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Working Paper No. 2001/01 - Accounting for Change in Disability and Severe Restriction, 1981-1998


There is increasing interest in changes in the prevalence of disability and the higher levels of restriction over time, particularly in the light of the ageing of the Australian population.

The Australian Bureau of Statistics has conducted four disability surveys, beginning in the International Year of Disabled Persons, 1981:
  • Survey of Handicapped Persons, 1981. The four surveys are:
  • Survey of Disabled and Aged Persons, 1988;
  • Survey of Disability, Ageing and Carers, 1993; and
  • Survey of Disability, Ageing and Carers, 1998.

The next Survey of Disability, Ageing and Carers is scheduled for 2003.

Each of these surveys has built on the previous ones, keeping much in common but fine-tuning criteria for disability and for the levels of severity of restriction. However, these changes to the surveys, as well as the fact that disability rates are so closely linked with age, have meant that it has not been possible to directly compare results from the surveys. Age standardisation and some adjustment for criteria in common are required.

The 1998 disability survey, had an unexpectedly high rate of disability with severe restriction (6% of the total population, compared with 4% in the previous two surveys). Since people whose disability leads to severe restriction are part of the eligible population for disability and aged care services, and data from the survey are used for funding and service planning decisions, it was necessary to understand the reasons for the increase. Had there been an actual change in disability levels in the community? Were people readier to report need for assistance in basic activities? As disability is a complex concept, including a wide range of different types of conditions, was the increase located in a particular type of disability? Was it connected to changes in the structure of the population? Were people surviving previously fatal events because of medical advances, but with some abilities impaired? Or did the results relate more to developments in the survey and the way it was conducted?

The attached paper provides a background analysis of disability and severe and profound levels of restriction over time, by age rates and type of disability. The main focus then becomes the increase in severe restriction in 1998. Three main age groups are identified as contributing most of the increase, and the paper discusses the validity of the classification and the questions raised above.

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