Profile of people with a core need for assistance in Australia

• 5.8% of Australians had a core activity need for assistance, an increase from 5.1% in 2016.
• Over half (54.2%) of people with a need for assistance were aged 65 years and over.
• Nearly nine in ten people (88.1%) with a need for assistance had a long-term health condition.
• In 2021 those aged 3 years and over with a need for assistance were less likely to be attending an educational institution than those without a need for assistance (14.9% compared with 27.5%).

Around one in five Australians have a disability (Survey of Disability, Ageing and Carers, 2018), and many others are involved in providing care to those with disability. People with disability are a diverse population who actively engage in all aspects of Australian society. However disability may limit a person’s engagement in various aspects of life, particularly for those who have a high need for assistance.

The 2021 Census collected information about a person’s need for assistance with one or more of the core activities of self-care, communication, and mobility due to disability, long-term health conditions or the effects of old age. The questions used in the Census are based on the ABS Survey of Disability, Ageing and Carers (SDAC) concept of ‘profound or severe core activity limitation’ and are used to identify those for whom service delivery is most important.

Collecting this information through the Census allows us to examine a range of detailed demographic and socio-economic characteristics for those needing assistance in our community, including their geographic distribution. It also allows us to identify small sub-populations that are more likely to need assistance. For detailed information on all ABS sources of disability data, including Census, and when each source should be used see Understanding disability statistics in the Census and the Survey of Disability, Ageing and Carers.

According to the 2021 Census, there were 1.46 million people (5.8% of the Australian population) who reported a core activity need for assistance. That is, they needed assistance with at least one of the core activities of self-care, communication, and mobility. This was an increase from 1.20 million people (5.1%) in 2016. When comparing those with a need for assistance to those without a need for assistance, it is important to note the differing age distributions given the strong relationship between age and disability. Australia is an ageing population and the proportion of people aged 65 years and over has increased from 15.7% in 2016 to 17.2% in 2021. 

Reflecting the strong relationship between age and disability, the proportion of people needing assistance increased significantly across age from 1.4% of those aged less than four years to 49.2% of those aged 85 years and over.

When looking at the percentage increase, or growth in each age cohort, it is interesting to see that younger age groups with a core need for assistance experienced the highest rate of growth between 2016 and 2021. In particular, the number of people with a need for assistance in the 5-14 year age group increased by 46.7%.

Over half (54.2%) of people with a need for assistance were aged 65 years and over in 2021, compared with 14.8% of those without a need for assistance. This should be kept in mind given the correlation between age and many factors analysed in this article, such as living arrangements and income. 

Some interesting observations can be drawn when looking at need for assistance by sex across the lifespan. Young males were more likely to have a need for assistance than young females in the first half of the lifespan, particularly between the ages of 5-24 years. Conversely, older females were more likely to have a need for assistance than males in the second half of the lifespan, with this difference between males and females increasing in size from the age of 75 years.

According to the 2021 Census, 8.2% of Aboriginal and Torres Strait Islander people reported a core activity need for assistance, an increase from 6.7% in 2016. Overall, Aboriginal and Torres Strait Islander males were more likely to report a need for assistance (8.7%) compared with Aboriginal and Torres Strait Islander females (7.6%), both increases since 2016.

In 2021, the proportion of people with a need for assistance varied by the state or territory in which they lived:

• Tasmania had the highest proportion of people who reported a need for assistance (6.8%) followed closely by South Australia (6.7%), reflecting the relatively older age profile in these states, where around two in ten people were aged 65 years or over.
• The Northern Territory had the lowest proportion of people with a need for assistance (3.6%), reflecting the younger age profile in the Territory, where less than one in ten (9.0%) people were aged 65 years or more.

In 2021, rates of need for assistance had increased slightly across all states and territories since 2016.

People living in Greater Capital Cities were less likely to have a need for assistance (5.4%) compared with those living outside of greater capital cities/rest of state (6.5%), reflecting the younger age profile of those living and working in major cities.

