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4445.0 - People with a Need for Assistance - A Snapshot, 2006  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 05/08/2008  First Issue
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AGE AND SEX

GEOGRAPHY

LIVING ARRANGEMENTS

HOME OWNERSHIP

LABOUR FORCE PARTICIPATION


INTRODUCTION

Disability affects about one in five Australians to varying degrees and in various ways. This can range from someone who has a mild hearing impairment that is overcome by the use of a hearing aid, to a person who cannot wash or dress without help. In 2006, the Census of Population and Housing included questions for the first time on people with disabilities at the more severe end of this spectrum, that is those who need assistance with self-care, communication or mobility activities (footnote 1).


DATA SOURCES

Information about the prevalence of disability, the conditions causing disability and the nature of assistance required because of disability is available from the six-yearly Survey of Disability, Ageing and Carers (SDAC). The SDAC uses 75 questions during a personal interview to identify disability status. When last conducted in 2003, it found that 6.3% of people were severely or profoundly limited in at least one of the core activities of self care, communication and mobility.

The Census variable 'need for assistance' was designed to be conceptually comparable to the SDAC measure of profound or severe core activity limitation. In 2006, the Census showed that 4.4% of people had a need for assistance (see footnote 2 for a more detailed explanation of the Census variable). The difference between the two measures is largely explained by the use of different question sets and different collection methodologies (footnote 3). Although the rates produced by the two collections differed, the likelihood of having a need for assistance or of having a profound or severe core activity limitation varied across age and sex in the same manner and showed a similar increase with age. The main advantage of the Census is its size and comprehensive coverage which enables the examination of small populations by demographic, geographic or economic characteristics.

This article examines the characteristics of people who reported a need for assistance in the 2006 Census.

PROPORTION OF PEOPLE IN EACH AGE GROUP WHO HAD A SEVERE OR PROFOUND CORE ACTIVITY LIMITATION, 2003
Graph: Proportion of people in each age group who had a severe or profound core activity limitation, 2003

PROPORTION OF PEOPLE IN EACH AGE GROUP WHO NEEDED ASSISTANCE, 2006
Graph: Proportion of people in each age group who needed assistance, 2006


AGE AND SEX

There is a strong relationship between age and disability. In general, as a person ages, they are more likely to need assistance with daily activities. This likelihood increases significantly for ages over 70 years. The 2006 Census data shows that this relationship is very similar for males and females, with the proportion who needed assistance increasing from 1.2% of boys and 0.7% of girls aged 0-4 up to 55% of men and 69% of women aged 90-94 years.

Whereas 18% of the general population was aged 60 or more years, 61% of the population who reported a need for assistance were aged 60 or more. In the population 80 years or older with a need for assistance, there are more than twice as many women as men, consistent with their greater life-expectancy. For both men and women, the largest number of people needing assistance was in the 80-84 age group and the smaller numbers in older age groups reflect the smaller overall populations in these groups.
AGE DISTRIBUTION OF PEOPLE AGED 60 YEARS AND OVER WITH A NEED FOR ASSISTANCE
Graph: Age distribution of people aged 60 years and over with a need for assistance

In almost all age groups, the proportion of Indigenous people who needed assistance was higher than for non-Indigenous people. Consistent with their lower life expectancy and generally poorer health outcomes, higher proportions of younger Indigenous people reported a need for assistance.

