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ABS SOURCES OF DISABILITY DATA FOR THE ABORIGINAL AND TORRES STRAIT ISLANDER POPULATION

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SURVEY OF DISABILITY, AGEING AND CARERS (SDAC)

The most detailed and comprehensive source of disability data in Australia is the Survey of Disability, Ageing and Carers (SDAC). One of the main purposes of the SDAC is to collect extensive national and state level data on disability, and to provide accurate prevalence rates of disability for the total Australian population.

The SDAC has been developed to align with international measures of disability as described in the International Classification of Functioning, Disability and Health (ICF). It contains 168 screening questions to identify people with disability, and provides a wealth of detail on:

• underlying conditions;
• severity of restriction;
• participation in education, employment and community services; and
• the need for, and receipt of, assistance (extended to cover older people without a disability).

Disability data for the Aboriginal and Torres Strait Islander population

Disability data for the Aboriginal and Torres Strait Islander population is available from the SDAC since 2009, when the Standard Indigenous Question (SIQ) was first included in the survey. The SIQ was also included in the 2012 and 2015 SDAC, and will again be collected in the 2018 SDAC.

Limitations of the SDAC

The SDAC was not developed and tested to collect data for the Aboriginal and Torres Strait Islander population specifically; as such there are limitations in the collection of disability data for this population:

• Limited geographic coverage and small population data - Although the SDAC provides the best quality disability information from an Australian household survey, as a sample survey it cannot provide reliable data at the small geographic level or for small populations of interest. This is particularly the case for the Aboriginal and Torres Strait population as the SDAC sample for this population is small and does not include respondents living in very remote Australia, or those from discrete Aboriginal and Torres Strait Islander Communities.
• The sample is not benchmarked to the Aboriginal and Torres Strait Islander population - Population weights in the SDAC are not separately calibrated (or benchmarked) to the Aboriginal and Torres Strait Islander estimated resident population (ERP). This means that when the SDAC sample is weighted to the total population, no compensation is made to correct any sampling bias that may occur in the Aboriginal and Torres Strait Islander population estimates. For information on the survey design, sampling and weighting of the SDAC, see the 2015 SDAC - Explanatory Notes.
• Respondent burden – the large number of questions needed to assess levels of disability severity means there is limited time to ask respondents additional questions on various social and economic characteristics.

The SDAC provides disability data by severity (see table below).

‘Disability Status’ outputs available from the SDAC
1	Disability
		11	Specific limitation or restriction
				111	Core activity limitation
						1111	Profound core activity limitation
						1112	Severe core activity limitation
						1113	Moderate core activity limitation
						1114	Mild core activity limitation
				112	Education/employment restriction only
		12	No specific limitation or restriction
2	Long-term health condition without disability
3	No disability or long-term health condition

For a full list of the screening questions used in the SDAC to identify people with disability see Appendix: Disability screening questions from the Survey of Disability, Ageing and Carers.

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SHORT DISABILITY MODULE (SDM) – THE NATSIHS AND NATSISS

A short set of disability questions was developed for use in social surveys in the early 1990s, and various forms of these questions have been used since 1992. The standard Short Disability Module (SDM), as it has come to be known, was first used in the 2002 General Social Survey (GSS). This module was revised ten years later, with the current version of the SDM appearing for the first time in the 2012 Australian Health Survey (AHS).

The questions used in the SDM are compatible with the Activities and Participation component of the International Classification of Functioning and are based directly on questions used in the SDAC. The criteria used in the SDM for identifying people with disability, and determining their severity of restriction, are closely aligned with the SDAC. However, unlike the SDAC where respondents are asked about each limitation or restriction separately, the SDM uses a condensed set of 16 broad questions that give a range of response options in the form of prompt cards.

Disability data for the Aboriginal and Torres Strait Islander population

The SDM, in the NATSIHS and NATSISS, provides an estimate of Aboriginal and Torres Strait Islander people who report experiencing a restriction in their everyday activities. By identifying this population, it is possible to analyse the health, social and economic characteristics of this group, and compare these characteristics to those without restriction, both within the survey collection and across time.

Inclusion of the SDM within the NATSIHS and NATSISS has developed over time:

• 2002 NATSISS – the SDM was included with a modified measure of disability for people in remote areas.
• 2008 NATSISS – the SDM was again modified for remote areas, and had fewer questions which limited the outputs for disability severity to a combined profound/severe measure only.
• 2012-13 NATSIHS – a revised version of the SDM was included, but was again modified for collection in remote areas.
• 2014-15 NATSISS – the standard SDM was collected in both non-remote and remote areas, with no modifications outside of minor wording changes in remote areas to aid comprehension.

For a detailed look at the disability measures available from all NATSIHS and NATSISS collections, see Appendix: The Short Disability Module in ABS National Aboriginal and Torres Strait Islander household surveys.

