4120.0 - Disability and Handicap, Australia, 1988
ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 24/10/1990
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A disabled person was defined as a person who had one, or more than one impairment or a disability which had lasted, or was likely to last, for six months or more.
A handicapped person was in turn defined as a disabled person aged 5 years or over who was further identified as being limited to some degree in his/her ability to perform certain tasks in relation to one or more of the following five areas:
(a) self care;
(c) verbal communication;
(e) employment (not asked of those in health establishments).
Disabled people aged under 5 years were all regarded as being handicapped, but the specific areas of life in which they experienced handicap were not determined.
The definitions of disability and handicap were based on the International Classification of Impairments, Disabilities and Handicaps as published and developed by the World health Organisation (Geneva, 1980).
Disability and handicap increases with age. Three per cent of children aged 0 to 4 years were disabled, while 64 per cent of people aged 75 years and over were disabled.
Care is needed when making comparisons between disabled or handicapped people and the general population on the basis of variables that are likely to be correlated with disability. For example, the strong relationship between disability (and handicap) and age must be kept in mind when interpreting data for disabled or handicapped people, to avoid attributing to disability or handicap alone effects which may be wholly or partly a response to age, or to age and disability combined.
The percentage of the total population who are handicapped varies from 12 per cent to 14 per cent in the States, but is slightly lower (9%) in both the Australian Capital Territory and the Northern Territory.
In 1988, 1,960,600 handicapped people lived in households (92% of the handicapped population), and 160,000 handicapped people lived in health establishments such as general hospitals, psychiatric hospitals, nursing homes and retirement villages.
The marital status profile of handicapped people in health establishments differs from that of handicapped people in households. Of handicapped people in health establishments , 57 per cent are widowed and only 13 per cent are married. Of handicapped people in households, only 15 per cent are widowed and 54 per cent are married. Of the handicapped people living in households, 1,572,700 (80%) live with other people.
Most people living in health establishments were disabled; only 7 per cent were not disabled. On the other hand, 85 per cent of people living in households were not disabled.
DIAGRAM 1. DISABLED AND HANDICAPPED PERSONS AS A PERCENTAGE OF THE TOTAL POPULATION IN EACH AGE GROUP
SEVERITY AND AREA OF HANDICAP
More handicapped people (1,634,000), both in households and in health establishments, suffered from a mobility handicap than from any other type. This was the case for both males and females. The most frequently reported area of handicap was employment limitation for the handicapped in households and self care for the handicapped in health establishments.
Severity of handicap in self care, mobility or communication was determined for all handicapped people aged 5 years or more. Based on the person's ability to perform tasks relevant to these three areas of handicap, and on the amount and type of help required, three levels of severity - severe, moderate and mild were determined. The highest level of severity in any one of the areas of self care, mobility or communication determines the severity of total handicap for handicapped people.
The handicapped population comprised:
(a) 657,500 people who had a severe handicap (needed help from another person to perform one or more of a group of selected tasks);
(b) 550,000 people who had a moderate handicap (needed no help but had difficulty performing one or more of the selected tasks);
(c) 607,500 people who had a mild handicap (needed no help with, and did not have difficulty with any of the selected tasks, but used an aid to perform one or more of them, or had difficulty walking 200 metres or walking up and down stairs);
(d) 305,700 people whose severity of handicap was 'not determined' (had schooling or employment limitation only, or were aged less than 5 years).
The distribution of severity of handicap varied for the different areas of handicap. Forty four percent of people with a self care handicap were severely handicapped; 91 per cent were either severely or moderately handicapped. These people needed help or had difficulty with self care. On the other hand, a minority (38%) of people with a communication handicap were either severely or moderately handicapped.
Handicapped people in health establishments were more likely to need help (86% were severely handicapped) than those in households, where only 27 per cent were severely handicapped. A high proportion of severely handicapped people in health establishments (82%) were aged 65 years and over, compared to only 42 per cent of severely handicapped in households in the same age range.
There were one and a half times more severely handicapped females than males. As Diagram 2 shows, this effect is concentrated in the older age groups. Of the total population aged 75 years and over, 38 per cent of females were severely handicapped whereas only 20 per cent of males were.
