• Introduction
• Research Methodology
• Estimates of the Blind and Vision Impaired Population
• Overview of Costs Identified
• Costs of Blindness
• Societal Costs of Blindness

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Introduction

The Royal New Zealand Foundation of the Blind (RNZFB) commissioned Gravitas Research and Strategy Ltd and Market Economics Ltd to conduct research into the direct, indirect and opportunity costs of blindness in New Zealand. To advance understanding of both the individual and societal costs of blindness, three main research questions were addressed:

• how many blind and vision impaired people are there in New Zealand;
• what are the quantitative and qualitative costs of blindness to the individual; and,
• what are the costs of blindness to society?

The costs of blindness are defined to include financial, time and opportunity costs as well as non-quantifiable qualitative costs. Individual costs are defined as extra, non-optional costs incurred by blind and vision impaired individuals because of their blindness or vision impairment. Costs are above and beyond those that would be encountered if the person did not have vision impairment. Societal costs are defined as the costs to society to provide the services, treatment, equipment, benefits and other support required to mitigate the effects of vision impairment.

Costs are identified and reported purely on the basis that they exist and not on the basis that they have been assessed as costs appropriately compensated for by the government.

The study provides greatest focus on quantifying the financial costs of blindness, whilst also providing some qualitative discussion of costs to support the quantitative analysis.

The definitions of blindness and vision impairment used in the study are the same as those used by the World Health Organisation (1997). Total blindness is defined as anything less than visual activity of 3/60 but not including 3/60. 'Low vision' is defined as anything less than 6/18 but not including 6/18. Throughout the report, the terms 'blind' and 'vision impaired' are used to distinguish between individuals defined as having total blindness and those defined as having low vision.

In this research report the definitions of 'individual' and 'society' have been taken to describe the following:

• the individual is defined as including both the blind or vision impaired person and his or her family;
• society is defined as including government, charitable organisations and persons who fall outside the above definition of the individual, for example friends, flatmates and neighbours.

Whilst family members have been included as part of the individual unit, a distinction has been made when discussing support and assistance. Throughout this report helpers have

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been distinguished as those being members of the blind or vision impaired person's family, defined as 'family helpers'; those falling outside this definition are referred to as 'society helpers'. Society helpers will include a varied mix of individuals and organisations as relevant to the specific area of research investigated; as such society helpers may include flatmates, friends, neighbours, shop assistants, members of the public, transport workers, workmates, employers, fellow students, volunteers, government aid (benefits, subsidies and paid helpers) and so on as relevant.

Research Methodology

The research assesses the current incidence of blindness and vision impairment in the New Zealand population and the individual and societal costs of blindness (i.e. blindness and vision impairment).

The research data was collected through:

• a review of the national and international literature on the costs of blindness;
• an extensive review of secondary data sources;
• eleven in-depth key informant interviews;
• four focus groups with RNZFB members; and
• a national telephone survey of 200 RNZFB members using Computer Assisted Telephone Interviewing (CATI).

The research methodology was primarily designed to enable quantification of the costs identified. In doing so, the study reports average costs for different sub-groups and aggregates costs into two categories; those incurred by either the 'individual or family' or 'society'. These costs are further differentiated as costs incurred by blind or vision impaired persons. Average costs per recipient are reported to demonstrate the magnitude of costs to those who incur them. Of course, these averages are only of those respondents who reported a cost, and in some cases the range of responses is very wide. The RNZFB may find it useful to expand some costs to show lower quartile median, and upper quartile figures. Total costs are estimated for the blind and vision impaired population. Three total cost estimates have been considered and these are discussed in the next section.

In recognising the individuality of the costs of blindness, the study examines how costs differ in relation to variables such as life stage, employment status, gender and location. These are identified and discussed where statistically significant differences occur. For a full set of tables which cover all variables, please see separate document: 'The Cost of Blindness in New Zealand Full Table Set' (Excel format). Analysis of cost differences at the specific sub-group level, for example, between those in the prime working age years and those in retirement years, enables identification of how the cost burden differs between such groups.

