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4433.0 - Disability and Disabling Conditions, 1998  
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 27/10/2000   
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Further Tables are available from the Survey of Disability, Ageing and Carers, particularly providing additional data on long term health conditions and disability groups Catalogue Number 4430.0.55.001 under the Category of Data Cubes.


Further Tables are available from the Disability, Ageing and Carers, Disability and Long Term Health Conditions, Tables 12 to 19 Catalogue Number 4430.0.55.002 under the Category of Data Cubes.




MAIN FEATURES - 1993 ISSUE

INTRODUCTION

It is accepted in our society that people with disabilities may need assistance from others to participate in the various aspects of community life. Information on the numbers of people with disabilities and their support needs assists government and non-government agencies to plan appropriate types and numbers of services.

An individual may have an impairment, a disability and a handicap. Impairment involves damage to, or poor functioning in, any part of the body or mind, such as loss of sight or a limb. Impairment may result from genetic or birth circumstances, disease or injury. Impairments may be categorised as physical, sensory, psychological (or psychiatric) or intellectual types. These categories are specifically identified in the Commonwealth/State Disability Agreement 1991.

Having an impairment can, but does not necessarily, lead to a disability. A disability occurs when the impairment restricts people from performing their usual activities. For example, incomplete use of arms may make it difficult to get dressed.

A disability may lead to a handicap and this happens when, as a result of their disability, people are limited in performing certain tasks. As a result they have difficulty performing one or more activities of daily living such as eating, showering, dressing, moving around and/or communicating. They may take longer to perform these activities, or require assistance from an aid or help from another person.

RELATIONSHIP BETWEEN CONDITIONS, IMPAIRMENT, DISABILITY AND HANDICAP



A classification of broad impairment types has been developed from the 1993 Survey of Disability, Ageing and Carers. These are:
  • physical impairment (involving loss of, or damage to, internal or external parts of the body). This includes incomplete use of limbs, difficulty walking, bending, carrying/gripping or holding things;
  • sensory impairment (loss of sight which is not corrected by glasses, or loss of hearing);
  • psychological impairment including nervous and emotional conditions (for which people are receiving treatment), blackouts, fits, or mental illnesses which require supervision; and
  • intellectual impairments including slowness at learning or understanding things.

People with disabilities can have one or more impairments and there can be many different combinations of impairment types. For example, a person may have two impairments - sight loss and hearing loss. Both of these are categorised to the sensory impairment type. Another person may be receiving treatment for a nervous condition, and also have difficulty gripping or holding things. This person also has two impairments, but they are categorised to different impairment types, psychological and physical. To assist discussion of characteristics of people with impairments, groups were constructed so that each person with a disability fitted into one group. Each group reflected a particular impairment type or combination of impairment types.


DISABILITY

In 1993, there were just over 5 million people, or 29% of the Australian population, who had one or more impairments or long-term health conditions. Many of these people were not restricted by their condition but almost 3.2 million people had one or more disabilities (18%) as a result of their condition. There were 2.5 million people with a handicap (14%) as a result of their disability.

The most common difficulties experienced by people with a disability included restrictions in physical activities or work, hearing loss and restricted use of feet or legs. The most common type of handicap involved mobility limitations (73%).

Impairment type

Over half of all people with a disability had a physical impairment, either alone (30%) or in combination with another impairment (27%). More them one-third (37%) had a sensory impairment, around half of these (18%) having a sensory impairment only. Other types of impairment were less common, 18% with psychological and 9% with intellectual impairment.

PERSONS WITH A DISABILITY: IMPAIRMENT TYPES



The likelihood of having one or more impairments that restricts activity increases with age. A smaller proportion of people age 0-59 years (12%) had a disability compared with those aged 60 years and over (51%). Younger people with disabilities are more likely to have physical or intellectual impairments while older people are most likely to have physical or sensory impairments that restrict activities.

Men (8% of all men) are more likely to than women (6% of all women) to develop sensory impairments, particularly hearing loss. Nearly one-quarter (23%) of men aged 25-59 years with a disability had a sensory impairment only compared with 13% of women with a disability in this age group.

Impairment groups

Around half (48%) of people with a disability were in the groups which have a physical or sensory impairment type only. Around 30% were in groups with a combination of impairment types.

PERSONS WITH A DISABILITY: PROPORTION BY IMPAIRMENT GROUPS



Severity of handicap

People are classified as having a handicap when their impairment, and consequent disability, makes it difficult or impossible, without assistance, to perform everyday activities such as dressing, showering, eating, walking, talking or going to school or work. Almost all people in the group with three or four impairment types had a handicap, as did over 90% of those in groups with two impairment types, or with intellectual impairment only. Sensory impairment (mainly hearing loss) by itself was least likely to give rise to a handicap (47%).

The level of handicap is classified as mild, moderate, severe or profound, based on the amount of support required. People with a mild handicap are usually able to manage their daily activities using an aid, without difficulty, whereas those with a profound handicap always need help from others. People in groups with combinations of impairment types were much more likely to rely on others sometimes (severe level of handicap), or always (profound level of handicap), for their personal care, for moving around, or for communicating with others. Almost 60% of those in the group with three or four impairment types had a severe or profound level of handicap.

