4430.0 - Disability, Ageing and Carers, Australia: Summary of Findings, 2015 Quality Declaration 
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ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE WITH DISABILITY

Background

Improving educational outcomes, employment rates, income and service delivery for Aboriginal and Torres Strait Islander people with disability are national policy priorities. In 2007, the Council of Australian Governments (COAG) committed to ‘closing the gap’ in health status and life expectancy between Aboriginal and Torres Strait Islander and non-Indigenous people by 2030. In order to effectively inform policies like this, it is important to understand the experiences of Aboriginal and Torres Strait Islander people with disability. Statistics are important in providing an evidence base for informing such policies and planning services to drive better outcomes for Aboriginal and Torres Strait Islander people with disability. This article uses data from the 2015 Survey of Disability, Ageing and Carers (SDAC) to examine the prevalence and impact of disability among Aboriginal and Torres Strait Islander people.

About the SDAC

The SDAC is designed to measure the prevalence of disability in Australia and the need for support for people with disability. It collects detailed information from three target populations; people with disability; older people (those aged 65 years and over); and people who care for those with disability, who have a long-term health condition, or who are aged 65 years and over. These groups can overlap - for example a carer may be aged 65 years or over and also live with disability.

Due to the scope of the SDAC, it should be noted that information about Aboriginal and Torres Strait Islander people and non-Indigenous people presented in this article is limited to households (and excludes nursing homes and cared-accommodation). The coverage of the SDAC does not include people living in very remote areas and discrete Aboriginal and Torres Strait Islander communities. Therefore, data presented in this article are not necessarily representative of all Aboriginal and Torres Strait Islander people living across Australia. More information about the SDAC sample population can be found in the Technical Note at the end of this article and in the Explanatory Notes.

Population

At the time of the 2015 SDAC, there were estimated to be 523,200 Aboriginal and Torres Strait Islander people and 22,689,000 non-Indigenous people living in households.

There are demographic differences between the Aboriginal and Torres Strait Islander and non-Indigenous populations. Younger people make up a greater proportion of the Aboriginal and Torres Strait Islander population, while older people comprise a larger share of the non-Indigenous population. Rates of disability increase with age in both populations. In comparing prevalence rates between the two populations, the influence of the age distribution is removed when feasible. This age standardisation is a way of removing the effects of differing age structures so that comparisons can be made between the two populations about the non-age related aspects of disability. The disability rate without age standardisation is known as the crude disability rate. Further information on age standardisation may be found in the Glossary.

Prevalence of disability

Of the 523,200 Aboriginal and Torres Strait Islander people living in households in 2015, almost one-quarter (23.9%) reported living with disability. This has remained largely unchanged since 2012 (23.4%). In 2015, prevalence of disability amongst non-Indigenous people living in households was 17.5%. This has also remained relatively stable between 2012 and 2015.

Disability prevalence rates for Aboriginal and Torres Strait Islander males and females were similar (22.7% and 25.1% respectively).

Graph Image for Disability rates (a), by age and Indigenous status - 2012 and 2015

Footnote(s): (a) Persons living in households

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings—2015



When taking differences in the age structure of the two populations into consideration, Aboriginal and Torres Strait Islander people were 1.8 times more likely than non-Indigenous people to be living with disability.

Severity of disability

The severity of disability is defined by the level of specific limitation or restriction caused by the disability. This is determined by the amount of difficulty experienced, the level of assistance needed or the use of an aid to undertake a particular core activity (self-care, mobility or communication), and/or to participate in education or employment activities. The different levels of limitation are described in more detail in the Glossary.

In 2015, 7.3% of all Aboriginal and Torres Strait Islander people had a profound or severe limitation. This rate has remained stable since 2012 (7.8%), and rates for males and females were similar (7.1% and 7.0% respectively). The prevalence of profound or severe limitation increased with age, with Aboriginal and Torres Strait Islander people aged 55 years and over more than five times as likely as those aged 15-34 years to have a profound or severe limitation.

