Disability

Information was obtained from men and women aged 18 years and over in the 2021-22 PSS.

In the context of health experience, the International Classification of Functioning, Disability and Health (ICF) defines disability as an umbrella term for impairments, activity limitations and participation restrictions. It denotes the negative aspects of the interaction between an individual (with a health condition) and that individual's contextual factors (environment and personal factors).

In the PSS, a person has a disability if they report they have a limitation, restriction or impairment, which has lasted, or is likely to last, for at least six months and restricts everyday activities.

Disability is classified by whether or not a person has a specific limitation or restriction. The specific limitation or restriction is further classified by whether it is a limitation in core activities, or a schooling/employment restriction only.

There are four levels of core activity limitation (profound, severe, moderate, mild). These are based on whether a person needs help, has difficulty, or uses aids or equipment with any core activities (self-care, mobility, or communication). A person's overall level of core activity limitation is determined by their highest level of limitation in any of these activities.

The ‘schooling/employment restriction only’ category includes people with disability who do not have a core limitation but have difficulties with education and/or employment.

The PSS uses a standard set of sixteen questions designed to identify whether a person has a disability or long-term health condition, the type(s) of disability that they have, and the level of severity in terms of core activity restrictions and limitations.

Respondents were asked about whether they had any conditions that have lasted, or were expected to last, six months or more, including:

• shortness of breath
• chronic or recurring pain
• a nervous or emotional condition
• memory problems or periods of confusion
• social or behavioural difficulties
• long-term effects as a result of a head injury, stroke, or other brain damage
• receiving treatment or medication for any other long-term condition
• any other long-term condition (such as arthritis, asthma, heart disease etc).

More than one condition may have been reported.

Respondents who reported a condition were then asked if the condition(s) they had reported restricted them in their everyday activities, and if so, which ones.

All respondents were then asked if they had any of the following conditions which had lasted, or were likely to last, for six months or more:

• sight problems not corrected by glasses or contact lenses
• hearing problems
• speech problems
• blackouts, seizures or loss of consciousness
• difficulty learning or understanding things
• limited use of arms or fingers
• difficulty gripping things
• limited use of legs or feet
• any condition that restricts physical activity or physical work (e.g. back problems, migraines)
• any disfigurement or deformity
• any mental illness for which help or supervision is required.

More than one condition may have been reported.

Respondents who selected a condition(s) in the first question and reported a restriction in everyday activities and/or selected a condition in the second question were then asked about the levels of help or supervision that they required with any of the following tasks:

• self-care (e.g. bathing/showering, dressing/undressing, eating/feeding, going to the toilet, bladder/bowel control)
• mobility (e.g. moving around away from home, moving around at home, getting in or out of a bed or chair)
• communication in own language (e.g. understanding/being understood by strangers, friends or family, including use of sign language/lip reading).

Respondents who reported requiring help or supervision for these tasks were asked whether they always needed help with any of these tasks.

Respondents who did not require help or supervision were asked if they ever had any difficulty with the tasks.

Respondents who did not have any difficulty were then asked if they used any aids to assist with those tasks and then whether they could do any of the following additional mobility tasks:

• easily walk 200 metres
• walk up and down stairs without a handrail
• easily bend to pick up an object from the floor
• use public transport without difficulty, help or supervision.

Respondents with a disability were then asked whether they had any difficulties with the following education-related activities:

• not attending school/further study due to condition
• need time off school/study
• attend special classes/school
• other related difficulties
• no difficulty with education.

Respondents were also asked whether they had any difficulties with the following employment-related activities:

• type of job they could do
• number of hours that can be worked
• finding suitable work
• needing time off work
• permanently unable to work
• other related difficulties
• no difficulty with employment.

Based on their responses, respondents with a disability were classified to one or more of the following categories of disability type:

• sensory and speech
• learning and understanding
• physical restriction
• psychosocial
• head injury, stroke, or acquired brain injury
• other.

Based on their responses, respondents with a disability were classified to one of the following categories of disability severity:

• Profound core activity limitation – Those who answered yes to always needing help with self-care, mobility and communication tasks.
• Severe core activity limitation – Those who don't always need help with self-care, mobility, and communication tasks, but may require help at times.
• Moderate core activity limitation – Those who had difficulty with self-care, mobility, and communication tasks but did not require help.
• Mild core activity limitation – Those who only required aids to undertake self-care, mobility, and communication tasks, or who were unable to do any of the additional mobility tasks (e.g. easily walk 200 metres, walk up and down stairs without a handrail etc.).
• Schooling/employment restriction only – Those who did not have any difficulty with the core activities or additional mobility tasks but identified as having difficulty with school/study or work. The school/study component of this category is restricted to persons aged 18 to 20 years only.
• No limitation or specific restriction – Those who indicated that they had no difficulties with the core activities, additional mobility tasks, and school/study or work.

Those who had not reported any conditions in the first or second question OR had not reported any everyday restrictions caused by conditions in the first question were identified as having ‘no disability’.