PERSONS WITH A DISABILITY: IMPAIRMENT GROUPS BY SEVERITY OF HANDICAP



People with physical impairments only were more likely to have a mild handicap (34%), having no difficulty if they used aids; or moderate handicap (19%), not needing assistance from others but having difficulty even when using aids. A smaller proportion of those with a physical impairment only had a profound (9%) or severe (14%) handicap. However the number of people involved, 213,800, is a significant proportion of all people with a handicap.

Intellectual impairment in combination with other impairments produced high levels of support needs or difficulty in the areas of self-care, mobility and communication, as well as in studying or working. Where a person had an intellectual impairment only, it was more likely to result in mobility and schooling difficulties.

The number and combination of impairment types influence the level of handicap and consequent support needs. More than half of the people with a profound handicap were in groups which had some combination of impairment types. Correspondingly, 74% of those with mild handicap had a single impairment type or other condition. However, having a physical impairment only can also result in high support needs. People with a physical impairment only were the largest single group among people with profound (29%) or severe (42%) handicap.

Assistance required

Women with disabilities are more likely to need some form of assistance than men with disabilities, across most impairment groups. More than half of all women with disabilities, who lived in households, needed help (60%) compared with 39% of men. Home maintenance was the most common form of assistance required by both women (42%) and men (22%).

PERSONS WITH A DISABILITY LIVING IN HOUSEHOLDS: NEED FOR HELP WITH HOME MAINTENANCE



Difficulty moving around becomes increasingly common as people grow older. One-third of all people aged 60 years and over had a mobility handicap, and many required some form of assistance because of this. In addition, over 200,000 men (14%) and nearly half a million women (34%) needed help with transport.

Two-thirds of the people in impairment groups with two, three or four types of impairment needed some kind of assistance. People in groups with only one impairment type were less likely to need help, but that varied according to the type of impairment. For example, one-fifth of people with hearing or vision loss only needed assistance (21%) compared with nearly half of those who had a physical (58%) or intellectual (41%) impairment only.

PERSONS WITH A DISABILITY LIVING IN HOUSEHOLDS: NEED FOR HELP MOVING AROUND


PERSONS WITH A DISABILITY LIVING IN HOUSEHOLDS: NEED FOR HELP WITH TRANSPORT



Public transport

Nearly one-third of women with disabilities who lived in households had difficulties using public transport (30%) compared with one-fifth of men. People with physical impairments were most likely to have problems using public transport, particularly if they had other impairments as well. Almost one-third of those in the group with three or four types of impairment, and around a quarter of those with both physical and one other type of impairment, experienced difficulty getting into vehicles and/or carriages.

Living arrangements

People's living arrangements vary depending on the number and type of impairments they have. People in the group with three or four impairment types are less likely to live alone once they are over 60 (20%) compared with those who have fewer impairment types, and are more likely than others to live in a health establishment, particularly as they grow older. The number of people with intellectual impairments only in this age group is too small to provide reliable information.

PERSONS WITH A DISABILITY AGED 60 YEARS AND OVER: SELECTED LIVING ARRANGEMENTS BY IMPAIRMENT GROUP



DISABLING CONDITIONS

People may have a variety of diseases or health conditions during their lives. For some people, a condition produces a disability which makes it difficult for them to carry out certain activities. Some conditions, such as arthritis, may not result in a disability immediately, but may do so later as the effects worsen with age. The number of people with this type of condition can be a useful indicator of the number of people who may develop a disability. Other conditions, like asthma, are less likely to cause a disability and are therefore less likely to restrict people's lifestyles.

All disabling conditions

In 1993, about 5 million people had a long-term health condition. A number of these were quite prevalent in the community - three conditions accounted for nearly two-thirds of those with a long-term condition, arthritis (27%), circulatory diseases (27%) and asthma (21%). Asthma is more common among children under 15 (9%), its prevalence declining to around 4% for those aged 25-54, and rising a little in older age groups. Arthritis and circulatory disease are much more likely to occur mid to later life. The prevalence of both these diseases increases rapidly, and with a very similar pattern, from 45 years onward.

Almost two-thirds of those with a long-term condition had a disability (63%), just under 3.2 million people. Over half of these had arthritis, asthma or circulatory diseases either on their own or combined with other conditions (54%). Similar proportions of the 2.5 million people with a handicap, also, had arthritis, asthma and/or circulatory diseases (59%), which may have contributed to their difficulty or requirement for support.

ALL PERSONS: PREVALENCE OF SELECTED CONDITIONS



Number of conditions

Generally, the more conditions a person has, the more likely they are to have more than one type of impairment. It is possible for one condition to produce several types of impairment. Diabetes, for example, can produce physical, sensory and/or psychological impairments. There are around 69,000 people who have combinations of impairment types arising from a single condition, 2% of all people with disabilities. It is much more common, however, for one or two conditions to be associated with one impairment type. The majority of people with a single impairment type (80%) had no more than two conditions, and many had only one. More than half of those in the sensory only (56%) or psychological only (66%) impairment had one condition. In contrast, almost half of those in the group with three or four types of impairment had five or more conditions (46%).

PERSONS WITH A DISABILITY: PROPORTION WITH ONE CONDITION ONLY



MAIN CONDITIONS

People can be affected by more than one condition and this is more likely to be the case as they grow older. For those with one condition, it is considered to be their main disabling condition. If they have more than one condition, the one they report as causing them the most problems is said to be their main disabling condition.

When people were asked what condition caused them the most problems almost half identified one of the following: arthritis (16%), asthma (16%) or circulatory diseases (14%). Of these conditions more women had arthritis than asthma or circulatory diseases and more men had asthma.