In 2006, 73% of people needing assistance in the Indigenous population were younger than 60 years, almost twice the corresponding proportion of the non-Indigenous population (38%). In addition, the proportion of people needing assistance was distributed more evenly across all ages in the Indigenous population than the non-Indigenous population.
AGE DISTRIBUTION OF PEOPLE WHO NEEDED ASSISTANCE
Graph: Age distribution of people who needed assistance
GEOGRAPHY

The proportion of people who needed assistance was highest in South Australia (5.1%) and Tasmania (5.2%) and lowest in the Northern Territory (2.7%) and the Australian Capital Territory (3.3%). This largely reflects the different age structures across the States and Territories. Once the effect of the different age structures across States is removed (footnote 4), there are less differences among the States and Territories. The high proportion for NT partly reflects its relatively high Indigenous population with its higher prevalence of disability.
PROPORTION OF PEOPLE IN EACH STATE WHO NEEDED ASSISTANCE
Graph: Proportion of people in each State who needed assistance


As measured by the Accessibility/Remoteness Index of Australia (footnote 5), Inner Regional areas are more likely than other areas to have a comparatively high proportion of people needing assistance. In 2006, 5.0% of people in Inner Regional Australia needed assistance, compared with 3.4% of people in Major Cities and 2.8% of people in Very Remote areas. Some of these differences are related to the age structures of the populations in the different regions. In Very Remote areas, there are relatively few older people, whereas Inner Regional areas generally have an older population. As people get older, there is a tendency for them to relocate, moving away from Remote and Very Remote areas and into Inner and Outer Regional areas in order to gain access to appropriate medical and community facilities. There is also a trend for people retiring to move away from Major Cities to Regional areas.

When the effect of age structures has been taken into account, the differences between regions are no longer as distinct and, in 2006, Major Cities had the lowest adjusted proportion of people needing assistance.
PROPORTION OF PEOPLE IN EACH REMOTENESS AREA WHO NEEDED ASSISTANCE
Graph: Proportion of people in each remoteness area who needed assistance

LIVING ARRANGEMENTS

Families provide emotional, physical and financial support to their members. Most Australians experience several distinct phases in living arrangements at various stages of their lives: living with their parents, living with a partner without children, as parents, and living alone (often in old age after a partner dies but also increasingly as younger people prior to living with a partner).
HOUSEHOLD RELATIONSHIPS(a) BY WHETHER HAS A NEED FOR ASSISTANCE
Age group (years)
0–14
15–24
25–44
45–64
65–84
85 +
Total
Has need for assistance with core activities
%
%
%
%
%
%
%
Husband, Wife or Partner
with children
. .
1.4
26.6
24.5
8.7
2.8
13.0
without children
. .
2.4
9.6
37.9
45.4
22.2
29.7
Lone parent
. .
1.0
8.2
7.3
8.8
14.6
7.8
Child
in couple family
70.3
55.2
16.1
1.0
0.0
0.0
11.9
in one parent family
29.7
27.3
10.0
2.4
0.1
0.0
6.1
Other related individual (a)
. .
3.2
3.0
4.0
10.0
17.1
7.2
Unrelated individual (a)
. .
1.4
1.3
0.8
0.4
0.4
0.6
Group household member
. .
4.8
9.6
5.5
2.0
1.3
3.7
Lone person
. .
3.4
15.5
16.6
24.4
41.6
20.0
Total
100
100
100
100
100
100
100
Does not have need for assistance with core activities
%
%
%
%
%
%
%
Husband, Wife or Partner
with children
. .
3.3
50.8
40.8
8.0
3.6
26.5
without children
. .
8.4
17.7
34.3
56.2
30.3
21.0
Lone parent
. .
1.7
7.2
6.8
3.7
5.6
4.5
Child
in couple family
81.3
51.3
5.1
0.4
0.0
0.0
25.5
in one parent family
18.7
15.1
2.4
1.2
0.2
0.0
7.0
Other related individual (a) household
. .
5.0
1.9
1.5
3.1
5.3
2.0
Unrelated individual (a)
. .
2.8
1.2
0.5
0.2
0.3
0.9
Group household member
. .
8.6
4.7
1.9
1.7
1.3
3.2
Lone person
. .
3.6
8.9
12.5
26.9
53.6
9.4
Total
100
100
100
100
100
100
100
(a) Data presented only for people living in private dwellings
Source: 2006 Census of Population and Housing

The majority of people, whether they need assistance or not, live in households with other family members. But the family characteristics of people who need assistance are generally different from the people who do not need assistance. In the 2006 Census, people needing assistance were about half as likely as people who didn't need assistance to be in a couple family with their own children (13% compared with 26%), with this ratio holding for each of the age groups between 15 and 64. Between the ages of 25 and 44, people who need assistance were also much less likely (36% compared with 69%) to be in partner relationships, with or without children, than those without a need for assistance. Lone parents 65 years and over were more than twice as likely to need assistance. This may reflect a parent living with an adult child who is providing them with assistance.