Graph Image for Profound or severe core activity limitation rates (a), by age and Indigenous status, 2015

Footnote(s): (a) Persons living in households

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings—2015



Disability group

Disabilities can be broadly grouped depending on whether they relate to functioning of the mind or the senses, or to anatomy or physiology. Grouping this way can help inform policy and service providers about the prevalence of different types of disability and the form of assistance required. For more information about disability groups, see Appendix 2-Disability Groups.

In 2015, one in seven (14.8%) Aboriginal and Torres Strait Islander people reported living with physical disability. This was the most commonly reported type of disability for Aboriginal and Torres Strait Islander people. For Aboriginal and Torres Strait Islander children (aged 0-14 years), intellectual disability (7.0%) was most commonly reported.

When compared with non-Indigenous people, Aboriginal and Torres Strait Islander people had significantly higher crude rates of physical disability (14.8% compared with 11.4%), psychosocial disability (6.6% compared with 3.8%), intellectual disability (5.9% compared with 2.5%), and head injury, stroke or acquired brain injury (2.1% compared with 1.1%). However, there was no significant difference between the reported crude rates of sensory and speech disability in the two populations (6.1% of Aboriginal and Torres Strait Islander people compared with 5.8% of non-Indigenous people).

Graph Image for Disability group rates (a), by Indigenous status, 2015

Footnote(s): (a) Persons living in households

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings—2015



Remoteness

Where a person lives can have a significant impact on their health and well-being and for those with disability, may affect their access to services and associated costs.

The geographic distribution of Aboriginal and Torres Strait Islander people with disability differs between major cities, inner and outer regional and remote areas. In 2015, Aboriginal and Torres Strait Islander people with disability were more likely to live in a major city (42.7%) than in outer regional and remote areas (30.4%). It may be that some people re-locate to cities to seek treatment for their conditions.

Need and receipt of assistance

People with disability may require a range of assistance to help them with their day to day activities, and to support them to participate in the community. Understanding these assistance needs is important for ensuring the provision of effective disability support services.

In 2015, 59.5% of Aboriginal and Torres Strait Islander people with disability needed assistance with at least one activity of daily life (such as self-care, mobility and communication). There has been no significant change since 2012 (63.1%).

Based on crude rates, Aboriginal and Torres Strait Islander people were more likely than non-Indigenous people to need assistance with cognitive or emotional tasks (28.1% compared with 21.4%) and less likely to report needing assistance with health care (23.2% compared with 29.5%). There were no statistically significant differences between the crude rates for any of the other tasks.

Graph Image for Persons with disability (a) - Type of assistance needed, by Indigenous status, 2015

Footnote(s): (a) Persons living in households

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings—2015


The majority (91.4%) of Aboriginal and Torres Strait Islander people with disability who reported needing assistance had received assistance with at least one activity. This rate has remained stable since 2012 (93.2%).

Education

Education is an important factor in participation in employment, preparing individuals for entry into the labour force and ensuring they have the skills necessary for employment and community participation (Endnote 1). People with disability can be limited in their participation in education due to the nature of their disability, or a lack of necessary equipment or assistance.

In 2015, almost half (46.4%) of Aboriginal and Torres Strait Islander people aged 15 years and over with disability had completed Year 10 or below as their highest level of educational attainment, a significantly smaller proportion than in 2012 (59.7%). This is a positive indication that a higher proportion of Aboriginal and Torres Strait Islander people with disability are completing education beyond Year 10. The proportion of Aboriginal and Torres Strait Islander people with disability that had completed Advanced diplomas, Diplomas or Certificate III/IV increased from 21.4% in 2012 to 29.5% in 2015.

Graph Image for Aboriginal and Torres Strait Islander people with disability (a) - Level of highest educational attainment, 2012 and 2015

Footnote(s): (a) Persons living in households

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings—2015



Employment

Participation in the workforce contributes towards better health outcomes, economic independence, social inclusion and a better standard of living (Endnote 2). Some people with disability experience employment barriers such as being restricted in the type of job they can do or the number of hours they can work, or needing special assistance in the workplace.