ALL PERSONS: NUMBER WITH SELECTED CONDITIONS



Arthritis

In 1993, over 800,000 women had arthritis and more than half a million nominated it as their main condition, compared with 285,000 men. Arthritis was more common in the older age groups for both men and women. Of all people aged 60 years and over 22% of women and 13% of men gave arthritis as their main condition.

It is common for people with arthritis to experience restrictions or limitations (i.e. a disability). More than half of the men (67%) and women (59%) who had arthritis as their main disabling condition had a disability. This was particularly common amongst those aged 70 years and over (79% for men and 71% for women).

PERSONS WITH ARTHRITIS: DISABILITY STATUS BY AGE



The majority of those with a disability also had a handicap (87%), and this rate did not vary much by age. Two-thirds of people with a handicap needed to use an aid or had difficulty performing a task such as showering, dressing, walking or talking to others.

Although a greater proportion of men with arthritis had a disability, women were more likely to be handicapped by their disability and to experience more severe levels of handicap than men. Women aged 75 years or more with a handicap, who had arthritis, were particularly likely to need assistance from others. More than one-third of this group always needed help or supervision with one or more activities such as getting out of bed, bathing, cutting up food or eating, (30,000 or 35%) compared with 13% of men in this group who needed such assistance.

Asthma

In 1993, just over one million people had asthma. Around 800,000 gave it as their main condition. Asthma is more common in the younger age groups with 9% of boys and 7% of girls aged 0-14 years having it as their main condition compared with 3% of men and women aged 60 years and over.

PERSONS WITH ASTHMA: DISABILITY STATUS BY AGE



Asthma is one of the most common childhood conditions but for the majority of people, particularly young people, it is not usually restricting. Of those aged 0-24 years, with asthma as their main disabling condition, close to 400,000 (80%) did not have a disability.

Two-thirds of those with a disability also had a handicap (147,000), but more than half of these (55%) did not need help from others to perform daily tasks. They could manage these tasks using an aid, but may have had some difficulty.

Circulatory diseases

Around 1.3 million people had circulatory diseases, such as high blood pressure or angina. Similar proportions of men and women gave a circulatory disease as their main condition (both around 350,000 or 4% of all men and women). Circulatory diseases were more common in the older age groups with 17% of men and 15% of women aged 60 years and over having it as their main condition.

Less than half of those with circulatory disease as their main condition were restricted by it (40%), although it was more likely for men to have a disability (44%) than women (35%). Men with circulatory diseases were also more likely to have heart disease (43% of those with circulatory disease) than women (29%).

Although the majority of those with a disability also had a handicap, less than 10% overall had a severe or profound handicap and needed any help or supervision in their daily activities.

PERSONS WITH CIRCULATORY DISEASES: DISABILITY STATUS BY AGE



One or more conditions

Patterns of disability and handicap varied depending on whether people had one condition only or two or more conditions. These patterns were similar for both men and women and for any of the selected conditions. The majority of people, with asthma or circulatory diseases as their only disabling condition, did not have a disability (83% and 85% respectively) and this was also the case for more than half of those with arthritis (61%).

In contrast, those who had two or more conditions were more likely to experience restrictions because of these conditions. Of this group, people with arthritis were more likely to have a disability than those with asthma or circulatory diseases (81% compared with 72% and 73%).

People with arthritis or circulatory diseases as their main condition were more likely to need assistance if they also had other conditions. More than one-fifth of those with arthritis (21%) and 17% with circulatory diseases, who had other conditions as well, sometimes or always needed help with one or more daily activities compared with those who had either arthritis or circulatory diseases only (6% and 2%, respectively).

This suggests that by themselves these conditions are less likely to restrict activities, and it is the combination of conditions, or the other conditions that people develop, that increase their difficulties. With arthritis or circulatory diseases, however, the resulting restrictions usually become more severe with age, and increasingly restrictive, at the same time as eyesight or hearing begin to fail and other conditions develop.

Age of onset

Arthritis and circulatory diseases are more likely to develop in the middle years with two-thirds of these conditions starting when people are aged between 30 and 64 years. In comparison, nearly half of all asthma sufferers were aged between 0 and 4 years when their condition first became evident (49%), and 70% were aged between 0 and 14 years.

AGE OF ONSET OF MAIN CONDITION



Children aged 0-4 years

The majority of children aged 0-4 years are healthy and many of those who have a condition are not restricted by it, and can lead normal lives. In 1993, there were about 125,500 children (10%) aged 0-4 years who had a condition which had the potential to lead to a disability. Most of these children had a physical condition (97%) and more than half were not restricted by it (56%).

Respiratory diseases were the most common condition (59%) among young children, and most of them had asthma (98%). Less than one-fifth of the children with asthma were restricted by the condition (19%). In contrast, most of the children who had ear or eye disorders, nervous system diseases or congenital abnormalities were restricted by their condition, that is, had disabilities.

Boys (58%) were more likely to have a condition than girls (42%), with some conditions more common to one sex. More boys had asthma (63%) than girls (52%) whereas greater proportions of girls had eye, ear and associated disorders, and congenital anomalies, than was the case for boys.


