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Income Support: Trends in disability support
Who receives disability support payments?
Just as the likelihood of having a disability increases with age, the proportion of disability support pension recipients in each age group also increases towards older ages. In 2000, 11% (66,300) of disability support pension recipients were aged less than 30 years, and 35% (208,500) were aged 30-49 years. However, the majority of disability support pension recipients (54%) were aged 50 years and over.
In 2000, the majority of disability support pension recipients (63%) were men. Men comprised 60% of all disability support pension recipients under the age of 50 years. This proportion was slightly lower (57%) for those aged 50-60 years, but was highest (85%) for 60-64 year olds, as the majority of women in this age group qualified for the aged pension.
In 2000, musculo-skeletal and connective tissue conditions, such as arthritis, were the most common conditions. Of recipients between the ages of 16 and 64 years, 124,500 men and 65,700 women with these conditions, accounting for 32% of all recipients, were receiving the disability support pension.
DISABILITY SUPPORT PENSION RECIPIENTS
Source: Department of Family and Community Services, Income Support Customers: A statistical overview, 1999 and 2000.
Main conditions differed depending on the age, and to a lesser extent the sex of disability support pension recipients. Younger people tend to have higher rates of intellectual impairments which are often caused by congenital disorders such as Down syndrome. Recipients in older age groups displayed higher rates of physical disabilities related to ageing, such as arthritis, but also injury from physical work, accident or sport. Overall, the pattern of conditions was similar for male and female recipients. However, women tended to be more likely to have psychological or psychiatric disorders than men, while men were more likely to have musculo-skeletal or circulatory disorders than women.
In 2000, the main conditions of recipients aged 16-29 years were intellectual and learning difficulties (38%), followed by psychological and psychiatric conditions (27%). Between the ages of 30 and 49 years, psychological and psychiatric conditions were the most common for those receiving the disability support pension (32%). Musculo-skeletal and connective tissue conditions were the main condition for 25% of recipients in this age group.
MAIN CONDITION OF DISABILITY SUPPORT PENSION RECIPIENTS AGED 16-65 YEARS - 2000
Despite the proportion of recipients whose main condition was an intellectual or learning disorder being lower for those aged 30-49 years than those aged 16-29 years (13% and 38% respectively), the number of recipients with this condition was higher. The number of male recipients was 450 higher than in the younger age group, bringing the total number of male recipients to 15,400. For women, the number of recipients was 1,300 higher, totalling 11,800 recipients.
The most common main condition among recipients aged 50-64 years was musculo- skeletal and connective tissue. These conditions accounted for 41% of people receiving the disability support pension in this age group, compared with 25% in the 30-49 year age group. Reflecting the higher number of recipients in total in the 50-64 year age group, (325,200 compared with 208,500 in the 30-49 year age group), there were 55,400 more men and 26,800 more women recipients with this condition. Men with a musculo-skeletal condition in the 50-64 years age group totalled 88,700 and women totalled 45,200.
The ethnic and cultural background of disability support recipients is an important issue to welfare support providers. To ensure that a helpful and efficient service is accessible to its clients, cultural needs such as language need to be taken into account. The countries of birth of disability support recipients reflect migration patterns over the last 50 years (see Australian Social Trends 2001, Coming to Australia). Immigrants who settled in Australia shortly after the Second World War, such as those from the United Kingdom and other European countries, constitute the largest proportion of overseas-born disability support pension recipients in 2000. However, more recent immigrants from countries such as the Philippines and Cambodia constitute the largest proportional increases between 1995 and 2000.
DISTRIBUTION OF DISABILITY SUPPORT PENSION RECIPIENTS ACROSS AGE GROUPS - 2000
Source: Department of Family and Community Services administrative data.
In 2000, 29% of disability support pension recipients were born outside of Australia, a slightly higher proportion than for the overseas-born in the total population (24%). This reflects the older age structure of the overseas-born population and the associated higher disability rates. The older age structure of many migrant groups is reflected in their median ages (see Australian Social Trends 2002, Older overseas-born population). In 2000, while the median age for the Australian-born population was relatively low (30.9 years) it was higher for those born in Italy (61.1 years), the United Kingdom (50.8 years) and the Former Yugoslav Republics (49.1 years). Median ages were somewhat lower for those born in the Philippines (38.0 years), Viet Nam (36.5 years) and Cambodia (35.8 years) than their European born counterparts.1 However, taking the effect of age structure into account, there are differences in recipient rates between immigrant groups. For example, disability support pension recipients from Viet Nam and the Philippines have lower rates than Australian-born recipients. This may be explained by health requirements for more recent immigrants, and the 10 year waiting period for all immigrants to receive the disability support pension if they have an existing condition on arrival in Australia.
SELECTED COUNTRIES OF BIRTH OF DISABILITY SUPPORT PENSION RECIPIENTS - 2000
(b) Includes countries of birth not specified above.
Source: Centrelink administrative data.
Factors for increase
A number of factors have contributed to the increase in disability support pension recipients since 1980. These include legislative changes, changes in living arrangements, health improvements and population ageing.