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The costs of blindness identified have not been discussed in terms of whether they do or do not constitute costs which are appropriately compensated for by government. The study, has, however, sought to focus on the extra, non-optional costs which are incurred as individuals seek to participate in society in the manner and extent to which any society member should rightfully expect to be able to. In striving for such integration, the extent to which blind and vision impaired individuals should personally incur subsequent costs clearly demands further discussion.

Estimates of the Blind and Vision Impaired Population

No one data source exists to estimate the total blind and vision impaired population in New Zealand. Data is derived from a variety of sources, each providing different estimates. Because of this, three estimates were considered:

• a low estimate gives a current blind and vision impaired population of 11,293, this being the total RNZFB membership in June 2004;
• a medium estimate guided by leading NZ ophthalmologists gives a current population of 12,000 blind and 34,700 vision impaired people; and
• a high estimate provides a June 2004 equivalent to the estimated 98,400 New Zealanders identified by the 2001 New Zealand Disability Survey estimated by Statistics NZ.

Applying population forecasts to these three estimates gives projections for the blind and vision impaired populations:

• under the low estimate, the blind population is projected to grow 36% from 3,200 in 2004 to 4,300 in 2021. During this same time, the vision impaired population will reach 11,500, up 3,400 (42%) from 2004.
• under the medium estimate, the blind population will grow by 36% from 11,600 in 2004 to 16,000 in 2021. The vision impaired population will reach 44,600 in 2021, up 10,000 (29%) from 2004.
• under the high estimate, the blind population will grow by 34% from 10,900 in 2004 to 14,600 in 2021. The vision impaired population will reach 113,000, up 25,000 (37%) from 2004.

Because there is insufficient knowledge about the circumstances of people who would fall into the medium and high estimate groups, it has been decided to base the analysis of costs on the experiences of a known group represented by those who participated in the research. For that reason the discussion and tables in this report use the low estimate based on RNZFB's actual membership in June 2004.

Overview of Costs Identified

The direct financial costs incurred by the blind or vision impaired individual are shown to be substantial. From the need to pay for assistance to undertake relatively minor domestic and household tasks through to expenditure on adaptive equipment, these costs are shown to be varied and unavoidable. Further indirect financial costs are also

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identified. While not quantifiable, these costs include difficulties faced in easily and consistently purchasing cheaper grocery items and the need for housing which has proximity to necessary amenities, services and other supports which can be more expensive.

The discussions held as part of this research indicate that substantial time costs are incurred by blind and vision impaired persons. Qualitative findings indicate that additional time is spent undertaking domestic and personal tasks, travel, study, and training by those who undertake these tasks unassisted Qualitative findings also indicate that those employed spend longer undertaking the requirements of their job and often spend more time travelling to work if they use public transport.

Time costs are incurred in many ways: extra time spent undertaking activities; time spent planning, scheduling and marshalling resources; time lost in not being able to do something immediately, or in waiting for necessary assistance; time spent identifying, accessing and asserting a right to available support and assistance.

Time costs also constitute a significant opportunity cost. While not quantifiable, the additional time spent undertaking daily living activities means less time for other activities and endeavours.

Time costs are also shown to be substantial for those providing assistance to blind and vision impaired individuals. These costs are particularly evident in areas such as the undertaking of domestic tasks, travel, recreation and voluntary work participation. Much of the time family members spend providing such assistance is unpaid and again constitutes a significant opportunity cost.

While of less focus in the study, the research findings provide further understanding of the range of opportunity costs faced by blind and vision impaired individuals. These costs have not been quantified nor have attempts been made to attribute a dollar value to them. Collectively, however, they illustrate the huge impact blindness and vision impairment has on available options, choices and the level of independence possible. The cost of a loss or reduction in autonomy, flexibility and spontaneity should also not be underestimated.