MAIN FEATURES - 1998

ANALYSIS OF RESULTS

Introduction

At some time in their life most people will be affected by a disability or long-term health condition. Disability is sometimes present at birth or can appear in the early developmental years. However it is more commonly due to a chronic or acute disease, or as the end result of an accident or injury. Having a disability leads to a range of outcomes, not just for the individual but also for the society within which they are located. For the individual it can impair bodily functions such as speech or sight, limit daily activities as a result, and restrict social participation in many different ways. For society there may be an effect on family and friends and the wider community or an impact through reduced education or workforce participation. However, many people with disabilities or long-term health conditions are able to continue with their usual activities, even if with some difficulty, and others are enabled to do so with appropriate supports. The range of supports available are many: from manual aids and changes to the physical environment, or occasional help from a family member or friend, to high levels of support from the family and/or assistance from private or government organisations.

The World Health Organisation (WHO) defines disability as: "Any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being." A long-term health condition is a disease or disorder, including damage from accidents or injuries, which has lasted, or is likely to last, for six months or more. Not all long-term health conditions restrict people in their everyday activities and result in a disability.
This publication focuses on people with disabilities and long-term health conditions, and the effect these conditions have.

1998 DISABILITY, AGEING AND CARERS POPULATION




DISABILITY AND LONG-TERM HEALTH CONDITIONS

Disability or long-term health conditions

Disability rates

According to the 1998 Survey of Disability, Ageing and Carers, there were 3.6 million people with a disability (19%) and a further 3.1 million with a long-term condition or impairment, but no disability (17%). The proportion of males and females with a disability was similar (around 19% or 1.8 million each), and the likelihood of having a disability rose with age (table 1). However, these similarities mask a number of differences at certain ages. For example, from birth to early adolescence boys had higher rates of disability (5% to 12%) than girls (3% to 7%). This reflected the higher incidence of birth disorders in boys and their higher prevalence of childhood conditions, such as asthma and intellectual disorders (table 12).

The disability rate for men aged between 60 and 79 years was also higher than that for women. Of men aged 60 to 64 years, 42% had a disability compared with 36% of women in this age group. This may be due to the earlier age of onset for men of health conditions such as cardiovascular disease. However, by the time they reached 85 years of age or more, men and women had the same rate of disability (84%). As there were more women than men in this age group, the number of women with a disability was substantially higher (132,100) than the number of men (58,200) (table 1).



Having a disability may not interfere with a person's participation in normal daily activities. That will depend on the level of restriction associated with their particular disability. In 1998, a small proportion of the total population (6%) had a profound or severe restriction from their disability. That is, their condition either completely restricted them from undertaking everyday activities such as dressing, washing, eating or walking, or they sometimes or always required assistance from others to do these things, or they had difficulty in communicating. Unlike the disability rate, which increased gradually over the lifespan, the likelihood of being profoundly or severely restricted remained relatively low (less than 9%) until about age 70. After this age it increased rapidly - from 14% for those aged 70 to 74, to almost one in three (31%) for those aged 80 to 84. From 85 years onward almost two-thirds (65%) in this age group had a profound or severe restriction (table 1).
    Men and women had similar rates of profound or severe restrictions in their early and middle years. However, from age 70 greater proportions of women had these levels of restriction than did men. For example, there were 107,900 women aged 85 and over (69%) who had a profound or severe restriction, compared with 38,600 men in this age group (56%), even though the same proportion of these men and women had a disability (84%). This reflects the fact that more women live to advanced old age (over 90 years) than men, with a subsequent increased risk of having a profound or severe restriction (table 1).

    Long-term health conditions

    In 1998, there were 6.7 million people with a long-term health condition and just over half of these (54%) had a disability as a result. People could have more than one condition and there were 6.4 million or 95% with a physical condition and 1.2 million or 18% with a mental condition (table 2). Some conditions were more likely at particular ages. Asthma was more prevalent in children (9% of those aged 5 to 14 years) than in elderly people (5% of those aged 75 to 84 years), while for hearing loss the reverse was the case (1% and 31% respectively) (table 3).




    The likelihood of having a disability varied according to the type of condition a person had. Asthma and hypertension, for many people, often occur with only mild symptoms which do not restrict everyday activities. Less than half of people with asthma (37%) or hypertension (47%) had a disability, compared with over three-quarters (76%) of people with hearing loss. The probability of having hearing loss increases with age as does the risk of having a disability from one or more other conditions.


    RESTRICTING IMPAIRMENT GROUPS

    Restricting impairment groups

    It can be useful to group certain types of restricting impairments together on the basis that they are likely to have similar effects on people's lives, and therefore require similar types of assistance. In 1998, there were 3.6 million people with a disability and 3.2 million of these had at least one specific restriction (i.e. in the area of self care, mobility or communication) (table 8).

    Those restricted by a physical impairment were the largest group and comprised 14% of all people (2.6 million). There were 6% (1.2 million) who were restricted by a sensory impairment or by speech loss. Sensory (including speech) and intellectual impairments were somewhat more common in men (7% and 3% respectively) than in women (6% and 2% respectively) (tables 6 and 8). Men tended to be more at risk of developing industrial deafness than women and to have higher rates of intellectual disorders from birth. Intellectual disorders can also occur at varying times throughout the lifecycle and arise from many different types of conditions, such as brain damage through accident or injury, or senile dementia (table 6).




    The likelihood of having a restricting impairment generally increased with age. For those aged 85 years and over, 75% of women and 68% of men had a physical impairment compared with 3% each of boys and girls aged 0 to 14 years. However, some restricting impairments are more common at particular ages. Of those with an intellectual impairment, 42% were aged under 25 years and 30% of those with a psychological impairment were aged between 35 and 54 years (table 6).