A major contributor to the rapid increase in numbers of disability support pension recipients between 1990 and 1995 was the introduction of the Disability Reform Package in 1991. These reforms were initiated with the objective of more effectively integrating people with a disability into the labour market.2 As a consequence, the disability support pension replaced the invalid pension and the sheltered employment allowance. This restructuring added 10,100 sheltered employment allowance recipients to the disability support pension in 1991. The new disability support pension also broadened the eligibility basis to include people who could perform part-time (up to 30 hours per week), but not full-time work, as well as enabling greater access to the disability support pension by people with psychiatric, and drug and alcohol conditions.
In the late 1990s, the increase in the age at which women qualify for the age pension also influenced disability support pension recipient numbers. Between 1995 and 2013, the qualifying age for women to receive age pension is being increased gradually to 65 years. Therefore, female disability support pension recipients who, prior to the new legislation would have changed to the age pension at younger ages, are now remaining on the disability support pension for longer. In 1995, 650 women aged 60-64 years received the disability support pension. By 2000 this number had increased to 16,900.
The number of older women receiving the disability support pension is also likely to have increased with the phasing out of payments based on current or former dependence on a male breadwinner. Since the closure to new entrants of the wife pension in 1995 and widow B pension in 1987, women who might have previously claimed these pensions may qualify for the disability support pension, which is more generous than the two aforementioned pensions.
The increase in numbers of disability support pension recipients since 1980 may have been influenced by the higher number of people living alone either by choice, or as a result of separation and divorce. Since the disability support pension requires that an applicant meet both asset and income tests, a single person who lives alone is more likely to be eligible for a full pension than someone living with a partner who may be earning income.
Paradoxically, numbers of disability support pension recipients have increased due to improvements in the mortality of Australians. Medical advances, combined with personal lifestyle choices, mean that more people, including those with a disability, are surviving at every age.3 As a result, people who are receiving the disability support pension do so for longer periods of time. Improved health care also means that people are more likely to receive life saving treatment for a vehicle accident, stroke or heart attack. Despite surviving the treatment, the person may be left with a severe or profound disability. In earlier times, the risk of dying from injuries sustained was higher.
Australia's ageing population has also had a major influence on the number of disability support pension recipients. In 1997, the 'baby boomers' began to enter the 50 years and over age groups (see Australian Social Trends 1999, Our ageing population). Between 1992 and 1998, about 38% of disability support pension recipients aged 50 years and over received an income support payment for the first time.4 Apart from this generation contributing to an increase in numbers of disability support pension recipients, the rates of severe restrictions are higher in this age group.
Additionally, the severe restriction rate has increased over the last 10 years for people of older ages. Male and female respondents in the 50-64 year age group reported higher incidences of severe restrictions in 1998 than they had in 1988 or 1993. This increase was mainly due to the prominence of reported musculo-skeletal conditions, particularly conditions other than arthritis such as neck, shoulder and back disorders.
PROJECTED CHANGE IN POPULATION WITH A SEVERE OR PROFOUND CORE ACTIVITY RESTRICTION - 2000-06(a).
(a) Estimated numbers were calculated by applying age and sex specific prevalence rates derived from the ABS Survey of Disability, Ageing and Carers to ABS 1998 population projections (Series K) as at 30 June.
(b) Projected change for 20-29 year age group is -0.1%.
Source: AIHW analysis of ABS 1998 Survey of Disability, Ageing and Carers data.
Australia's ageing population is likely to have a profound influence on the number of disability support pension recipients in the future, as could further changes in legislation. ABS population projections suggest that Australia's 45-64 year age group will increase from 4.5 million, or 23% of the population in 2001, to 5.1 million, or 25% by 2006.
An analysis of projected numbers of Australians with a severe or profound disability was undertaken by the Australian Institute of Health and Welfare (AIHW) in 1999, utilising ABS Survey of Disability, Ageing and Carers data. The AIHW suggested that between 2000 and 2006, the total number of Australians with a severe or profound restriction is likely to increase by 12% while the Australian population is projected to increase by 7%. If these projections hold true, the number of people aged less than 65 years with a severe or profound disability is likely to increase by 9%. The greatest increase is projected to be in the 45-64 years age group which will increase by 19%.5
The composition of people receiving the disability support pension is also likely to change in the future. To qualify for the disability support pension with an existing condition, an individual must have been a resident of Australia for at least 10 years (five of these years in a single period). Therefore, as more recent immigrants with existing conditions, from Viet Nam, Cambodia and the Philippines for example, become eligible for the disability support pension, the proportion of recipients from these countries can be expected to increase. Such changes in the composition of recipients will affect the demand for welfare support services such as language services. Evidence of this trend is already apparent, with immigrants from these aforementioned countries constituting the largest percentage increase in disability support pension recipient numbers between 1995 and 2000.
1 Australian Bureau of Statistics 2001, Migration Australia, 1999-2000, cat. no. 3412.0, ABS, Canberra.
2 Australian Institute of Health and Welfare (AIHW) 1995, Australia's Welfare 1995: Services and assistance, AIHW, Canberra.
3 Australian Institute of Health and Welfare (AIHW) 2000, Disability and Ageing, Australian population patterns and implications, AIHW, Canberra.
4 Australian Institute of Health and Welfare (AIHW) 1999, Australia's Welfare 1999: Services and assistance, AIHW, Canberra.
5 Australian Institute of Health and Welfare (AIHW) 2001, Australia's Welfare 2001, AIHW, Canberra.