Consideration of manageability, accessibility and the availability of support can dominate decision making, rather than preferences, convenience and appropriateness. Under such consideration, qualitative findings indicate that opportunities may be more likely to be forgone. Difficulties accessing information can also mean that opportunities are missed or less likely to be considered.

Costs of Blindness

The following sections discuss the costs of blindness identified and where quantified in the range of areas researched. The total costs reported are annual costs based on

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depreciation of capital expenditures and grossing up of day-to-day expenses and time costs. Costs include those incurred by individuals, their family and society as captured in the survey of Foundation members. Additional societal costs, such as the cost of the Total Mobility Scheme, benefits and medical costs, also exist and, where possible, are discussed in later sections.

Undertaking Domestic and Personal Tasks

Survey respondents commonly report requiring assistance to undertake domestic tasks around the home. Family members providing this assistance are reported to provide an average of 290 minutes of assistance each week. Almost all (95%) of these helpers are unpaid. Society helpers provide an average of 174 minutes of weekly assistance, with 80% of these helpers being paid.

In total, 42% of survey respondents report that they or their family incur a personal financial cost for domestic assistance received around the home. This cost is estimated at an average of $75.24 per month.

Summary Table 1: Total cost to both the individual and society of Domestic and Personal Tasks

Grocery Shopping

Survey respondents report an average of 143 minutes per week spent shopping for groceries, with blind respondents spending on average an extra 42 minutes per week shopping compared to vision impaired respondents. Over two thirds of respondents who shop require assistance to do so. Family helpers provide an average of 116 minutes of assistance per week, with most of this assistance identified as unpaid. Society helpers provide an average of 67 minutes assistance per week.

Qualitative discussions also identify a lack of ability to be ad hoc or spontaneous, resulting in time spent and clear necessity for careful planning and arranging of shopping needs and shopping trips.

Indirect financial costs related to shopping reported by participants include restricted ability to take advantage of sales and specials and heightened difficulties accessing cheaper goods generally. Reported opportunity costs include: fewer shopping trips than desired, less purchasing choice, a more limited range of products generally purchased, and reliance on others to undertake or assist with shopping.

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Summary Table 2: Total cost to both individual and society of Grocery Shopping

Communication Equipment

Communication equipment commonly used includes magnifying equipment (75% of all survey respondents), talking book players (65%), tape recording equipment (29%) and personal computers (23%). Tape recording and magnifying equipment is most commonly acquired through personal purchase while CCTVs, talking book players and OCR scanners are commonly acquired through loan, lease or being given by someone else.

Forty-two percent of computer users report using screen magnification software such as Zoomtext and 33% report use of screen reader software such as JAWS.

Approximately six percent of the survey sample report using Braille equipment. This equates to approximately 600 Foundation members. Braille-writing machines are reported to be used by 52% of Braille users, while 41% of users use Braille embossers. Braille embossers are most likely to have been purchased personally, although most commonly with financial assistance or subsidy from society sources. More expensive Braille equipment such as Braille-writing machines and electronic notetakers are mostly bought for the user by someone else, primarily by society sources.

Other communication costs identified include the loss of privacy due to requiring others to read personal correspondence such as bank statements. Respondents also discuss delays and the inconvenience of being unable to read information exactly when required, and a loss of privacy and independence in this context.

The cost of adaptive equipment is particularly significant given the increasing importance and potential of adaptive technology to mitigate the disadvantages of blindness. Cost barriers to accessing adaptive equipment or difficulties learning communication technology can mean heightened reliance on others, more pronounced loss of communication skills and reduced ability to remain connected and conversant within society generally. In addition, access to and ability to use adaptive technology are increasingly important in the preparation for, and likelihood of, gaining employment.

Communication Equipment Training

Recipients of Braille training estimate an average of 39 days spent in training while recipients of personal computer training estimate an average of 16 days training. Training in adaptive software is also time consuming - recipients of screen reader software training estimate an average of 12 days of training, while those undertaking screen magnification software training estimate 13 days of training. While most respondents do not directly pay for training received, the time and financial costs of travelling to and from training are

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commonly identified. Time off work and lost income are also identified, albeit less frequently.