    The severity of restriction varied according to the type of restricting impairment a person had. People with head injury, stroke or brain damage (64%) and those with a psychological (65%) or intellectual impairment (60%) were the most likely to have a profound or severe restriction. Generally, women had higher levels of restriction than men, consistent with their higher numbers in the older age groups. Of the 199,800 women with an intellectual impairment, 70% had a profound or severe restriction, compared with 53% of the 293,300 men with this impairment type. Similarly, of those with a sensory or speech impairment, 48% of women and 34% of men had a profound or severe restriction (table 8).

    Area of restriction

    Being able to easily move about at home or in the community, to communicate with others without difficulty, or to perform basic self care functions such as dressing, washing and eating, are all important elements of independent living. In 1998, there were 2.4 million Australians living in households who had a mobility restriction, and just over one million who had a restriction in the area of self care. As expected, the likelihood of being restricted in one of these areas, or in communication, was greater for older people. For women aged 65 and over who were restricted by a physical impairment, 92% had a mobility restriction and 49% a self care restriction. Figures for older men were slightly lower (86% and 41%) (table 9).

    It is not only people with a physical restriction who have problems with mobility or self care. Although fewer older people were restricted by an intellectual or psychological impairment than a physical impairment, greater proportions of them had a mobility or self care restriction. The mobility restriction was more likely to result in a need for supervision, for example for people with dementia, rather than for actual assistance in walking or moving about. Almost all older women living in households who had an intellectual impairment also had a mobility restriction (99%) and 81% had a self care restriction (93% and 62% respectively for men) (table 9).

    Living arrangements

    Not everyone with a disability needs assistance, and of those who do, most have sufficient support to continue living at home. In 1998, the majority of people with disabilities lived in private dwellings (93%), 50% with their partner and 23% with other relatives. Just over one in six lived alone (18%). There were 245,900 people with disabilities (7%) who lived in non-private dwellings such as boarding houses and hostels, with nearly three-quarters of these (5%) living in cared accommodation. Not surprisingly, the majority of people who lived in cared accommodation had a disability - of these most had a physical impairment (91%) and were 65 years of age or over, though some 22,100 people under 65 years also lived in cared accommodation. Women accounted for more than two-thirds of people with a disability living in cared accommodation (124,000 compared with 60,100 men) (table 7).




    Of the total population, people who lived alone were more likely to have a disability (637,400 or 40%) than those who lived with a partner (1.8 million or 21%). This is partly because the probability of being widowed and having a disability increases with age. However, those under 65 years who lived alone also had the highest rates of disability (31%) (table 7).

    Certain impairments increase the likelihood of needing to live with another person or in cared accommodation. The majority of people with an intellectual impairment lived with a relative other than a partner, such as a parent (241,100 or 49%), or in cared accommodation (109,900 or 22%), as did people with a psychological impairment (28% and 25% respectively), reflecting the fact that they are likely to be younger. In contrast, people with a physical impairment were more likely to be living with a partner (1.3 million or 52%) or alone (496,800 or 19%) (table 7). This group are more likely to be older and their disabilities to be associated with ageing.

    Need for assistance

    Most people with a disability continue to live independently in the community. However, many do require some assistance from either family, friends or neighbours, or from formal sources such as government or private organisations. In 1998, there were two million people with disabilities (57% of those in households) who needed assistance with at least one daily living activity (table 10).

    Assistance may be obtained from a range of sources, depending on the person's circumstances or age. This assistance may be received from more than one person or organisation. However, assistance is usually received from family, friends or neighbours rather than from formal organisations. Almost half (49%) of people with a disability received informal assistance while 27% received formal assistance. The ratio of informal to formal assistance was similar across impairment types. For example, 72% of people with head injury, stroke or brain damage received informal assistance and 44% received formal assistance.

    The need for assistance varied according to a person's particular restricting impairment. People with a psychological impairment or head injury, stroke or brain damage were most likely to need assistance (79% of all people with these impairments), while those with a sensory impairment were least likely to need help (55%).

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    The type of assistance required also varied according to impairment. Almost half of those with a psychological impairment or with head injury, stroke or brain damage needed help with mobility (46% each) and health care (44% and 48% respectively). In contrast, only 25% of people restricted by a sensory impairment needed mobility assistance. As might be expected, people restricted by an intellectual impairment were more likely than those with a physical impairment to need communication assistance (28% compared with 3%) (table 10).

    Intellectual impairments are often diagnosed early in a person's life and generally affect the younger population (42% were aged less than 25 compared with 26% aged 65 years or more), although older people are also at risk through conditions such as dementia (table 6). Given the age profile of this impairment, it is not surprising that more people restricted by this impairment received assistance from their parents (38%) than from other sources, although one-quarter (25%) received some type of support from government organisations. Partners were most likely to provide assistance to people with physical impairments (48% of those receiving assistance) (table 10).

    Most people with a disability did not need assistance (43%) or had their needs fully met (36%). A further 18% had their needs partly met. Of the 57% who did need assistance, over one-third (36%) had needs which were not met or were only partly met, ranging from 37% of those with a physical impairment to 47% of those with a psychological impairment.


