Aboriginal and Torres Strait Islander Health Performance Framework - 2010
Why is it important?:Disability may be an impairment of body structure or function, a limitation in activities and/or a restriction in participation of a person in specific activities. A person’s functioning or disability is conceived as an interaction between health conditions and environmental and personal factors. Aboriginal and Torres Strait Islander peoples are at greater risk of disability because they are more frequently exposed to many factors that predispose them to disability, including low birthweight, chronic disease, infectious diseases (e.g. otitis media, especially among young children), accidents and violence, mental health problems and substance use. This, along with limited access to early treatment and rehabilitation services, increases the risk of acquiring a disability. These factors tend to be more prevalent in populations where there are higher rates of unemployment, lower levels of income, poorer diet and living conditions, and poorer access to adequate health care.
Findings:In 2008, an estimated 162,900 (50%) of Aboriginal and Torres Strait Islander people aged 15 years or over had a disability or a long-term health condition. Of these, 26,000 or 8% of the population aged 15 years or over had a profound or severe core activity limitation, meaning that they always or sometimes needed assistance with at least one activity of everyday living (self-care, mobility or communication). The rates for males and females were similar. The proportions of Aboriginal and Torres Strait Islander people with a disability or long-term health condition were higher in older age groups, ranging from 35% of those aged 15–24 years to 78% of the 55 year and over age group.
Physical disabilities accounted for 33% of the disabilities reported by those aged 15 years and over, followed by sensory/speech disabilities (17%), and intellectual disabilities (8%).
Comparisons of disability amongst Aboriginal and Torres Strait Islander peoples and other Australians are only available for non-remote areas. In these areas, Aboriginal and Torres Strait Islander peoples 15 years and over were 1.4 times as likely to have a disability or long-term health condition. The differences were more marked for profound/severe core activity limitation, where Aboriginal and Torres Strait Islander peoples were 2.2 times as likely to have such a limitation as other Australians.
The 2006 Census collected data on one element of disability (i.e. those reporting the need for assistance with core activities). In the 2006 Census, around 20,000 Aboriginal and Torres Strait Islander people, 4% of the total Indigenous population (i.e. all age groups), were identified as needing assistance with a core activity (self-care, mobility or communication) some or all of the time. Rates were similar for males (4.5%) and females (4.1%). Slightly more Aboriginal and Torres Strait Islander people living in non-remote areas needed assistance with a core activity compared with remote areas (4.1% versus 2.83%). Rates ranged from 3% of Indigenous Australians in the Northern Territory to 5% in New South Wales and Victoria. In 2006, Aboriginal and Torres Strait Islander peoples were twice as likely to have a core activity need for assistance as non-Indigenous Australians. The number of people with a core activity need for assistance was higher in all age groups. (See Technical Appendix for Census data quality issues.)
Ten per cent of Indigenous Australians who needed assistance with a core activity were living in a hospital, a residential care facility, hostel for the disabled or another non-private dwelling, compared with 19% of non-Indigenous Australians (ABS & AIHW 2008).
Eighty per cent of Indigenous Australians aged 15–64 years reporting core activity restrictions were not in the labour force, compared with 38% of those not reporting core activity restrictions (ABS & AIHW 2008). Among Aboriginal and Torres Strait Islander peoples in the 25–54 years age groups, the median income for those who needed assistance with a core activity was around 60% of that for Indigenous Australians who did not need assistance (ABS & AIHW 2008).
In 2006, the Census collected, for the first time, information on the number of carers aged 15 years or over in Australia. The median age of Indigenous carers was 37 years; 12 years less than the median age of non-Indigenous carers (49 years). After adjusting for differences in the age structures of the Indigenous and non-Indigenous populations, Indigenous Australians were 1.2 times as likely as non-Indigenous Australians to be caring for another person with a disability, long-term illness or problems related to old age.
In 2006, 2% of Indigenous children aged 0–18 years had a core activity need for assistance, approximately 1.3 times higher than for non-Indigenous children.
In 2008, serious disability was reported as a stressor for self, family or friends in the last 12 months by 7% of people aged 18 years and over surveyed in the 2008 NATSISS. Those living in non-remote areas tended to be affected slightly more (7%) than those living in remote areas (6%).
Implications:The high levels of disability among Aboriginal and Torres Strait Islander peoples are consistent with the levels of disease and injury, socio-economic and environmental factors, risk factors and the lower access to health services relative to need. Factors during pregnancy have also been shown to raise the likelihood of intellectual disability in children (Leonard et al. 2008). Core activity restrictions occur earlier in life for Aboriginal and Torres Strait Islander peoples. Core activity restrictions are associated with a range of other social disadvantages including lower levels of educational attainment, lower levels of participation in the workforce and lower income.
In November 2008, COAG agreed to sustained engagement by all governments over the next decade and beyond to achieve the Close the Gap targets for Indigenous peoples. This included targeted initiatives for Indigenous Australians of $4.6 billion across early childhood development, health, housing, economic participation and remote service delivery. The National Indigenous Reform Agreement sets out the policy framework for Closing the Gap in Indigenous disadvantage. These initiatives are targeted at many of the underlying issues impacting on high disability rates. Through the National Disability Agreement all Australian Governments have agreed to develop a National Indigenous Access Framework to ensure the needs of Indigenous Australians with disability are addressed through appropriate service delivery arrangements.
The National Disability Strategy pays particular attention to the complex needs of those with significant impairments, and those who may experience double or multiple disadvantages.
Figure 34 – Disability status by Indigenous status and age group, Indigenous persons aged 15 years and over living in non-remote areas of Australia, 2008(a)
(a) Totals are age-standardised
Source: AIHW analysis of 2008 NATSISS and 2007–08 NHS
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Table 22 – Disability type(a), by age group, Indigenous persons aged 15 years and over living in non-remote areas of Australia, 2008
55 years and over
|Sight, hearing, speech||10||10||13||17||27||31||17||18|
|Total with a disability or long-term health condition(b)||35||38||43||51||66||78||50||52|
|Total with no disability or long-term health condition||65||62||58||49||34||23||50||48|
Source: AIHW analysis of 2008 NATSISS
Figure 35 – Proportion of persons with core activity need for assistance, by Indigenous status and age group, 2006
Source: ABS & AIHW analysis of 2006 Census data
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Figure 36 – Proportion of Aboriginal and Torres Strait Islander people with core activity need for assistance, by jurisdiction and remoteness, 2006
Source: ABS & AIHW analysis of 2006 Census data
Text description of figure 36 (TXT 1KB)