The data items and related output categories for this topic are contained within the SPS Level – Health & Disability tab in the data item list available under Downloads.

Data for this topic has been collected to examine the relationship between disability and experiences of violence. It can be used to understand the prevalence rate of different types of violence for people with and without disability, and measure changes in prevalence rates over time.

Data items from this topic should not be used on their own to produce population estimates of disability status. The Survey of Disability, Ageing, and Carers is a more appropriate data source for those purposes. Further information on ABS disability statistics can be found in Understanding disability statistics in the Census and the Survey of Disability, Ageing and Carers.

Points to be considered when using and interpreting data for this topic include the following:

• Disability status is determined based on the respondent’s limitations, restrictions or impairments at the time of the survey. It does not necessarily indicate whether they had a disability at the time of any violence. It is recommended that disability status is used only when examining recent experiences of violence (i.e. in the previous 12 or 24 months), as characteristics are fluid and more likely to have changed over longer timeframes.
• Conditions are 'as reported' by respondents and do not necessarily represent conditions as medically diagnosed. However, as the definition includes conditions which had lasted, or were expected to last, for six months or more, there is a reasonable likelihood that medical diagnoses would have been made in most cases. The degree to which conditions have been medically diagnosed is likely to vary across condition types.
• 'Restricted in everyday activities' means less able, or unable, to engage in the everyday activities that a healthy individual of the same age could. Respondents can perceive themselves to be restricted in everyday activities by causes other than the specific conditions listed.
• Aids needed for any condition lasting less than six months (i.e. broken leg) were not included. Examples of aids are hearing aids, wheelchairs for long-term use, special cutlery and changes to floors/steps/paths.
• Only current difficulties with education and/or employment were collected. Any difficulties a respondent may have previously experienced were excluded. Therefore, it is recommended that only recent experiences (i.e. in the previous 12- or 24- months) are considered in conjunction with this data.
• If a person was selected to participate in the survey but cannot communicate independently with the interviewer due to a disability, a proxy interview was conducted with the person’s guardian or carer. However, sensitive questions about experiences of violence were not asked during proxy interviews. As such, a small number of persons with a severe communication disability that prevented them from responding to survey questions themselves were excluded from the sensitive component of the survey. Whilst there is a small under representation of persons with profound or severe disability who cannot communicate independently, this does not impact on the overall representativeness of persons with disability in the PSS sample. For further information about the representation of persons with disability in the PSS sample, refer to the Response Rates section of the Sampling chapter of this publication.
• Persons residing in non-private dwellings are excluded from the PSS coverage. This includes persons with disability living in health care establishments or other institutional settings. The exclusion of persons with disability living in institutional settings from the coverage of the PSS does not impact on the overall representativeness of persons with disability in the PSS sample, as persons with disability living in care-accommodation comprise less than 5% of all persons with disability (SDAC, 2018).
• Of persons in the approached sample, who reported a severe/profound disability, 64.8% were fully responding.  Approximately 35.2% of respondents with severe/profound disability did not complete the full interview due to proxy interview or opting out. For more details regarding proxy interviews refer to Proxy Interviews in the Survey procedures section of the Survey Development and Data Collection chapter of this publication.

The Disability topic was added to the PSS in 2012, and data is considered generally comparable across all PSS cycles from 2012 onwards.

However, some changes to collection categories and output labelling should be considered when comparing across cycles. For 2021-22:

• The PSS collected information about psychosocial disability. This replaced the narrower in scope psychological disability type category used in the 2012 and 2016 PSS. Psychosocial disability includes the new categories of ‘Memory problems or periods of confusion’ and ‘Social or behavioural difficulties’ in the first list of conditions asked about. Due to the broader population who may now be included in the psychosocial disability type category compared with the previous psychological disability type category, care should be taken when making comparisons between these disability types across survey cycles.
• Additional changes were made to the disability type output category labelling. A comparison of the category labelling between the 2021-22 and earlier PSS cycles is presented below.

In 2021-22, there were a number of changes made in the collection of employment and education restrictions. These include:

• Education restriction and employment restriction questions were expanded (including the collection of restriction types), compared to previous cycles which asked respondents whether they had any difficulties with education and employment (yes/no response categories).
• The question population changed to ‘All persons’ in 2021-22 for both education restriction and employment restriction. In 2012 and 2016 the question population was persons aged 18 to 64 years.
• The disability status output category for ‘schooling/employment restriction only’ was restricted to persons aged 18 to 20 years for schooling restrictions in 2021-22. In 2012 and 2016 the output category included persons aged 18 to 64 years.
• The response option ‘other related difficulties’ was added to the employment restriction question. While previous surveys did not collect what types of restrictions people experienced (just whether they experienced any) they did list the specific restrictions as a prompt for respondents. The addition of an ‘other related difficulties’ category in 2021-22 may have led to an increase in the number of people reporting an education and employment restriction under disability status, as well as the specific employment restriction items.