disorder, and Tourette's syndrome.

Disability estimates and projections

Estimates and projections of the number of disabled people in the city have been produced using national prevalence rates applied to local population data; these suggest that in Southampton, in 2023 there may be around 7,346 adults aged 18-64 who have impaired mobility (meaning that they experience either moderate, severe or complete difficulty with mobility, and certain activities are limited in any way as a result, such as walking or climbing stairs). By 2040 there are projected to be over 7,201 adults of working age impaired mobility. A fall of -2.0% between 2023 and 2040. Projecting Adult Needs and Service Information (PANSI) from Oxford Brookes University.

Modelling by Projecting Older People Population Information System (POPPI), also from Oxford Brookes University, estimates in 2023, there are 6,552 people aged 65 and over unable to manage at least one mobility activity on their own, (this estimate is adjusted for the underlying age and gender distribution). Activities include going out of doors and walking down the road; getting up and down stairs; getting around the house on the level; getting to the toilet; getting in and out of bed. This is predicted to increase to 8,631 Southampton residents aged 65 and over by 2040, an increase of 31.7% by 2040.

Leading causes and risk factors of disability

Years Lived with Disability (YLDs) is described as years lived in less than ideal health. This includes conditions such as influenza, which may last for only a few days, or epilepsy, which can last a lifetime. It is measured by taking the prevalence of the condition multiplied by the disability weight for that condition. Disability weights reflect the severity of different conditions and are developed through surveys with the general public.

In Southampton, the leading causes attributed to Years Lived with Disability (YLDs) are type 2 diabetes, lower back pain, alcohol use disorders, COPD and falls. The top five risk factors include high body-mass index, high fasting plasma glucose (which is an indicator of a higher risk of diabetes), smoking, alcohol use or drug use. More information is available in the slide set below or on the Global Burden of Disease website.

Levels of disability in Southampton

In February 2023, data on Disability Living Allowance (DLA) claimants amongst the under 16 years old shows that 3,538 Southampton children receive DLA.

The three main disabling conditions for children in the city can be broken down as:

• Learning difficulties – 2,008 children (56.8%)
• Behavioural disorder – 649 children (18.3%)
• Hyperkinetic syndrome, also known as ADHD - 265 children (7.5%)

In the same period there were 1,144 working age adults, the top three main disabling conditions are:

• Learning difficulties – 280 working age adults (24.5%)
• Psychosis – 131 working age adults (11.5%)
• Arthritis - 75 working age adults (6.6%)

In February 2023, there were 1,524 adults over state pension age and the main disabling conditions were:

• Arthritis – 487 adults over state pension age (32.0%)
• Disease of the muscles, bones or joints - 111 adults over state pension age (7.3%)
• Back pain – 107 adults over state pension age (7.0%)

There are currently 3,382 (March 2023) individuals known to Southampton City Council Adult Social Care as visually/hearing impaired and/or with a physical disability, living inside and outside the city boundary.

Of these, 3,234 are residents, living in the city, who are known to adult social care as having visually/hearing impaired and/or with a physical disability:

• 947 registered visually impaired
• 1,111 registered hearing impaired
• 1,385 people with general classes of physical disability

More information can be found in the Statistics on people living with a disability in Southampton slide set, available in the resources section below.

Multiple long-term conditions

Multiple long-term conditions which impact mobility and day-to-day living increase with age, this is illustrated using GP data for the city.

The Care and Health Information Exchange (CHIE) estimates 10,300 residents have moderate or severe frailty and are at higher risk of adverse outcomes such as falls, disability, admission to hospital, or the need for long-term care.

• 0% of people aged 0-4 have no long-term conditions
• By aged 40-44 over half of adults have at least one long-term condition
• By age 60-64 over a third (38%) have at least three long-terms conditions
• Older people aged 80 to 84 over a third (34%) have at least six long-term conditions

People with a Learning Disability

In 2022-23 it is estimated that 25,359 residents, aged 18+ have a learning disability, in Hampshire, Southampton and the Isle of Wight. Of which 8,904 are diagnosed on GP registers (5.21 crude rate per 1,000 registered patients). The lowest of our Sub-integrated care board (ICB) comparators and lower than the England average of 5.58 crude rate per 1,000 registered patients.

In Southampton the key characteristics of people with learning disabilities are:

• More males, than females have a learning disability
• A higher percentage of residents who have a learning disability live in Coxford, Redbridge and Thornhill
• Prevalence in the most deprived areas of Southampton is four times higher than in the least deprived areas (6.72 per 1,000 population in the 20% most deprived areas compared to 2.61 per 1,000 population in the least deprived areas).

More information is available on the Learning Disabilities page.

People with autism

Autism is a lifelong condition that can affect how a person communicates with and relates to other people. It can also affect how a person makes sense of the world around them.