Summary Table 3: Total cost to both individual and society) of Communication Equipment (including training and maintenance)

Transport and Mobility

Accounting for Total Mobility subsidies, the average reported weekly spend for blind and vision impaired taxi users amounts to $15 per week. Expenditure for those 18 years or younger is significantly higher than average at $40 per week.

These findings do not suggest that expenditure on taxi use constitutes travel costs above and beyond that which sighted equivalents would incur (for example in running and maintaining a vehicle). However, expenditure on taxis does not represent all travel undertaken or necessarily indicate total satisfaction of travel needs, i.e. the average spend on taxis by blind and vision impaired users may be low because users simply cannot afford to spend more than it. For twenty nine percent of the 18 to 65 year olds surveyed, cost is the main reason for not taking taxis or not taking taxis more regularly. This finding suggests cost as a constraint on the regularity or freedom with which travel is undertaken. This is confirmed in the qualitative discussions. While not examined in the study, such cost barriers may also contribute further to costs experienced by others, for example, through increased reliance on others for transport assistance. Indeed the research suggests that it is the loss of travel independence which constitutes a significant transport related cost for blind and vision impaired individuals.

Reliance on others for transportation is identified as a significant opportunity cost as well as one resulting in substantial time costs. While not quantified, time can be lost waiting for arranged transport or in needing to structure activities around available transport, for example, public transport timetables. Planning and carrying out travel arrangements is also seen as highly time consuming. Time spent travelling can impact on time available to undertake other activities.

Being relied upon for transport inevitably incurs financial and time costs for those providing transport assistance. On average, family members providing this assistance contribute an average of 126 minutes of assistance each week. Society sources such as volunteer drivers are reported to provide an average of 112 minutes of travel assistance each week. While not quantified, parents of vision impaired children also report that transportation entails a significant time cost for them and one not envisaged to diminish as their children grow older.

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Summary Table 4: Total cost to both individual and society) of Transport and Mobility (excluding travel to work or study)

Housing

Housing related costs identified include the need for additional safety features (24% of respondents), contrasting features within homes (21%), additional or special lighting (20%) and additional security features (14%). Participants also report less flexibility and choice when choosing where to live, particularly because of the need for proximity to amenities and support services. Some report this requirement resulting in higher housing costs, with houses close to required amenities reported as generally being more expensive than those in other areas.

Summary Table 5: Total cost to both individual and society of Housing

Recreation

Patterns of recreation activities undertaken are illustrative of the functional limitations of blindness. Compared to vision impaired respondents, blind respondents more commonly undertake home-based, individual focused activities such as crafts, playing with pets, reading and listening to talking books. Activities more commonly undertaken by vision impaired respondents tend to be more public and social in nature: for example, voluntary work, sports, socialising and attending movies, concerts and other performances. Vision impaired respondents are also more likely to undertake activities requiring a higher level of functional ability: for example, gardening, playing computer games, puzzles, games and cards and DIY projects.

Around half (51%) of the respondents undertaking recreation and leisure activities require assistance from others to do so. This includes the need for guidance and assistance during the activity undertaken and for transportation (both at 62%). Society helpers spend an average of 124 minutes per week providing assistance, most of which is unpaid. Family helpers spend an average of 239 minutes per week proving this type of assistance, most of which is also unpaid.

Summary Table 6: Total cost to both individual and society of Recreation

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Opportunity costs include being unable to undertake recreational activities previously undertaken, reduced choice in activities possible, reduced access to information about the availability of events and activities, and the possibility of avoiding certain activities simply because of participation difficulties, for example, transport logistics. Parents of vision impaired children report incurring time and money costs so that their children are able to participate in recreational and sporting activities that are appropriate and enjoyable for them.

