Better health and ageing for all Australians

Aboriginal and Torres Strait Islander Health Performance Framework (HPF) 2012

Tier 1—Human function—1.14 Disability

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Why is it important?:

Disability may be an impairment of body structure or function, a limitation in activities and/or a restriction in a person's participation 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 due to increased exposure to factors such as low birthweight, chronic disease, infectious diseases (e.g., otitis media), accidents and violence, mental health problems and substance use. Along with limited access to early treatment and rehabilitation services, these factors increase the risk of a person acquiring a disability. Such 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 Indigenous Australians 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 and over had 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 Indigenous Australians with a disability or a long-term health condition were higher in older age groups, ranging from 35% of those aged 15–24 years to 78% of the 55 years and over age group.

Physical disabilities accounted for 33% of all disabilities reported by those aged 15 years and over, followed by sensory/speech disabilities (17%), and intellectual disabilities (8%).Top of page

Comparisons of disability among Indigenous Australians and other Australians are only available for non-remote areas. In these areas, Indigenous Australians aged 15 years and over were 1.4 times as likely to have a disability or a long-term health condition. The differences in rates were more marked for profound/severe core activity limitation, with Indigenous Australians 2.2 times as likely as other Australians to have such a limitation.

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 Indigenous Australians, 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 Indigenous Australians living in non-remote areas needed assistance with a core activity compared with remote areas (4.1% versus 2.8%). Rates ranged from 3% of Indigenous Australians in the NT to 5% in NSW and Victoria. In 2006, Indigenous Australians were twice as likely to have a core activity need for assistance as non-Indigenous Australians. The number of Indigenous Australians with a core activity need for assistance was higher in all age groups. In 2006, 2% of Indigenous children aged 0–18 years had a core activity need for assistance, approximately 1.3 times as high as the rate for non-Indigenous children.

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).

In 2009–10, Indigenous Australians used disability support services at higher rates than non-Indigenous Australians (28 per 1,000 compared to 13 per 1,000). Rates were highest in Victoria (84 per 1,000) and lowest in the NT (12 per 1,000). Rates were higher in non-remote areas (34 per 1,000) than remote areas (17 per 1,000). Intellectual disability was the most common disability group (9 per 1,000 population), followed by physical and psychiatric (both 4 per 1,000 population).

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). The median income for Indigenous Australians aged 15–64 years who needed assistance with a core activity was around 60% of the median income for those 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, a long-term illness or problems related to old age.

In 2008, serious disability was reported as a stressor for self, family or friends in the last 12 months by 7% of adults surveyed in the 2008 NATSISS.

Implications:

The high levels of disability among Aboriginal and Torres Strait Islander peoples are consistent with the levels of disease and injury, socioeconomic and environmental factors, health risk factors and 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 developed a National Indigenous Access Framework which aims to ensure the needs of Aboriginal and Torres Strait Islander peoples with disability are addressed through appropriate service delivery arrangements. The National Disability Strategy outlines a 10-year national policy framework to guide government activity across six key outcome areas and to drive future reforms in mainstream and specialist disability service systems to improve outcomes for people with disability, their families and carers.

The Australian Government has committed $1 billion to support the first stage of a National Disability Insurance Scheme (NDIS). The funding will see an NDIS start in mid-2013 for around 10,000 people with significant and permanent disabilities in select locations. Top of page
Figure 53—Disability status by Indigenous status and age group, persons aged 15 years and over living in non-remote areas of Australia, 2008(a)
Figure 53—Disability status by Indigenous status and age group, 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 14—Disability type(a), by age group, Indigenous persons aged 15 years and over, 2008
Disability type
15–24 years
(%)
18-24 years
(%)
25–34 years
(%)
35–44 years
(%)
45–54 years
(%)
55 years and over
(%)
Total (15+)
(%)
Total (18+)
(%)
Sight, hearing, speech
10
10
13
17
27
31
17
18
Physical
19
22
26
35
47
59
33
35
Intellectual
9
9
6
6
10
6
8
8
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
Total
100
100
100
100
100
100
100
100
(a)Excluding psychological disability
(b)Includes disability type not specified. Note that more than one disability type may be reported and thus the sum of the components may add to more than the total.
Source: AIHW analysis of 2008 NATSISS
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Figure 54—Proportion of persons with core activity need for assistance, by Indigenous status and age group, 2006
Figure 54—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 55—Proportion of Aboriginal and Torres Strait Islander peoples with core activity need for assistance, by jurisdiction and remoteness, 2006
Figure 55—Proportion of Aboriginal and Torres Strait Islander peoples with core activity need for assistance, by jurisdiction and remoteness, 2006
Source: ABS & AIHW analysis of 2006 Census data
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