People with disability may face barriers to participating in education both during primary and secondary schooling, as well as higher and vocational education. In 2021, those aged 3 years and over, with a need for assistance were less likely to be attending an educational institution than those without a need for assistance (14.9% compared with 27.5%), with some notable differences across age groups.

Among those with a need for assistance:

• 20.2% of those aged 20-24 years were studying at an educational institution, less than half the rate of those of the same age without a need for assistance (43.5%).
• 13.0% of those aged 25-29 years were studying at an educational institution, compared to 19.4% of those of the same age without a need for assistance.

Between 2006 and 2021, the proportion of people with a need for assistance attending an educational institution increased from 10.1% to 15.0% of people aged 3 years and over. There was a smaller increase for people without a need for assistance (26.0% in 2016 compared to 27.5% in 2021). There were some notable differences across age groups:

• Among those aged 20-24 years, the proportion of people with a need for assistance attending an educational institution decreased from 22% in 2006 to 20% in 2021. People without a need for assistance in this age group were more likely to be attending an educational institution in 2021 (33.7% in 2006 compared to 43.5% in 2021)
• Among those aged 25-29 years, people with a need for assistance were equally likely to attend an educational institution in both 2006 and 2021 (13.0% in both years). People without a need for assistance were more likely to be attending an educational institution in 2021 (14.5% in 2006 compared to 19.4% in 2021).

The 2021 Census measured the number of people who reported that they had at least one of ten selected long-term health conditions, including arthritis, asthma and mental health conditions. The Census question also included an option for ‘any other long-term health condition’. See Census Dictionary for more information on long-term health conditions. 

In 2021, close to nine in ten people (88.1%) with a need for assistance had a long-term health condition compared to three in ten (29.8%) people without a need for assistance.

Among people with a need for assistance, other than ‘any other long-term health condition’ (38%), the most commonly reported long-term health conditions were:

• Arthritis (31.7%), compared with 8.5% of the total Australian population
• Mental health condition (29.3%), compared with 8.8% of the total Australian population.

The language a person uses at home may be an important part of their culture, identity, and wellbeing. Proficiency in English may impact on a person’s ability to access employment, education and government and non-government services.

According to the 2021 Census, among those with a need for assistance:

• Three in four (75.7%) used only English at home, similar to the rate for those without a need for assistance (75.8%)
• 22.6% (330,250 people) communicated in a language other than English at home, with the most common languages being Italian (12.0%), Arabic and Greek (both 10.2%).

Among those with a need for assistance who communicated in a language other than English at home, around half (50%) spoke English very well or well. This varied depending on their main language spoken. Over three quarters (75.6%) of people with a need for assistance who speak Vietnamese, either didn’t speak English well or at all. Compared to 37% of Italian speakers who don’t speak English well or at all.

In 2021, 89.2% of people with a need for assistance lived in a private household (DWTD), a slight increase from 86.2% in 2016. Among those with a need for assistance living in a private household:

• Just over three-quarters (76.8%) lived in a family household compared to 86.7% of people without a need for assistance
• Two in ten (19.2%) lived in a lone person household compared to one in ten people (9.7%) without a need for assistance

The remaining 10.8% of people with a need for assistance (152,450 people) were living in a non-private dwelling. Of these:

• Most (92.7%) were aged 65 years or over
• Most (92.7%) lived in a nursing home or accommodation for the retired or aged, reflecting the older age profile of this group.

Housing costs are often a major component of total living costs. According to the 2021 Census, among those living in rented private dwellings (RAID), 40.7% of people with a need for assistance had rental payments of more than 30% of their household income, compared with 26.7% of those without a need for assistance.

Equivalised total household income (weekly) (HIED) is an indicator of the income resources available to a household and does not take into consideration the assets that might be held by members of a household (such as the family home).

People with a need for assistance tended to have a lower household income than those without a need for assistance, in part reflecting the older age profile of this group and therefore the higher likelihood they are retired. In 2021, over two-thirds (67.3%) of people with a need for assistance who lived in a private dwelling lived in a household with a weekly equivalised household income of less than $1,000, compared with 37.6% of those without a need for assistance.

More data related to this article can be found in the data downloads on the Disability and carers: Census topic page.