    POPULATION GROUPS

    Children aged 0 to 14 years

    Disability and long-term health conditions

    Disability is commonly associated with older people. However, children are also at risk of having a disability, due to accidents, environmental factors, or because they were born with a particular health condition. There are a number of conditions which occur more frequently or are of particular interest. These include asthma, attention deficit disorder/attention deficit and hyperactivity disorder (ADD/ADHD), intellectual and developmental disorders and hearing or speech loss. Of the 3.9 million children aged 0 to 14 years in 1998, less than one in 12 had a disability (296,300 or 8%), with boys more likely to be affected (10%) than girls (5%). In association with this, there were more boys with one or more of the selected conditions than girls (291,700 and 181,200 respectively) (table 12).

    Asthma was the most common long-term health condition for this age group affecting 312,000 children (8%). However, unlike other conditions, there was a lower level of restriction associated with this condition. Almost three-quarters (74%) of those with asthma had no disability (table12).




    While the overall incidence of these selected conditions was greater for boys than for girls the difference between the sexes was particularly pronounced in the case of ADD/ADHD. Of children with a disability, nearly one in five boys (19%) had this condition compared with approximately one in 14 girls (7%). While ADD/ADHD only represents a small number of children overall it is a condition which has been diagnosed more frequently during the last decade. It often causes difficulties in learning, which may potentially lead to more restricted education and employment opportunities, as well as problems in the home environment due to the behavioural aspects of the condition. Nearly two-thirds (61%) of children with a disability who had this condition had a profound or severe restriction and needed some form of assistance (table 12).

    Assistance

    In 1998, there were 199,100 children who needed assistance because of a disability. Guidance support was the type of assistance most likely to be needed by both boys and girls (104,700 and 41,000 respectively). This type of support involved helping children to manage their own behaviour, interact better with others or to cope more easily with their feelings and emotions. In addition, boys were more likely to need help with communication activities (67,600), and girls with health care tasks (32,700). Of children with a disability, those who had ADD/ADHD and intellectual/developmental disorders were most likely to need some type of assistance (90% and 69% respectively) (table 12).

    Schooling restrictions

    There were 185,800 children aged 0 to 14 (5% of all children) who had some form of schooling restriction. Consistent with the higher disability rate for boys, they were twice as likely as girls to have this type of restriction (6% and 3% respectively) (tables 12 and 13). As might be expected, schooling restrictions were reported more often for children who had ADD/ADHD or for those with an intellectual or developmental disorder (84% and 88% respectively). Various problems arise as a result of these restrictions, but the most common problem reported was learning and intellectual problems which affected 73,300 boys and 24,200 girls (table 13).

    There are a range of supports available to children with a schooling restriction. For example, 77,400 children attended a special class or school, and 89,200 received special assistance or tuition. Not all children receive as much support as they need. However, of the 148,100 children who experienced difficulties, 85% received some form of support (table 13).

    Persons aged 15 to 64 years

    Labour force participation

    Whether, and to what extent, a person is restricted by a disability can affect their opportunities for employment. In 1998, there were 12.5 million people of working age (15 to 64 years) living in households and of these, 2.1 million (17%) had a disability. More than two-thirds of those with a disability also had an employment restriction (71%) and over one-quarter were permanently unable to work due to their condition (27%) (tables 15 and 17).




    Overall, the likelihood of being employed was less for people with a disability. Almost three-quarters (74%) of working age people without a disability were employed compared with less than half (47%) of those with a disability and just under one-third (32%) of people with a profound or severe restriction. As the severity of restriction increased, the proportion of people working part-time instead of full-time also increased (from 29% of those employed to 42% progressively). Working age people with a disability tended to drop out of the workforce altogether rather than remain unemployed. While only one-fifth (20%) of those without a disability were not in the labour force, almost half (47%) with a disability and two-thirds (66%) with profound or severe restrictions had ceased to work or look for work (table 17).

    The likelihood of having a particular type of employment restriction was influenced by the type of impairment a person had. Half of all people of working age who had a psychological impairment were permanently unable to work, and around two in five of those with an intellectual impairment had difficulty changing or getting a better job (40%) or were restricted in the type of job they could do (41%) (table 15).

    Impairments are more likely to occur during a person's lifetime than at birth. For people of working age with a disability, nearly one-quarter of their main impairments were caused through accident or injury (23%) or were due to working conditions or overwork (15%). Of those due to accidents, more than one-third (36%) occurred at work (table 14).

    Income and housing

    In 1998, the majority of people aged 15 to 64 years earned their main source of income from wages or salary or their own business (8.1 million or 65%). Just over one in five (22%) received a government pension or allowance as their main income. People in this group were more likely to have a disability (34%) than those whose main income was from wages, salary or their own business (11%). Consistent with the employment patterns of the different impairment groups, a higher proportion of those with sensory or speech (46%) or physical impairment (38%) received their main source of income from wages, salary or own business than did those with an intellectual (20%) or psychological impairment (14%) (table 16).




    The impact of lower employment opportunities experienced by people with a disability is reflected in their generally lower levels of income. In 1998, the median weekly income for people aged 15 to 64 years living in households was $360, but for those with a disability it was $210. As mentioned previously, some impairments have a greater impact on people's ability to work than others. For example, working age people with a sensory impairment averaged $250 per week, however the median income for those with an intellectual impairment was $170 per week (table 16).