In the 2006 Census, there were 74,600 dependent children (footnote 6) who needed assistance living in households and of these, 83% were under the age of 15. Children generally develop increasing independence as they grow older, but many children with a need for assistance will require support from their families and the community for the rest of their lives. In 2006, the 20,300 adult children aged 25-44 years, an age when children have generally moved out of the family home, who had a need for assistance were more than three times as likely to be living in their parent's home (26% compared with 8% who didn't need assistance). There were far fewer people 45 years and older with a need for assistance living with parents (5,900 in the 2006 Census). This is most likely because the parents are less able to provide the necessary care and alternative living arrangements may have to be found.

While people may live by themselves for a variety of reasons, there was a greater likelihood that people aged between 25 and 64 with a need for assistance would be living alone compared with those without a need for assistance. For people aged 65 and over, those who reported a need for assistance were less likely than others to be living alone. It is likely that older people who need assistance move into cared accommodation if they do not have a partner to care for them. That said, across the total population, people with a need for assistance were twice as likely to be living alone as those who didn't report a need for assistance. This high ratio is because older people are comparatively more likely to be living alone and need for assistance is strongly related to age.
AGE DISTRIBUTION OF PEOPLE LIVING ALONE
Graph: Age distribution of people living alone

In 2006, the Census identified 55% of people who needed assistance living in the same household as someone who provided unpaid care or assistance. Census data does not allow for analysis of the relationship between the person providing care and the person receiving it, but the Survey of Disability, Ageing and Carers conducted in 2003 showed that 78% of all primary carers lived in the same household as the recipient of care.

In common with the 97% of the general population who live in private dwellings, the majority (81%) of people with a need for assistance live in private dwellings. But in 2006, 489,000 people lived in non-private dwellings, of whom 33% had a need for assistance, much higher than the 3.7% of people living in private dwellings. Many non-private dwellings are specifically set up to care for older people and, as people age, the burden of care is increasingly transferred from home to institution. However, in 2006, some other types of non-private dwellings that are not specifically set up for caring, such as hostels and caravan parks, also had relatively high numbers of residents who needed assistance.
PROPORTION OF PEOPLE IN EACH AGE GROUP WHO NEEDED ASSISTANCE
Graph: Proportion of people in each age group who needed assistance


HOME OWNERSHIP

Housing security is important to most people. For those with a need for assistance, the ability to make modifications which maximise their comfort, functioning and independence in their own homes, is an additional consideration. Most people buy their homes during their working years. There were relatively high rates of home ownership for older people who reported a need for assistance. This may reflect people who had purchased their homes before the onset of disabling conditions in old age. The earlier the onset of disability, the more difficult it becomes to work and gain assets. The 2006 Census showed that the rate of home ownership in general, was lower in all age groups for those with a need for assistance.
PROPORTION OF PEOPLE LIVING IN HOMES OWNED OUTRIGHT OR BEING PURCHASED
Graph: Proportion of people living in homes owned outright or being purchased

More people with a need for assistance (10%) rented from State/Territory housing authorities or housing cooperatives, community and church groups than the general population (4%). LABOUR FORCE PARTICIPATION