DIAGRAM 2. SEVERELY HANDICAPPED PERSONS AS A PERCENTAGE OF THE TOTAL POPULATION IN EACH AGE GROUP
A person may have more than one disabling condition. For each disabled person, the survey identified up to five disabling conditions. In general, disabling conditions were much more likely to be physical disorders than mental disorders. However, 52 percent of people in health establishments reported mental disorders as a disabling condition compared with 15 per cent of people in households.
Disabling conditions have been grouped in this publication into nine broad categories. The most frequently reported group of disabling conditions was 'diseases of the musculoskeletal system and connective tissue' (881,600). The next most frequently reported condition was 'loss of hearing' (680,400) followed by 'circulatory diseases' (478,200).
These results can be expressed in terms of prevalence rates for these condition groups within the Australian population. For every 1,000 of population, there were 54 people disabled by 'diseases of the musculoskeletal system and connective tissue' (for example, arthritis, rheumatism), 42 by 'hearing loss' and 29 by 'circulatory diseases'.
Survey results also show the primary disabling conditions, that is, the condition identified by the respondent as the one causing the most problems. The primary condition which was most frequently reported was again 'diseases of the musculoskeletal system and connective tissue' (706,800).
The types of primary disabling conditions tended to vary with age and sex. Respiratory disease (for example asthma, bronchitis) was the most common primary disabling condition for the 0 to 14 years age group, while the most commonly reported primary disabling condition for people aged 15 years or over was diseases of the musculoskeletal system and connective tissue. 37,900 children aged 0 to 14 years have mental retardation/slow at learning as their primary disabling condition. These children represent 34 per cent of all people with this primary disabling condition.
Among those who were severely handicapped, 'diseases of the musculoskeletal system and connective tissue' was also the most commonly reported primary disabling condition (208,300). Of the severely handicapped, 17 per cent reported mental disorders as their primary disabling condition. The condition group reported least often as a primary disabling condition by severely handicapped people was loss of hearing (4%).
Although 30 per cent of handicapped people did not know the general cause of their main condition, a further 21 per cent reported disease/illness/hereditary and 14 per cent reported an accident as the cause. Most of these accidents occurred on a street, road or highway (37%) or at work (31%). More handicapped people aged over 65 years reported accidents occurring at home/establishment than did any other age group.
USE OF AIDS
The extent to which handicapped people, because of their disabilities, made use of aids (for example, hearing aids, walking sticks) in performing their daily activities was examined for all those aged 5 years and over. Ordinary items, which may have been used for special purposes because of a disabling condition, were also considered to be aids.
Four out of every ten handicapped people aged 5 years and over used at least one aid. People in health establishments used aids more than did those in households, with 81 per cent of handicapped people in health establishments using one or more aids compared to 37 per cent of handicapped people in households. The use of aids also tended to increase with age.
DIAGRAM 3. HANDICAPPED PERSONS AGED 5 YEARS AND OVER WHO USED AIDS: SEVERITY OF TOTAL HANDICAP BY TYPE OF RESIDENCE
Handicapped people using aids used them in more instances for mobility (48%) and self care (44%) than for other activities. Severely and moderately handicapped people used mobility aids more than any other aid, followed by self care aids. The mildly handicapped however, mainly used aids for communication.
Diagram 4 shows the broad range of aids used. 334,700 people used washing or bathing aids, while the next two most commonly used aids were sticks, frames or crutches (309,400 people) and hearing aids (227,400 people).
DIAGRAM 4. HANDICAPPED PERSONS AGED 5 YEARS AND OVER WHO USE AIDS: TYPE OF AID USED
Forty nine per cent of handicapped people lived in homes which were owned outright (either by them or by some other usual resident), compared to 33 per cent of the general population. However, 31 per cent of the general population are purchasers compared to only 18 per cent of the handicapped. This result is consistent with the relationship between age and the nature of housing occupancy, and the bias towards older age groups among disabled and handicapped people. In 1988, older handicapped people were more likely to be owners than younger handicapped people.
The living arrangements of handicapped people has obvious implication for the provision of care and support. 1,572,700 of the 1,960,600 handicapped in households lived with other people. Of the 344,000 people living alone, 63 per cent were female.
DIAGRAM 5. HANDICAPPED PERSONS: LIVING ARRANGEMENT
Of the 220,000 handicapped people aged 5 to 20 years, 171,300 attended school. More than two thirds of handicapped school children attended ordinary classes; 94,600 at Government schools and 25,000 at non-Government schools. Physically handicapped children were more likely to be in an ordinary class in an ordinary school than were handicapped school children with mental disorders.