SDM ‘Disability Status’ outputs

The standard SDM allows for the following severity of disability measures to be output (see table below). These measures are intended to be broadly comparable to those collected in the SDAC.

‘Disability Status’ outputs available from the Short Disability Module
1	Disability
		11	Specific limitation or restriction
				111	Core activity limitation
						1111	Has profound core activity limitation
						1112	Has severe core activity limitation
						1113	Has moderate core activity limitation
						1114	Has mild core activity limitation (a)
				112	Has education/employment restriction only
		12	Has no specific limitation or restriction (b)
2	Has no disability, but has a non-restrictive long-term health condition (c)
3	Has no disability or long-term health condition

For a full list of the SDM questions and prompt cards used in the 2012-13 NATSIHS and 2014-15 NATSISS, and how responses to these questions are used to classify people’s severity of disability, see Appendix: Short Disability Module Questions: 2012-13 NATSIHS and 2014-15 NATSISS.

Limitations of the SDM

The SDM was designed to be included in household surveys in order to provide insights into aspects of life that the SDAC does not examine, however users need to be aware of the limitations of the SDM. Capturing the full complexity of disability and accurately assessing the full range of disability severity using only a small number of questions is very difficult. The SDM has been designed to collect disability measures that align with the SDAC, however, users need to be aware that the SDM cannot provide the same accuracy as the SDAC, due to the limited number of questions.

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CENSUS OF POPULATION AND HOUSING

The Census of Population and Housing is Australia’s largest statistical collection. The collection provides an estimate of Australia’s population, which is used to set electoral boundaries for all levels of government, underpins the distribution of significant public funding and informs planning for services and infrastructure across every community in Australia. The Census is the only ABS collection that can provide data for the entire country, including small geographic areas and small population groups.

The complexity of disability service provision means that there is always a high level of demand for small area disability data. In response, the ABS developed a measure of disability for use in the 2006 Census of Population and Housing. The Census ‘Need for Assistance’ disability measure is based on 4 questions and has been designed to be both conceptually comparable to the SDAC, and practical for use in a national Census. The Census questions are based on the SDAC measure of combined ‘profound or severe core activity limitation’, the population for whom service delivery has the most consequence.

Disability data for the Aboriginal and Torres Strait Islander population

The ‘Need for Assistance’ questions and the SIQ were included in the 2006, 2011 and 2016 Census collections. Disability measures for Aboriginal and Torres Strait Islander people with profound/severe core activity limitation are available from these three Census years.

Census ‘Need for Assistance’ outputs

The first three disability questions asked in the Census identify people who have need for assistance with one or more core activity areas (self-care, communication or mobility). The fourth question identifies the reasons as to why this assistance was necessary; as a result of disability, a long-term health condition or the effects of old age.

The table below shows the disability measures available from the Census ‘Need for Assistance’ module.

For more information on the ‘Need for Assistance’ questions, and how responses are used to determine whether a person has a need for assistance, see Appendix: Census Core Activity Need for Assistance Topic. Detailed information on the ‘Need for Assistance’ measure is available in the information paper Disability Variables, 2006 (cat. no 1200.0.55.001).

Limitations of the Census ‘Need for Assistance’ measure

• Limited number of questions – The Census ‘Need for Assistance’ topic uses only 4 questions to collect a reduced range of disability measures (compared to the SDAC and SDM). This reduced question set means there are fewer opportunities for people to be correctly identified and categorised into the appropriate disability severity measure and may result in smaller than expected prevalence rates.
• Combined profound/severe core activity limitation measure only – The Census ‘Need for Assistance’ questions specifically targets those with a need for assistance in one or more of the core activity areas of self-care, communication and/or mobility. Output from the Census is limited to those with a combined ‘profound/severe core activity limitation’. This is considered to be a conceptually comparable measure to the SDAC and SDM.
• Estimated net Undercount - The 2016 Census had an estimated net undercount of 138,000 people in the Aboriginal and Torres Strait Islander population, which represents 17.5% of the estimated total Aboriginal and Torres Strait Islander population. This undercount means that ‘Need for Assistance’ data for the Aboriginal and Torres Strait Islander population should be considered carefully, as this data may not provide a complete picture of profound/severe disability for this population. For more information see the Explanatory Notes in 3238.0.55.001 – Estimates of Aboriginal and Torres Strait Islander Australians, June 2016.
• Item Non-Response - It is important to note that a response of ‘not stated’ can be recorded in the Census for both the SIQ and the ‘Need for Assistance’ questions and may result in a non-response bias in disability data for the Aboriginal and Torres Strait Islander population. In the 2016 Census, the SIQ and ‘Need for Assistance’ questions had a recorded ‘not stated’ response of 6.0% and 7.1% respectively. For more information on Item non-response in the 2016 Census see 2900.0 - Census of Population and Housing: Understanding the Census and Census Data, Australia , 2016.