Education

Data from the 2001 New Zealand Disability Survey shows that in comparison to the total New Zealand population, the percentage of blind and vision impaired adults with no qualifications (30%) is higher than the national average (24%). The proportion of the blind and vision impaired population having attained school qualifications (25%) is also less than the national average (34%). Approximately 28% of New Zealanders have post school qualifications. This is again significantly higher than the reported 4% for blind adults and 17% for vision impaired adults.

Students identify many challenges in reaching their academic potential. The difficulty in using or inability to use visual references such as graphs and diagrams is particularly noted. Past research in this area shows that such difficulties can have the effect of restricting access to certain subject areas and, consequently, higher paying career potential in the future.

All blind students and 75% of vision impaired students require some form of additional assistance in order to complete the requirements of their study. Society helpers are identified as providing on average 784 minutes of assistance each week.

Students estimate an average of 334 additional minutes spent studying each week because of their blindness or vision impairment. University students report 570 additional minutes per week, polytechnic students 480 minutes and secondary students 271 minutes each week.

Parents of vision impaired children report significant time costs in ensuring their children receive rightful access to education related support, adaptive technology and other funding. Parents may feel compelled to purchase adaptive equipment themselves (for example, computers) if it is felt that available government provision is not appropriately timed to meet their children's needs. Other reported financial costs include the cost of constructing appropriate educational resources for use within the home and parents undertaking training in adaptive equipment so as to be able to provide learning assistance within the home.

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Summary Table 7: Total cost to both individual and society) of Education

* A population base of 850 blind and vision impaired students (from primary through to tertiary education) was calculated using information on the number of students as reported by the Vision Education Agency (VEA) and an estimate of blind and vision impaired tertiary students accessing disability support services at the University of Auckland.

Economic Status and Employment

A review of the national and international literature shows that compared to national averages, blind and vision impaired adults have higher rates of unemployment and under-employment, are more likely not to be in the labour force and more likely to be in receipt of a government benefit.

Qualitative data derived in the study provides further support for previously identified opportunity costs in relation to employment. Amongst other employment related issues discussed, participants talk of reduced employment and career potential, under-employment, as well as forgone or lost income.

The research also shows that, when employed, blind and vision impaired workers face a number of employment related costs. Collectively, blind and vision impaired workers report an average of 190 minutes spent travelling to and from work each week. Assuming a five day week, this equates to 38 minutes a day travelling. By sub-group, blind workers report an average 49 minutes travelling per day.

Employed respondents using taxis to travel to work report an average personal weekly expenditure of $60.25 above any subsidies received.

Family members specifically driving workers to work reportedly spend an average of 287 minutes per week providing this assistance. Society drivers are reported to spend an average of 160 minutes per week. Employed respondents required to travel within their work report an average of 623 minutes of travel assistance provided to them each week.

Almost two thirds (64%) of employed respondents report requiring special assistance within the workplace, the most commonly mentioned type being additional administration or secretarial support. Blind workers requiring additional support report receiving an average of 265 minutes support per week. Vision impaired workers report an average of 241 minutes per week.

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Twenty percent of employed respondents also report modifications to their workplace in order to accommodate their particular needs. These include changes to the layout of work areas and additional or special lighting. Modified duties, modified hours and modifications to job responsibilities are also reported.

While not quantified, employed participants also self-report having to spend more time fulfilling the requirements of their jobs compared to sighted equivalents.

Summary Table 8: Total cost to both individual and society of Employment

Health and Medical

Just over half (52%) of survey respondents report they consulted an ophthalmologist in the preceding twelve months. Other health professionals consulted for advice and/or treatment for blindness or vision impairment include GPs (33%), optometrists (29%), pharmacists (25%), and podiatrists and chiropodists (25%).

Personal financial costs are most commonly incurred for consultations with GPs (80% of those consulting a GP), podiatrists and chiropodists (78%) and optometrists (64%).