More severe disabilities can be a barrier to employment. While the majority of people who needed assistance in 2006 were past retirement age, at all ages in which people usually participate in the labour force, the participation rates of people who needed assistance were much lower than for the rest of the population. The highest participation rate was 31% in the 25-34 age group. The 2003 Survey of Disability, Ageing and Carers found that provision of training was the major step that employers could take to enable people with disabilities to participate in the labour force. Other helpful steps identified were the provision of equipment and assistance with work or personal care tasks.
LABOUR FORCE PARTICIPATION RATE
Graph: Labour Force participation rate

Employed people with a need for assistance were more likely to be working part-time than full-time. While people with a need for assistance work in each of the major occupation groups, 31% were labourers compared with only 11% of people who did not report a need for assistance. Of the 15,700 Labourers with a need for assistance in 2006, the most common occupations were Commercial cleaners (1,500), Packers and assemblers (3,800), and Factory process workers in sheltered workshops (1,900).
MAJOR OCCUPATION GROUPS BY WHETHER NEEDED ASSISTANCE
Graph: Major Occupation groups by whether needed assistance


As a sub-population of workers, people with a need for assistance used buses and taxis more, walked more, caught lifts with other drivers more and used more combinations of travel to get to work than the general population. Still, 39% of working people with a need for assistance drove themselves all the way to work, although this is lower than the 68% of people without a need for assistance.
FOOTNOTES

1. Core activity need for assistance: 2006 was the first year the variable Core Activity Need For Assistance was included in the Census of Population and Housing. This was developed to measure the number of people with a profound or severe disability. Being able to shower, dress, eat and toilet oneself (self care), being able to move around your home, to bend and pick up things or to use public transport (mobility) and to be able to be understood and to make oneself understood, were deemed to be basic and important aspects of daily living. Needing assistance with one or more of these activities is an indication that someone has significant difficulties with basic human functions. People who reported needing help in at least one of the three core areas of self care, mobility or communication because of a disability, long term health problem (lasting 6 months or more) or old age, were categorised as needing assistance. The population of interest is related conceptually to those with severe or profound core activity limitation in the SDAC.
2. Census variable: There were 4 questions in the Census on need for assistance. The first three asked if a person needed assistance with each of the activities of self care, mobility and communication; the fourth asked why this assistance was needed. If a person indicated that they needed assistance in one or more of the three activities because of a disability, long term health problem or the effects of old age, they were categorised as 'having need for assistance'.
3. SDAC and Census methodologies: The SDAC form contained 75 questions compared with 4 questions on the Census form. In addition, the SDAC used a combination of personal interviews and, for residential care units, forms that were completed on behalf of the residents by a designated officer. The Census collected information by self completed forms.
4. Adjusting for age effect: To remove the effect of different age structures within different States, a standard population age distribution is used instead of the State's age distribution. The standard population used here is the final Australian Estimated Resident Population for June 30, 2001. The use of a standard population from a time point that is earlier than the survey explains why generally the outcome of removing the age effect is a reduction in the proportion; in 2001 there were relatively less people in the older age groups.
5. Accessibility/Remoteness Index of Australia (ARIA): Within the Australian Standard Geographical Classification (ASGC), each Collection District (CD) in the Census is given an average ARIA value according to how the physical road distance that points within the CD are from urban centres. These index values allow classification into the five categories of remoteness and accessibility: Major Cities, Inner Regional Australia, Outer Regional Australia, Remote Australia and Very Remote Australia.
6. Dependent children: Dependent children are all children under the age of 15 years plus those who are full-time students between the ages of 15 and 24 years.REFERENCES

Australian Bureau of Statistics (2006) Census Of Population and Housing Census Dictionary (Reissue), cat.no. 2901.0, ABS, Canberra.

Australian Bureau of Statistics (2006) Census Dictionary Data Quality Statements, cat no. 2901.0, ABS, Canberra.

Australian Bureau of Statistics (2003) Survey of Disability, Ageing and Carers, cat.no. 4430.0, ABS, Canberra.

Australian Bureau of Statistics (2007) Australian Standard Geographical Classification, cat no. 1216.0, ABS, Canberra.


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