    Older people

    Disability and long-term health conditions

    Older people are more likely than younger people to have a disability and to have developed degenerative conditions as a consequence of ageing. While some conditions affect both men and women at approximately the same rate, there are others that are more gender specific. In 1998, there were 944,700 men and 1,159,700 women aged 65 and over in households. Of these, 52% of males and 49% of females had a disability. Both women and men had high rates of circulatory disorders (excluding heart disease) (41% and 36% respectively) and arthritis (40% and 30% respectively), with women having higher rates of these conditions than men (table 18).




    The level of restriction varied between men and women. Women (18%) were more likely than men (12%) to have a profound or severe restriction. This may reflect the longer life expectancy of females which allows for the development of chronic conditions (table 18).

    Need for assistance

    As people grow older they are more likely to have a disability and to need assistance with activities of daily living. Of those aged 65 and over living in households, half of all women (50%) and one-third of men (33%) needed assistance with at least one activity. The likelihood of needing assistance was greatest for men and women with heart disease (56% and 75% respectively) and least for those with other circulatory disorders (44% and 58%). There were some areas, such as property maintenance, where women needed more assistance than men (36% and 22%) (table 19).

    Receipt of assistance

    Older people received more help from family and friends than from formal organisations. Men were slightly more likely to have received assistance from a partner than women (15% and 13% respectively). On the other hand, women were far more likely to receive assistance from their children than men (22% and 11%), reflecting the longer years of widowhood experienced by women (table 18).


    GLOSSARY

    Activity
    An activity comprises one or more tasks. In this survey, tasks were associated with a set of nine activities as follows:
  • self care;
  • mobility;
  • verbal communication;
  • health care;
  • home help;
  • home maintenance;
  • meals;
  • personal affairs;
  • transport.


    Aid

    A device or appliance used by a person with a disability or a person aged 60 years or more, to help with performing tasks. It is not help provided by a person or an organisation.


    Area of handicap

    Handicap was identified by determining if a person needed help, or had difficulty, in relation to self care; mobility; verbal

    communication; schooling; and/or employment.
    See Handicap for more details.

    Disability

    The
    International Classification of Impairments, Disabilities and Handicaps (ICIDH)
    defines disability as follows:
      'In the context of health experience, a disability is any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.'

    In this survey, disability was defined as the presence of one or more of the following impairments, conditions or limitations,
    which restricted ability to perform an action,and had lasted, or were likely to last, for a period of six months or more:
  • loss of sight (even when wearing glasses or contact lenses);
  • loss of hearing;
  • speech difficulties in native language(s);
  • blackouts, fits, or loss of consciousness;
  • slowness at learning or understanding;
  • incomplete use of arms or fingers;
  • difficulty gripping or holding small objects;
  • incomplete use of feet or legs;
  • treatment for nerves or an emotional condition;
  • restriction in physical activities or in doing physical work;
  • disfigurement or deformity;
  • head injury, stroke or any other brain damage, producing a long-term effect;
  • a mental illness requiring help or supervision;
  • treatment or medication for a long-term condition or ailment, which is still restricting; and/or
  • any other long-term condition that leads to restrictions.


    Disabling condition

    A disease, disorder or event (e.g. poisoning or accident) which had lasted or was likely to last for six months or more, or
    had produced a long-term effect, resulting in one or more of the limitations, restrictions or impairments listed under
    disability. Disabling conditions are classified into mental and physical conditions, and into further categories consistent
    with the International Classification of Diseases, version 9.

    Employment limitation

    An employment limitation relates to a person who has any of the following limitations because of their conditions:
  • is permanently unable to work;
  • is restricted in the type of work can/could do;
  • often needed time off work;
  • is restricted in the number of hours can/could work;
  • would require an employer to make special arrangements; or
  • is limited in prospects of obtaining/keeping/changing jobs.


    This information was collected for persons aged 15 years or more living in households, who were not attending school.
    Retired persons were excluded.

    Establishments

    Hospitals, nursing homes, hostels, retirement villages and other homes for the aged or for people with disabilities.


    Handicap

    A handicap is defined as a limitation in performing certain tasks associated with daily living. The limitation must be due to a disability and in relation to one or more of the areas listed below:
  • self care - showering, bathing, dressing, eating, toileting, bladder or bowel control;
    • mobility - going places away from the home/establishment, moving about the house/establishment, transferring to and from a bed or chair, walking 200 metres, walking up or down stairs without a handrail, or using public transport;
  • verbal communication - understanding or being understood by strangers/family/friends/staff in the person's native language;
  • schooling - unable to attend school or needing to attend a special school or special classes; and/or
  • employment- unable to work, limited in the type of work can/could do and other work problems such as regularly
    needing time off and/or requiring that special arrangements be made.


    Children under five years with one or more disabilities were all regarded as having a handicap, but were not further
    classified by area or severity of handicap. This was due to difficulties inherent in determining whether their needs were a
    function of their age or their disability.

    Health care

    This activity includes:
  • foot care;
  • taking medication; and
  • dressing wounds.


    Help needed

    A person with a disability, or aged 60 years or more, is identified as having a need for help with an activity, if that person

    required assistance or supervision to perform tasks, such as washing themselves, getting out of bed, doing housework
    and preparing meals, or would find the task(s) difficult to do alone. This person is considered to need help whether or not
    that help is actually received.


    Help received

    Help received with an activity relates only to persons with a disability and/or persons aged 60 years or more, who have

    identified that they need help. The source of help may be individuals, organisations or other bodies, but does not include
    help from the use of aids or appliances.