There are several names and terms that are used to describe autism, such as Asperger's Syndrome, autism spectrum disorder (ASD) or autism spectrum condition (ASC). Some professionals may also refer to autism by different names, such as classic autism or Kanner autism, pervasive developmental disorder (PDD) or high-functioning autism (HFA). The word "spectrum" is used because individuals can be affected in such different ways. While all people with autism share certain difficulties, their condition will affect them in different ways. Some autistic people can live relatively independent lives, but others may have accompanying learning disabilities and need a lifetime of specialist support. Autistic people may also experience over or under-sensitivity to sounds, touch, tastes, smells, light or colours. (Autism Hampshire)

In Southampton, it has been predicted that by 2040, there will have been an increase of 7.6% in the number of people, aged over 18, with autism from 2,088 in 2023 to 2,247 in 2040. A lower overall increase than that of the England average of 9.4%. The largest increase is predicted to be in the over 65 year age group with an increase of 26.8% in Southampton, lower when compared to a 32.4% increase in England over the same period (2023 to 2040). For Autism these predictions are based on information for Autism Spectrum Disorders (ASD) in adults living in households throughout England: Report from the Adult Psychiatric Morbidity Survey 2007 was published by the Health and Social Care Information Centre in September 2009. The prevalence of ASD was found to be 1.0% of the adult population in England, using the threshold of a score of 10 on the Autism Diagnostic Observation Schedule to indicate a positive case. The rate among men (1.8%) was higher than that among women (0.2%), which fits with the profile found in childhood population studies. The data for Autism comes from Projecting Older People Population Information System (POPPI) created by the Institute of Public Care.

More information is available in the learning disabilities and autism slide set available in the resources section below.

Sight loss

Modelling from PANSI and POPPI predict that in 2023, there are 110 Southampton residents aged 18-64 predicted to have severe visual impairment. Among those aged 65 and over it is predicted that there are 3,163 people with a moderate or severe visual impairment. By 2040 this is predicted to rise by 2.7% for those ages 18 to 64 (113 residents) and 29.1% for those ages 65 and over (4,082 residents).

Sight impaired (SI) and severe sight impairment (SSI) replace the terms partially sighted and blind for registration purposes. In January 2021, 76 children were known to Southampton schools to have a visual impairment and 947 people aged 18 and over are registered with a visual impairment.

In Southampton, in February 2023, there were 117 people claiming Disability Living Allowance (DLA) (1.9% of people claiming DLA) with the main disabling condition recorded as having visual disorders and diseases, higher than the rate for England (1.7% of people claiming DLA).

Of those residents recorded as having visual disorders and diseases, 29.9% were aged under 18, 30.8% were of working age (18 to 64) and 41.0% were aged 65 and over.

Diabetic retinopathy or diabetic eye disease is the leading cause of preventable sight loss in working aged people in the UK and early detection through screening halves the risk of blindness.

In 2021/22 Southampton’s rate of preventable sight loss due to diabetic eye disease in those aged 12 years and over was a crude rate of 4.22 per 100,000 population. This is higher but statistically similar to the crude rate for England of 2.76 per 100,000).

Age related macular degeneration (AMD) and glaucoma are the two other types of eye disease which can result in blindness or partial sight if not diagnosed and treated in time. In 2021/22, Southampton’s rate of AMD was a crude rate of 119.2 per 100,000 population aged 65 and over. This was higher but not significantly when compared to the England crude rate of 103.8 per 100,000 population.

In the same period, 2021/22, Southampton’s rate of preventable sight loss due to glaucoma was a crude rate of 11.4 per 100,000 population aged 40 and over, lower but not significantly compared to the England crude rate of 12.6 per 100,000 population.

Hearing loss and deafness

The newborn hearing test is offered to babies in their first four to five weeks and helps to identify if a baby has hearing loss in one or both ears. Nationally 1 to 2 babies in every 1,000 are born with permanent hearing loss in 1 or both ears. This increases to about 1 in every 100 babies who have spent more than 48 hours in intensive care. Most of these babies are born into families with no history of permanent hearing loss. In Southampton in 2021/22, the newborn hearing screening coverage was 99.1% better but not significantly than the England average of 98.7%.

In January 2021, 124 school age children were classed as having a hearing impairment in Southampton. Of the 3,382 residents known to Southampton City Council’s Adult Social Care, 32.9% have a hearing impairment.

In Southampton, in February 2023, 97 Southampton residents were receiving Disability Living Allowance (DLA) with the main disabling condition recorded as hearing disorders. Of these 97 residents, 52.6% were aged under 18 years, 34.0% were of working age (aged 18 to 64 years old) and 12.4% people were aged 65 years and over.