144,100 handicapped people aged 5 to 20 years had a schooling limitation due to their conditions (See Glossary for definition of schooling limitation). For example, 43,600 often needed some time off school because of their disabling conditions. Of the 52,900 severely handicapped aged 5 to 20 years with a schooling limitation, more than half attended either a special school or special classes in an ordinary school.
Comparable questions were not asked of those in the survey who were not handicapped, whether disabled or not.
The 1,121,000 handicapped people aged 15 to 64 years living in households comprise 10 per cent of people in this age group. However, handicapped people account for only 7 per cent of people in the labour force in this same age group. The labour force participation rate for a particular group of people is the percentage of that group who are in the labour force (either employed or unemployed). The participation rate for handicapped people aged 15 to 64 years is 46 per cent compared with 72 per cent for the general population. As might be expected, there is a relationship between the severity of handicap and the labour force participation rate. As the level of severity of total handicap rises, the participation rate of handicapped people declines. For example, the participation rate for mildly handicapped people aged 15 to 64 is 52 per cent but for severely handicapped people it is 34 per cent (See below).
LABOUR FORCE PARTICIPATION RATE OF PERSONS IN HOUSEHOLDS AGED 15 TO 64 YEARS: HANDICAP STATUS BY SEX
Unemployment rates for handicapped people are much higher than for the general population - 12 per cent for handicapped people aged 15 to 64 years compared to 8 per cent for this age group in the general population.
Of 1,121,000 handicapped people aged 15 to 64 years, 601,300 (54%) are not in the labour force compared to 28 per cent of the general population not in the labour force. People with mental disorders are less likely to be in the labour force than those with physical disorders. Handicapped people whose primary disabling condition was diseases of the circulatory system had the lowest participation rate (29%), while people with hearing loss had the highest (69%).
956,600 handicapped people in households and aged 15 to 64 years had an employment limitation. Fifty two per cent of these (501,200) were restricted in the type of job they could perform and 38 per cent (366,600) were permanently unable to work. Younger handicapped people with an employment limitation were most likely to report being restricted in their type of job (77%), but older ones were most likely to report being permanently unable to work.
Income units containing disabled people had a lower income than those containing non-disabled people. This pattern increased with severity of handicap; 61 per cent (397,600) of severely handicapped people were in income units whose total weekly income is less than $200. The principal source of income for most income units containing disabled people (1,156,000) is a Government pension or cash benefit, compared to wages and salary for most income units in the general population (9,860,100).
The main focus of the 1988 Disabled and Aged Persons Survey was on the provision of care from the perspective of the aged and disabled people themselves. By obtaining data from the recipient, a more complete measurement of the care requirements of aged and disabled people is possible.
The survey details the number of aged and disabled people who need help or supervision to perform one or more specified tasks, regardless of whether help is actually received. The survey also details the help received by disabled people and identifies unmet need for help.
The remainder of this Summary of Findings presents information on the need for, and receipt of, help by disabled people aged 5 years and over living in households and in health establishments.
DISABLED PEOPLE LIVING IN HOUSEHOLDS
1,432,600 (61%) of disabled people living in households needed help with at least one activity. More females needed help than males. Home maintenance, home help and transport were the activities for which the need for help was most frequently reported. Of the 1,432,600 people needing help, 20 per cent lived alone and 80 per cent lived with other people.
Of people needing help, 1,373,900 (96%) received help with at least one activity. Spouse/partners residing in the same household as the disabled person, were the most common providers of help over a wide range of activities. Daughters were the most frequently reported source of informal help provided by people not residing with the disabled person. The source of formal help varied depending on the activity for which help was received.
Disabled people who reported needing help but who received no help, or needed more help, with at least one activity, were classified as having an unmet need for help. In 1988, there were 439,400 disabled people who had an unmet need for help. Although people received help with the activities of home maintenance, home help and transport (activities for which there was the greatest need for help), there were still more disabled people with an unmet need for help in these areas than in other areas. More females had an unmet need for help than males, especially in the area of home help (52% compared to 23%).
DISABLED PEOPLE LIVING IN HEALTH ESTABLISHMENTS
Ninety one per cent of disabled people in health establishments needed help (86% males and 93% females). Health care and mobility were the activities for which a need for help was most frequently reported. Of the 150,400 people who needed help, 95 per cent received help, and staff members were the most common provider of this help.
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