    Home help

    This activity includes light and heavy housework such as laundry, vacuuming and cleaning windows.



    Home maintenance

    This activity includes gardening and home maintenance tasks such as changing light bulbs, mowing lawns, and carrying

    out minor repairs.


    Household

    A household consists of a person, or group of people who usually live together or who have common eating arrangements.

    Boarders who receive accommodation and meals with other people in the household are treated as part of that household.

    Lodgers who are provided with accommodation only are treated as separate households.


    Impairment

    Impairment is defined in the ICIDH as follows:
      'In the context of health experience, an impairment is any loss or abnormality of psychological, physiological or anatomical structure or function.'

    Examples of impairments are loss of sight or of a limb, disfigurement or deformity, mental retardation, impairment of mood or emotion, impairments of speech, hallucinations, loss of consciousness and any other lack of function of body organs.


    Impairment group

    Impairment groups have been formed, based on the particular type, or combination of types, of impairment reported. These groups are exclusive and exhaustive: each person has been included in one group only.



    Impairment type

    Impairments can be broadly grouped depending on whether they relate to functioning of the mind or the senses, or to anatomy and physiology. Mental functioning can be further subdivided into intellectual (relating to intelligence, memory and thinking); and psychological (relating to consciousness, perception, mood, volition, emotions and behaviour). In this publication, impairments and restricting conditions have been organised into four major types: intellectual; psychological; sensory (relating only to vision and hearing); and physical.



    Intellectual impairment

    Slow at learning or understanding.


    Living arrangement

    The number of persons in a household, whether the person lives alone, with other family members or with other unrelated persons.


    Living arrangements were not determined for persons in establishments.



    Long-term health condition

    A condition which restricts a person's ability to perform an action. The condition must have lasted, or be likely to last, for a period of six months or more.



    Main disabling condition

    The condition which causes the most problems. Where only one condition is recorded, this is coded as the main disabling condition.



    Mild handicap

    See Severity of handicap.



    Mobility handicap

    Comprises difficulties in performing one or more of the following tasks;
  • going places away from the home or establishment;
  • moving about the house or establishment;
  • transferring to and from a bed or a chair;
  • walking 200 metres;
  • picking something up from the floor;
  • walking up and down stairs; and /or
  • using public transport.


    Moderate handicap

    See Severity of handicap.



    Participation rate

    The number of persons, expressed as a percentage of a given population.



    Personal affairs

    This activity includes financial management and writing letters. Financial management covers day-to-day activities such as keeping track of expenses and paying bills. Writing letters includes drafting and writing correspondence.



    Personal care

    The combined activities of self care, verbal communication and mobility.



    Physical impairment

    Comprises the following impairments:
    • a restriction in doing physical activities or physical work;
    • difficulty gripping or holding things;
    • incomplete use of arms or fingers;
    • incomplete use of feet or legs.

    Profound handicap

    See Severity of handicap.


    Psychological impairment

    Comprises the following impairments:
    • receiving treatment for nerves or an emotional condition;
    • needs help or supervision in doing things because of a mental illness;
    • blackouts, fits and loss of consciousness.

    Provider of help

    A usual source of help nominated by a person with a disability and/or aged 60 years or more. Up to three sources of informal help and two sources of formal help could be nominated for each activity.



    Schooling limitation

    A schooling limitation relates to a person who, because of their disability:
  • is unable to attend school;
  • attends a special school;
  • attends special classes in an ordinary school;
  • needs time off from school; or
  • has difficulty at school.


    This information was collected for people living in households who were aged 5 --14 years, or aged 15 years or more and still attending school.


    Self care handicap

    Comprises difficulties in performing one or more of the following tasks;
  • showering and bathing;
  • dressing;
  • eating;
  • toileting;
  • bladder and/or bowel control.


    Sensory impairment

    Comprises sight loss and hearing loss.


    Severe handicap

    See Severity of handicap.


    Severity of handicap

    Four levels of severity (profound, severe, moderate and mild) were determined for self care, mobility and verbal communication. These levels were based on the person's ability to perform specified tasks in these areas, and on the amount of help required:
  • profound - personal help or supervision always required;
  • severe - personal help or supervision sometimes required;
  • moderate - no personal help or supervision required, but the person has difficulty in performing one or more of the
    tasks; and
  • mild - no personal help or supervision required and no difficulty in performing any of the tasks, but the person uses an
      aid, or cannot use public transport, walk 200 metres, walk up and down stairs without a handrail, or easily pick up an object from the floor.
    The highest level of severity in any one of the areas of self-care, mobility and verbal communication was used to determine the overall severity of handicap.

    Severity was not determined for people over 5 years of age whose only limitation was in schooling and/or employment.


    Task

    A task is a component of an activity. For example, self care comprises the following tasks: showering/bathing, dressing, eating; toileting, and bladder or bowel control.



    Transport

    This activity relates to using public transport, shopping and the need to be driven.



    Unmet need

    Relates only to persons with one or more disabilities and/or persons aged 60 years

    or more, who require assistance. A person with one or more disabilities is considered to have an unmet need if:
  • he/she requires help, but is not receiving it; and/or
  • he/she is receiving help, but the help is insufficient to satisfy the person's needs for a specific activity.


    Verbal communication handicap

    Comprises difficulties in performing one or more of the following tasks, in the person's native language:
  • understanding family or friends;
  • understanding strangers;
  • being understood by family or friends;
  • being understood by strangers.


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