The time spent travelling to medical consultations is also documented. Twenty percent of provincial respondents consulting optometrists travel two to three hours for each consultation. Thirteen percent of rural respondents travel one and two hours per optometrist consultation while 9% travel more than three hours. For some respondents, travel to ophthalmologist consultations is particularly time consuming. Sixteen percent of those consulting ophthalmologists travel between one to three hours and seven percent travel for more than three hours. Notably, 16% of rural respondents consulting ophthalmologists travel more than three hours to do so.

When assistance other than help given by drivers of taxis or public transport is required to attend medical consultations and treatments, this is most likely to be provided by family helpers. Ophthalmologist consultations require the greatest amount of family assistance (216 minutes per consultation), followed by GP consultations (59 minutes) and podiatrists and chiropodists (38 minutes).

Respondents incurring at least some personal cost through taking prescription drugs because of their blindness or vision impairment report an average personal cost of $204.47 a year for this treatment. Additionally, where costs are incurred by those taking non-prescription drugs and those taking herbal remedies or vitamins, the average spends are $81.08 and $138.25 a year respectively.

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Just over a third (35%) of all respondents report secondary health conditions or injuries related to their blindness or vision impairment. Grazes, cuts and bruises are most commonly experienced. While not quantified, associated costs reported include: loss of quality of life, time spent travelling to and from medical appointments, consultations with medical professionals and rehabilitation.

Summary Table 9: Total cost to both individual and society of Health and Medical

Social Costs

While not a primary focus within the study, two social costs commonly identified by participants include the loss of independence and increased potential for social isolation.

Loss of independence occurs through lessened ability to undertake a range of activities as well as increased reliance on others. Reliance on others can have further impacts on family members, for example, reduced time available for other siblings and fewer opportunities for parents of vision impaired children to have time-out.

Many barriers to achieving or maintaining social networks and relationships are identified. Difficulties may range from restricted ability to identify appropriate recreation opportunities through to the planning and logistics required to attend a group or activity. The inability to initiate and maintain visual contact with others is identified as a major barrier to social engagement and can lead to a withdrawal from social activities or a tendency to limit social contacts to known friends and smaller environments.

Costs to Parents of Vision Impaired Children

While limited investigation was undertaken, the study provides some understanding of the costs of blindness experienced by the parents of vision impaired children. Parents inevitably strive to provide as best they can for their children and to do as much as possible to mitigate and address disadvantages faced. In doing so, additional financial, time and opportunity costs are inevitably incurred. Many of these costs are not reimbursable and fall directly on to the parents themselves.

Societal Costs of Blindness

Provision of Welfare Benefits

Work and Income New Zealand (WINZ) and the Accident Compensation Corporation (ACC) are the main government and quasi government providers of welfare assistance to blind and vision impaired persons.

As at 27 June 2003, 799 people are estimated to be receiving the Invalid's Benefit with blindness as their primary disability. An annual cost of $9.6m at an average of $12,047

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per recipient is estimated. A further 518 people are estimated to be receiving an Invalid's Benefit with vision impairment as the primary disability. A total annual cost of $6.3m at an average of $12,202 per recipient is estimated.

As at 27 June 2003, 8 people are estimated to be receiving the Sickness Benefit with blindness determined as their primary disability. An annual cost of $73,700 at an average of $9,216 per recipient, is estimated. A further 194 people are estimated to be receiving a Sickness Benefit with vision impairment as the primary disability. The total annual cost of this provision is estimated at $1.9m at an average of $9,626 per recipient.

In addition, 495 blind and 405 vision impaired recipients also receive a Disability Allowance estimated to total in 2003, $689,000 and $398,000 respectively. Blind recipients received on average $1,393 per annum and vision impaired recipients $984.

Collectively, Invalid, Sickness and Disability Allowance provision is estimated at approximately $19 million per annum (net amount) for blind and vision impaired recipients.

