For 2023 SIPP, the question text on what condition(s) cause(s) difficulty with activities was modified. Data users should exercise caution when comparing 2023 SIPP disability conditions estimates to prior year SIPP disability conditions estimates.

In the SIPP questionnaire, respondents are asked a series of disability questions, ending with a question asking about health conditions lasting 12 months or longer that limit daily activities (EHLTHCOND). Respondents aged 5 and older who respond “Yes” to any of the disability questions are asked to report the condition(s) that cause(s) their difficulty with activities. Respondents can report up to three conditions, which are then used to construct several sets of recode variables in order to serve various data user needs (RCONDBRIDGE(1-3), RCONDTYP(1-3), and RCONDSUBTYP(1-3)). Respondents who report a condition other than “None” for the first condition question receive the second condition question, and respondents who report a condition other than “None” for the second condition question receive the third condition question.

The 2021 SIPP data suggested that the original wording of the first of the three conditions questions potentially read as an error in the skip pattern and may have resulted in higher reports of “None” for the conditions than would have otherwise been the case. While respondents reporting any disability were intended to receive the conditions questions, the text of the first condition question may have suggested that this first question was only a follow-up to the EHLTHCOND question immediately preceding that first condition question. As such, respondents may have reported their health condition as “None” if they responded “No” to the EHLTHCOND question, even if they did have a health condition in mind when responding “Yes” to earlier disability questions.

The improved text of the first condition question introduced in survey year 2023 clarifies that the disability conditions questions refer to the subset of disability questions the respondent previously reported “Yes” to, and not only to the EHLTHCOND question immediately preceding the first condition question. After this question text revision, the 2023 SIPP data show a decrease in reports of “None” for the first condition question (10.5 percent in 2023 for RCONDBRIDGE1, RCONDTYP1, and RCONDSUBTYP1, down from 34.3 percent in 2022), which suggests that the text change reduced respondent confusion and measurement error.

Data users should exercise caution when comparing 2023 SIPP disability conditions estimates to 2021 and 2022 SIPP disability conditions estimates. Change in disability condition prevalence between 2023 and prior years should be interpreted as a result of question text change rather than actual population change. Additionally, 2021 and 2022 estimates may be viewed as an underestimate of the full set of conditions underlying the total set of disability measures within the survey.

The wording of the first condition question is shown below. Note that the specific question wording presented to a respondent depends on the combination of disability questions they reported “Yes” to, in order to better reflect the actual disability type that they reported. The first condition question asks what condition or conditions limit the corresponding activities in the text shown below. Once the first condition is entered, the question text changes to “Any other condition(s)?” to capture any second and third conditions.

Previous question wording (for 2021 and 2022 SIPP):

What condition or conditions limit … daily activities? OR

What condition or conditions limit … ordinary activities? OR

Earlier you said … had a work limiting disability. What condition or conditions limit … work activities?

Updated question wording (for 2023+ SIPP):

What condition or conditions limit ... daily activities? OR

What condition or conditions limit … ordinary activities? OR

Earlier you said ... has difficulty with certain activities. What condition or conditions cause these difficulties? OR

Earlier you said ... has a work limiting disability. What condition or conditions limit ... work activities? OR

Earlier you said ... has a learning or developmental disability or a mental or emotional condition. What condition or conditions does … have?