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CONCLUSIONS AND RECOMMENDATIONS

Disability is an extremely complex and difficult concept to measure. This is particularly true when collecting disability data for the Aboriginal and Torres Strait Islander population, as the collection of disability information requires cultural awareness and sensitivity, as well as an understanding of the statistical complexities that come with collecting data for a self-identifying population.

The SDAC - is the most comprehensive source of disability data, designed to capture and measure the complexities of disability experience. It is not designed to collect disability information for the Aboriginal and Torres Strait Islander population specifically and data for this population is limited.

The Short Disability Module (SDM) – has been included in a range of household surveys, providing insights into aspects of life that the SDAC does not examine. The addition of the SDM in the NATSIHS and NATSISS means that an increased range of disability information can be obtained for the Aboriginal and Torres Strait Islander population, without increasing the survey respondent burden for this population. The inclusion of the SDM in the NATSIHS and NATSISS also addresses the data gap for very remote areas and provides larger population samples for key disability severity outputs than are currently unavailable in the SDAC.

The Census ‘Need for Assistance’ topic – provides a measure of profound/severe core activity limitation. The Census ‘Need for Assistance’ topic can provide information on Aboriginal and Torres Strait Islander people with profound/severe limitations across all of Australia including small geographic areas. ‘Need for Assistance’ measures for the Aboriginal and Torres Strait Islander population need to be considered with caution however, as the Census has a large estimated net undercount for this population, and the ‘Need for Assistance’ and ‘Standard Indigenous Question’ in the Census both have a large item non-response.

In assessing the qualities of the SDAC, the SDM and the ‘Need for Assistance’ questions in the Census, the following key points are made:

THE SDAC PROVIDES A MORE COMPREHENSIVE MEASURE OF DISABILITY WHEN COMPARED TO THE SDM

The analyses in this paper have shown that the ‘total with disability’ measure identified by the SDM is markedly different to the ‘total with disability’ measure identified in the SDAC:

• The SDM identifies a larger population with disability as it includes people who report having a restrictive long-term health condition that are defined in the SDAC as having a non-restrictive long-term health condition.
• The higher ‘total with disability’ measure in the SDM appears to be largely influenced by an over-count of people with long-term health conditions that impact sensory or speech, physical and intellectual capacity.

THE SDAC AND THE SDM (NATSIHS AND NATSISS) PROVIDE CLOSELY ALIGNED 'CORE ACTIVITY LIMITATION' MEASURES.

Total Core Activity Limitation

Analyses in this paper show that ‘total core activity limitation’ measures from the SDM, and all disaggregated categories within this measure (profound, severe, moderate, mild), align closely to measures identified in the SDAC.

The analyses also show that SDAC ‘total core activity limitation’ measures for the Aboriginal and Torres Strait Islander population are limited due to:

• Small population samples and higher associated levels of uncertainty; and
• Limited geographic coverage that excludes very remote areas and discrete Aboriginal and Torres Strait Islander Communities.

Education/Employment Restriction

Although prevalence rates for the ‘education/employment restriction only’ measure from the SDAC and SDM align closely in this analysis, care needs to be taken when using data derived from the SDM. The SDM uses more general wording on prompt cards which may elicit a higher proportion of positive responses to this category. As such, ‘education/employment restriction only’ data collected using the SDM should not be used as a measure of prevalence, but rather an indicator to compare characteristics of those with and those without an education/employment restriction.

No Specific Restriction or Limitation

In the SDM, the ‘no specific restriction or limitation’ measure is statistically significantly higher when compared with the SDAC. As such, data for this category should be used with caution and users need to have a full understanding of what information is being collected by the SDM in this category.

'PROFOUND/SEVERE LIMITATION' MEASURES IN HOUSEHOLD SURVEYS AND THE 'NEED FOR ASSISTANCE WITH CORE ACTIVITIES' MEASURE ARE CLOSELY ALIGNED (SDAC, NATSIHS, NATSISS AND CENSUS)

The combined ‘profound/severe limitation’ measure represents the population with the greatest disability and therefore the greatest need for assistance, and is available across all the collections included in this analysis.

‘Profound/severe limitation’ measures from the SDAC are closely aligned to those from the SDM and the measure of ‘need for assistance with core activities’ in the Census. The Aboriginal and Torres Strait Islander population sample in the SDAC is limited however, with high levels of variability.

The NATSIHS and NATSISS provide ‘profound/severe limitation’ measures across all remoteness areas, allowing for comparisons to be made between non-remote and remote/very remote data. However, data collected in remote areas have higher levels of variability, limiting the disaggregation of remote/very remote data.

The Census is the only collection able to provide disaggregated data for Aboriginal and Torres Strait Islander people with ‘profound/severe limitation’ at small geographic levels. Users need to be cautious when using Census data however as:

• The ‘Need for Assistance’ topic only includes four questions, and respondents have fewer opportunities to be identified and correctly categorised by disability severity.
• The Census has an estimated net undercount of Aboriginal and Torres Strait Islander people
• Both the ‘Need for Assistance’ topic and ‘Indigenous Status’ questions have a significant item non-response.