In 2002/03, there were 2,500 new claimants and 2,200 existing claimants to ACC receiving financial assistance relating to eye injuries at a cost of $10.4m. Note: this includes all severities and both permanent and temporary injuries.

Employment Support

It is estimated that Workbridge provided job placement support to blind and vision impaired job seekers to the value of $1.2m between June 2003 and May 2004. Blind job seekers are estimated to have on average received $5,964.50 of assistance during this year and vision impaired job seekers $4, 605.62.

Other employment support services have not been quantified due to a lack of access to, or the non-existence of, such information. Any employment support provided to blind and vision impaired persons by their employers was covered in the survey of RNZFB members and is included in this section of the report.

Transport and Mobility

In 2002, the total cost of the Total Mobility Scheme servicing blind and vision impaired users is estimated at $712,106.53. An average annual cost of $130.85 per blind or vision impaired user is estimated, this comparing to an average annual cost of $192.16 for all users. This figure has been derived based on research conducted by Transfund and through contact with individual regional councils where gaps were identified.

Public transport subsidies for blind and vision impaired users are also likely to incur some cost to society; however, information on these users is not collected. In Auckland, for example, bus and train subsidies are provided to blind and vision impaired persons, allowing them to travel at the senior citizens rate. As such, while the number of senior

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citizen fares can be derived, distinction between blind or vision impaired users and senior users cannot be made.

Health and Medical Treatment

Ministry of Health information on volumes of patient services contracted to District Health Boards provides the best available estimate of the number of people seeking treatment from ophthalmologists. This data, however, does not accurately show the number of people seeking treatment for blindness and vision impairment as it includes anyone treated for an eye related issue, rather than just those meeting the definition of blindness or vision impairment used in the study.

Approximately 46,000 events are budgeted for first time visits to ophthalmology clinics throughout the 2003/04 financial year. A further 108,000 second visits are budgeted for those as well as approximately 8,850 inpatient events. Total funding for Ophthalmology department services and treatment over the 2003/04 year is estimated at approximately $44 million.

In 2003, Pharmac spent $8.7m on drugs and $570,000 on prescriptions for eye and ear related treatments. Figures again account for all eye related medications and treatments and therefore do not accurately show the cost of just treating blind and vision impaired individuals.

Disability Support Services

Available data on government funded Disability Support Services shows that there were 7,300 clients in 2002 and 8,700 clients in 2003 receiving support for sensory disabilities which included both hearing as well as vision impairments.

Conclusion

The research reveals that the costs of blindness in New Zealand are wide ranging and significant. Key cost areas are related to carrying out domestic tasks, day to day travel, shopping, recreation and use of specialised equipment.

These costs are borne by individuals and their families and by society - though the greatest burden currently lies with the individual and their families.

Qualitative discussions reveal visual conditions generating a number of opportunity costs and also resulting in unrealised life potential in the economic and social areas.

Summary of costs quantified in the RNZFB Cost of Blindness Survey

The following table summarises the costs quantified in the survey of Foundation members. This table and tables throughout the report do not include data collected from other secondary sources such as RNZFB costs, government and council costs (in terms of subsidies or other costs) outside what was reported by respondents in the RNZFB Costs

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of Blindness survey. These have not been included because of the lack of information in terms of either detail or consistency (please see separate document: 'Data Collection Issues Encountered during the Cost of Blindness Research'). As such, discussions of identified and accessible secondary source information on societal costs are addressed throughout this report. Because of the issues stated above, no attempt to collate or integrate this secondary source data with the information derived from the Costs of Blindness survey has been made.

Education costs are omitted because figures for the total blind and vision impaired populations in education could not be accessed by the research team. It is believed that such information can be provided by the Tertiary Education Commission but could not be provided for use in this research. In place of this a population estimate of blind and vision impaired students totalling 850 (primary through to tertiary) has been generated from information provided by the VEA and Disability Support Services at the University of Auckland. Please see Section 6 for discussion of education costs.

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Executive Summary Table: By cost area activity, individual and society

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