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Disability

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Disability

Disability can be defined as a limitation, restriction or impairment which has lasted, or is likely to last, for at least six months and restricts everyday activities [1]. It can be considered in terms of the nature of the impairment in body structure or function, a limitation in activities (such as mobility and communication), a restriction in participation (involvement in life situations, such as work, education and social interaction), and the affected person’s physical and social environment [2][3]. A profound or severe core-activity limitation refers to ‘a specified condition for which the person requires help or supervision in one or more core activities (e.g. self-care, mobility or communication) [4].

The main source of information about the level of disability at a population level is the ABS periodic Survey of disability, ageing and carers (SDAC), which collects information about the prevalence of disability and also data about individual’s need for assistance with core activities [5]. Information about disability at a population level is also collected in Australia's five-yearly censuses [6] and information about disability among Aboriginal and Torres Strait Islander people is collected in surveys such as the 2014-2015 NATSISS [4]. Being based on self-reported information, each of these sources has limitations in capturing precise estimates of disability. This is particularly true for Aboriginal and Torres Strait Islander people, whose level of participation in surveys and censuses is lower than that of non-Indigenous people. Also, some Aboriginal and Torres Strait Islander people may perceive the concept of disability differently [7].

The greater burden of disability experienced by Aboriginal and Torres Strait Islander people is associated with poorer physical and mental health, increased exposure to risk factors, and higher levels of socio-economic disadvantage [8].

Extent of disability among Aboriginal and Torres Strait Islander people

Prevalence
In the 2012, the overall rate of disability among Aboriginal and Torres Strait Islander Australians was 23%, a little change from 21% in 2009 (after adjusting for differences in population ages structures, in both 2009 and 2012 the rate of disability for Aboriginal and Torres Strait Islander Australians was 1.7 times the rate for non-Indigenous Australians [9].

In 2014-2015, 45% of Aboriginal and Torres Strait Islander Australians aged 15 years and over reported having a disability (43% males compared to 47% females) [9][4]. The most needing assistance were the 8% reporting a profound or severe core activity restriction. The most common type of disability reported was physical disability (29%), followed by disability relating to sight, hearing or speech (21%) and psychological (9%) and intellectual (8%) impairments. Aboriginal and Torres Strait Islander females were more likely than males to have a physical disability (31% compared with 27%), or psychological disability (10% compared with 7%) [4].

Services

Increasing the access to disability services for the Aboriginal and Torres Strait Islander population is one of the priority areas identified by the National disability agreement (NDA), developed by COAG to improve the outcomes for Aboriginal and Torres Strait Islander people with disability [10][11]. The National Indigenous access framework forms part of the NDA and aims to ensure that the needs of Aboriginal and Torres Strait Islander people with disability are addressed through accessible and appropriate service delivery [12]. NDA services include accommodation support, community support, community access, respite and employment services [13].

As is the case with all health and related services, not all people who could benefit from the use of disability support services actually access them. To assess the level of use of disability services by Aboriginal and Torres Strait Islander people (and other ‘special needs’ groups), attention is directed to the ‘potential population’ of users: 'the number of people with the potential to require disability support services, including individuals who meet the service eligibility criteria but who do not demand these services' [13], p.14-18.

In 2014-15, 6% of service users were Aboriginal and Torres Strait Islander people, with most of these aged under 50 (84%) [14] (Table 27). In 2014-15, two in five Aboriginal and Torres Strait Islander service users lived in major cities (40%), compared with two in three non-Indigenous service users (68%). A further 28% lived in an inner regional area, 20% lived in an outer regional area, and 13% lived in a remote or very remote area, and did so in higher proportions than non-Indigenous service users (23%, 9%, and 1% respectively).

[14].

Table 27. Numbers and proportions (%) of disability services used, by Indigenous status, Australia, 2012-13 to 2013-15

Year

Indigenous

Non-Indigenous

Not stated/

not collected

Total

Number

Proportion

Number

Proportion

Number

%

Number

Proportion

2012-13

2013-14

2014-15

17,406

18,021

19,031

5.8

5.8

5.9

283,306

291,631

302,736

94

94

94

11,827

11,879

12,028

0

0

0

312,539

321,531

333,795

100

100

100

Notes:

  1. Service user data are estimates after use of a statistical linkage key to account for individuals who received services from more than one service type outlet during the 12-month period
  2. Service user data were not collected for all NDA service types
  3. Percentages are of the total excluding service users for whom Indigenous status was ‘not stated/not collected’

Source: AIHW, 2016 [14]

Education and employment

Aboriginal and Torres Strait Islander people with a disability tend to have poor education, employment and income outcomes than Aboriginal and Torres Strait Islander people without a disability [9]. In 2014-15:

A higher proportion of Aboriginal and Torres Strait Islander aged 15 years and over with disability reported an equivalised household income in the lowest quintile (43%) compared to those without disability (33%). Around one-third (33%) of Aboriginal and Torres Strait Islander service users aged 15 years and over were not in the labour force; this is consistent with non-Indigenous service users. However, those in the labour force (employed or looking for employment) were less likely to be employed than their non-Indigenous counterparts, 22% of those aged 15 and over who were in the labour force were employed, compared with 33% of non-Indigenous service users aged 15 and over who were in the labour force [14].

References

  1. Australian Bureau of Statistics (2013) Disability, ageing and carers, Australia: summary of findings, 2012. Canberra: Australian Bureau of Statistics
  2. Australian Institute of Health and Welfare (2014) Australia’s health 2014: the 14th biennial health report of the Australian Institute of Health and Welfare. Canberra: Australian Institute of Health and Welfare
  3. World Health Organization (2011) World report on disability. Geneva: World Health Organization
  4. Australian Bureau of Statistics (2016) National Aboriginal and Torres Strait Islander Social Survey, 2014-15. Canberra: Australian Bureau of Statistics
  5. Australian Bureau of Statistics (2016) Disability, Ageing and Carers, Australia: first results, 2015. Retrieved 29 April 2016 from http://www.abs.gov.au/ausstats/abs@.nsf/mf/4430.0.10.001?OpenDocument
  6. Australian Bureau of Statistics (2012) Census of population and housing: characteristics of Aboriginal and Torres Strait Islander Australians, 2011. Canberra: Australian Bureau of Statistics
  7. Productivity Commission (2011) Disability care and support: Productivity Commission Inquiry report overview and recommendations. Canberra: Productivity Commission
  8. Australian Institute of Health and Welfare (2016) Australia's health 2016. Canberra: Australian Institute of Health and Welfare
  9. Steering Committee for the Review of Government Service Provision (2016) Overcoming Indigenous disadvantage: key indicators 2016 report. Canberra: Productivity Commission
  10. National disability agreement (2009) Council of Australian Governments
  11. National disability agreement: intergovernmental agreement on federal financial relations (2012) Council of Australian Governments
  12. Disability Policy & Research Working Group (2012) National Indigenous access framework. Sydney: Disability Policy & Research Working Group
  13. Steering Committee for the Review of Government Service Provision (2013) Report on government services 2013: Indigenous compendium. Canberra: Productivity Commission
  14. Australian Institute of Health and Welfare (2016) Disability support services: services provided under the National Disability Agreement 2014-15. Canberra: Australian Institute of Health and Welfare
 

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