In 2015, Aboriginal and Torres Strait Islander people aged 15-64 years with disability were less likely to be in the labour force than those without disability (41.7% compared with 75.7%). There was no statistically significant change in the labour force participation rate from 2012 (34.8%) for Aboriginal and Torres Strait Islander people with disability. There was also no statistically significant difference between unemployment rates for Aboriginal and Torres Strait Islander people with and without disability (22.1% and 13.8%).

Graph Image for Aboriginal and Torres Strait Islander people aged 15 to 64 years (a) - Labour force status, by disability status, 2015

Footnote(s): (a) Persons living in households

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings—2015



Income

Disability can affect participation in the labour force and the ability to earn an income. A lack of financial resources may lead to socio-economic disadvantage.

Indicating relative socioeconomic disadvantage, in 2015, 32.6% of Aboriginal and Torres Strait Islander people with disability were living in households with an equivalised weekly gross income in the lowest quintile (Quintile 1). Just 4.8% of Aboriginal and Torres Strait Islander people with disability lived in households with an income in the highest quintile (Quintile 5). A definition of equivalised weekly gross income can be found in the Glossary.

Graph Image for Aboriginal and Torres Strait Islander people with disability (a) - Equivalised gross household income quintiles, 2015

Footnote(s): (a) Persons living in households

Source(s): ABS Survey of Disability, Ageing and Carers: Summary of Findings—2015



Experience of discrimination

The Disability Discrimination Act 1992 provides protection for people against discrimination based on disability. The Act promotes equal rights, opportunities and access for people with disability, as well as making disability discrimination unlawful. Disability discrimination occurs when people with disability are treated less fairly than people without disability. Aboriginal and Torres Strait Islander people with disability may experience different forms of discrimination, including disability or racial discrimination. The questions asked in the 2015 SDAC relate to the experience of discrimination in relation to disability only. The following results relate to people with a disability aged 15 years and over.

In 2015, around one in seven (15.0%) of Aboriginal and Torres Strait Islander people with disability reported experiencing discrimination due to their disability – almost twice the crude rate for non-Indigenous people with disability (8.4%).

In 2015, 38.2% of Aboriginal and Torres Strait Islander people reported they had avoided situations due to their disability. Over half (57.7%) of Aboriginal and Torres Strait Islander people with profound or severe core activity limitation reported avoiding situations due to their disability as did one-third (32.9%) of those with moderate or mild limitation.

Looking Forward

Analysis of data from the 2015 SDAC in this article shows that disability prevalence amongst the Aboriginal and Torres Strait Islander people remains high. Importantly, this analysis also helps to understand issues specific to Aboriginal and Torres Strait Islander people with disability compared with the rest of the population. For example, the analysis shows higher disability prevalence amongst Aboriginal and Torres Strait Islander children. The analysis also showed that psychosocial, physical and intellectual disabilities have much higher prevalence rates amongst Aboriginal and Torres Strait Islander people. These specific circumstances and needs are important and should be considered by service and support providers for services to be most effective.

TECHNICAL NOTE

AGE STANDARDISATION

Age standardisation is a technique used to enhance the comparability of rates between populations with different age structures. As many population characteristics are age-related, (for example, long-term health conditions and employment patterns), adjustments are made to account for the confounding effects of the different age structures on the prevalence of these characteristics. The Aboriginal and Torres Strait Islander population has a larger proportion of young people and a smaller proportion of older people than the non-Indigenous population.

As age is strongly related to many health measures, as well as labour force status, estimates of prevalence which do not take account of age may be misleading. The age standardised estimates of prevalence are those rates that 'would have occurred' if the Indigenous and non-Indigenous populations both had the same age structure. For this reason, where appropriate and where there was sufficient sample to support a robust analysis, estimates for Aboriginal and Torres Strait Islander people and non-Indigenous people in this article have both been age standardised to reflect the age structure of the same population — the total estimated resident population of Australia as at 30 June 2001. Direct age standardisation was used for this analysis.

