COMPARISON OF DISABILITY PREVALENCE BETWEEN ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLES AND NON-INDIGENOUS PEOPLES
ABOUT THE INFORMATION
Data presented in this article are from the Survey of Disability, Ageing and Carers (SDAC) conducted by the Australian Bureau of Statistics (ABS) in 2009. The SDAC is designed to measure the prevalence of disability in Australia and the need for support by people with disability. This article marks the first release of data on Aboriginal and Torres Strait Islander people from the SDAC. The survey sample in 2009 was much larger (around 74,000 people) than the 2003 survey, resulting in more robust estimates of the Aboriginal and Torres Strait Islander population being available.
Comparisons between Aboriginal and Torres Strait Islander people and non-Indigenous people in this article are limited to the scope of the SDAC collection (i.e. excluding people in very remote areas) and are therefore not necessarily representative of all people living across Australia. While the proportion of non-Indigenous people living in very remote areas is very small (less than 1%), Aboriginal and Torres Strait Islander people living in very remote areas account for around 15% of that population. This means that 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 than on data for non-Indigenous people (Endnote 1).
Age standardisation is often used when comparing data for the Aboriginal and Torres Strait Islander and non-Indigenous populations. This is because 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. The age standardised rates in this article are calculated using the direct age standardisation method, and using the age categories of 0 to 4 years, and then 10 year age groups to 55 years or over. Further information on age standardisation may be found in the Technical Note of the National Aboriginal and Torres Strait Islander Health Survey, 2004-05 (cat. no. 4715.0) (Endnote 2).
For clarity, in this article the surveyed groups will be referred to as 'Aboriginal and Torres Strait Islander' and 'non-Indigenous' people. All data are for people living in private dwellings.
Over the last decade there has been an increased awareness of the disparity that exists between the socioeconomic circumstances of theAboriginal and Torres Strait Islander and non-Indigenous populations of Australia. With Government and community initiatives aimed at ‘Closing the Gap’ in outcomesbetween the two populations, there has been a corresponding interest in comparative data related to both groups (Endnote 3). Aboriginal and Torres Strait Islander people with disability may be especially vulnerable to disadvantage.
This article compares the prevalence of disability among Aboriginal and Torres Strait Islander people and non-Indigenous people, using data from the 2009 SDAC which provides the most comprehensive measure of disability. Users should refer to the technical note for further discussion on other ABS’ disability measures relevant to Aboriginal and Torres Strait Islander people.
How common is disability?
In the SDAC, disability is defined as ‘any limitation, restriction or impairment which restricts everyday activities and has lasted or is likely to last for at least six months’ (Endnote 4). In 2009, it was estimated that 18.5% of all Australians had a disability that restricted their daily living in some way.
At the time of the survey, there were estimated to be 445,400 Aboriginal and/or Torres Strait Islander people and 20,964,000 non-Indigenous people. There were notable differences in the rates of disability for these two groups of people:
the overall rate of disability among Aboriginal and Torres Strait Islander people was 21.1% in 2009;
after adjusting for differences in the age structure of the two populations, Aboriginal and Torres Strait Islander people were 1.7 times as likely as non-Indigenous people to be living with disability;
the overall disability rates for Aboriginal and Torres Strait Islander males and females were not significantly different (22.9% and 19.5% respectively);
similar patterns of increasing disability could be seen in both populations as people aged, but rates peaked at an earlier age for Aboriginal and Torres Strait Islander people than for non-Indigenous people (Graph 1), reflecting the earlier onset of chronic diseases, such as heart disease and diabetes (Endnote 5);
Aboriginal and Torres Strait Islander children aged 0-14 years had much higher rates of disability than non-Indigenous children (14.2% compared with 6.6%). The differences were statistically significant for both boys (19.9% compared with 8.3%) and girls (8.9% compared with 4.8%);
Aboriginal and Torres Strait Islander adults in the age range of 25-54 years had rates of disability that were between 2.0 and 2.5 times the corresponding rates for non-Indigenous adults;
In the 35–44 years age group, the differences in disability rates for Aboriginal and Torres Strait Islander people and non-Indigenous people were significantly different for both men (35.1% compared with 12.3%) and women (29.0% compared with 12.5%).
Disability prevalence (a), by Indigenous status and age, 2009
Footnote(s): (a) excludes people in very remote areas (b) Difference between Aboriginal and Torres Strait Islander and non-Indigenous is not statistically significant
Source(s): ABS Survey of Disability, Ageing and Carers, 2009
Severity of Disability
A core-activity refers to one of three main everyday activities - self-care (eating, dressing, bathing etc), mobility and communication with others. A person with profound core-activity limitation is unable to do at least one of these activities at any time or needs constant help. A person with severe core-activity limitation needs help some of the time with at least one of these activities. The combined measure ‘profound/severe core-activity limitation’ therefore identifies people at the most severe end of the disability spectrum. In 2009:
one in twelve (8.2%) Aboriginal and Torres Strait Islander people had a profound/severe core-activity limitation (8.3% of males and 8.1% of females);
after adjusting for differences in the age structure of the two populations, Aboriginal and Torres Strait Islander people were twice as likely as non-Indigenous people to be living with a profound/severe core-activity limitation (males 1.7 times as likely and females 2.3 times as likely);
one in five (20.9%) older Aboriginal and Torres Strait Islander people (aged 55 years and over) had a profound/severe core-activity limitation — around three times the rate for younger age groups (Graph 2);
in every age group, Aboriginal and Torres Strait Islander people were more likely to have a profound/severe core-activity limitation than non-Indigenous people (Graph 2);
Disability status (a), by Indigenous status and age, 2009
Footnote(s): (a) Excludes people in very remote areas
Source(s): ABS Survey of Disability, Ageing and Carers, 2009
Remoteness
After adjusting for differences in the age structure of the two populations, Aboriginal and Torres Strait Islander people in major cities were 1.6 times as likely as non-Indigenous people in major cities to be living with disability. The differences between disability rates for Aboriginal and Torres Strait Islander people and non-Indigenous people were not statistically significant in inner regional, outer regional and remote areas.
TECHNICAL NOTE
Differences between the Survey of Disability Ageing and Carers, the National Aboriginal and Torres Strait Islander Social Survey, and the Census of Population and Housing
The National Aboriginal and Torres Strait Islander Social Survey (NATSISS) conducted in 2008 is a multi-faceted social survey which provides broad information across key areas of social concern. Information about the disability and long term health conditions of Aboriginal and Torres Strait Islander people was collected in this survey.
Disability estimates for Aboriginal and Torres Strait Islander people in the 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 (Endnotes 6 and 7 respectively). There are also differences in collection methodology, with SDAC using a series of screening questions which has been found to be more effective in differentiating between people with disability and those with long-term health conditions but no disability (Endnote 8). 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, and the dwellings in which they live. Information about need for assistance in the core activities of self-care, communication or mobility has been collected in the 2006 and 2011 censuses, and is designed to be comparable to 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 short question sets typically identify fewer people in the population of interest (Endnote 9).
Being a large survey dedicated specifically to the collection of data on people with disability, the SDAC is able to provide more detail about those with disabilities than is possible to achieve through the NATSISS or the Census. However, the SDAC, the NATSISS and the Census all show that Aboriginal and Torres Strait Islander people generally have higher rates of disability than the non-Indigenous population.
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