SDAC SAMPLE

The SDAC sample is selected to maximise the reliability of disability and carer prevalence estimates amongst the entire Australian population. It is not designed to specifically measure disability prevalence amongst the Aboriginal and Torres Strait Islander population.

As noted earlier, the scope of the SDAC excludes people living in very remote areas and discrete Indigenous communities and this article makes no assessment of disability prevalence in those areas excluded from the survey. Around 14% of Aboriginal and Torres Strait Islander people and 0.5% of non-Indigenous people live in very remote areas, so the exclusion of people in very remote areas from the SDAC is likely to have a greater impact on data for Aboriginal and Torres Strait Islander people.

The survey included over 1,700 respondents who were identified as being of Aboriginal or Torres Strait Islander origin, which is a large enough sample to produce reliable estimates at the national level, if there are no biases in the sample. The age and sex distribution of the survey sample were consistent with the distributions of the Aboriginal and Torres Strait Islander national population living outside very remote areas, suggesting biases were not likely to be an issue.

DIFFERENCES BETWEEN THE SURVEY OF DISABILITY, AGEING AND CARERS, THE AUSTRALIAN ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH SURVEY AND THE CENSUS OF POPULATION AND HOUSING

Information about the disability and long term health conditions of Aboriginal and Torres Strait Islander people were most recently collected in the 2014-15 National Aboriginal and Torres Strait Islander Social Survey (NATSISS).

Disability estimates for Aboriginal and Torres Strait Islander people in the Survey of Disability, Ageing and Carers (SDAC) may differ from those in the NATSISS due to differences in the scope of these surveys, and the weighting of estimates to different population benchmarks (Endnote 3 and 4 respectively). There are also differences in collection methodology, with SDAC using a much larger set of screening questions which have been found to be more effective in differentiating between people with disability and those with long-term health conditions but no disability (Endnote 5). Estimates of overall disability in the NATSISS, therefore, are markedly higher than the disability estimates for Aboriginal and Torres Strait Islander people in the SDAC.

The five yearly Census of Population and Housing measures the number and key characteristics of people in Australia on Census night, as well as information about the dwellings in which they live. Information about need for assistance with core activities of self-care, communication and mobility has been collected in the 2006, 2011 and 2016 Censuses, and is conceptually comparable with the SDAC measure of people who have a profound or severe core activity limitation.

The disability estimates in SDAC differ from those in the Census because of differences in scope and methodology. The information on need for assistance is derived from a short question set on the Census form, and these typically identify fewer people in the population of interest (Endnote 6).

Being a large survey dedicated specifically to the collection of data on people with disability, the SDAC is able to provide more detail about people with disability than is possible to achieve through the NATSISS or the Census. However, the SDAC, the NATSISS and the Census consistently show that Aboriginal and Torres Strait Islander people generally have higher rates of disability than non-Indigenous people.

Further information on ABS sources of disability information can be found in ABS Sources of Disability Information, Australia, 2003-2008 (cat. no. 4431.0.55.002).

Endnotes

1. Australian Bureau of Statistics, Australian Social Trends, Sep 2012 (cat. no. 4102.0)

2. Australian Bureau of Statistics, Australian Social Trends, March Quarter 2012 (cat. no. 4102.0)

3. Australian Bureau of Statistics, Disability, Ageing and Carers, Summary of Findings, 2015 (cat. no. 4430.0)

4. Australian Bureau of Statistics, National Aboriginal and Torres Strait Islander Social Survey, 2014-15, (cat. no. 4714.0)

5. Australian Bureau of Statistics, ABS Sources of Disability Information, Australia, 2003-2008 (cat. no. 4431.0.55.002)

6. Australian Bureau of Statistics, Census Dictionary, 2016 (cat. no. 2901.0)