4714.0 - National Aboriginal and Torres Strait Islander Social Survey, 2014-15  
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SOCIAL AND ECONOMIC WELLBEING OF ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE WITH DISABILITY

ACKNOWLEDGEMENT

The Australian Bureau of Statistics (ABS) acknowledges and thanks the First Peoples Disability Network Australia (FPDN) for their review of this feature article.

This paper is an outcome of ongoing discussions with FPDN over several years and its release coincides with a joint presentation given recently at the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS) National Indigenous Research Conference 2017. Using the rich stream of data from the National Aboriginal and Torres Strait Islander Social Survey (NATSISS), the paper helps fill a gap in information about the extent and nature of disability experienced by Aboriginal and Torres Strait Islander Australians. While the NATSISS can be investigated to provide the statistics, the ABS has partnered with FPDN to help bring these stories to life.  FPDN's research program takes a narrative research approach to investigate the intersection between the cultural inclusion of Aboriginal and Torres Strait Islander people and the social inclusion of a person with disability. The ABS agrees that the context and narratives provided by FPDN enhances understanding of the lived experience of Aboriginal and Torres Strait Islander people with disability.

"The lived experience of Australia's First Peoples with disability has historically been neglected in research and policy due to a number of factors, including limited data that genuinely reflects the prevalence and nature of disability among Aboriginal and Torres Strait Islander People. Disaggregated information on Aboriginal and Torres Strait Islander disability has not been available in this space and we welcome its publication. The opportunity to enhance the data available by connecting quantitative data generated through the NATSISS and other ABS instruments, with the narrative data on the lived experiences of disability gathered through FPDN’s ‘Living our ways’ research program, enables a new level of understanding of the scope and prevalence of disability in Aboriginal and Torres Strait Islander communities and its impact across a person’s life trajectory."

Scott Avery, First Peoples Disability Network

INTRODUCTION

The lived experiences of each Aboriginal and/or Torres Strait Islander person with disability are unique. In a society that seeks to be fair and inclusive, their contributions to contemporary life should be respected and valued. This includes recognising their individual and collective histories and connection to culture, and more broadly, their human rights. A social model of disability recognises that for people with impairments, barriers to equality and full participation in society are a root cause of disability. [1]

The 2014–15 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) provides a range of information about the social and economic circumstances of Aboriginal and Torres Strait Islander people aged 15 years and over living with disability or a restrictive long-term health condition. Results presented in this article are for Aboriginal and Torres Strait Islander people aged 15 years and over unless stated otherwise.

"Social justice is what faces you in the morning. It is awakening in a house with adequate water supply, cooking facilities and sanitation. It is the ability to nourish your children and send them to school where their education not only equips them for employment but reinforces their knowledge and understanding of their cultural inheritance. It is the prospect of genuine employment and good health: a life of choices and opportunity, free from discrimination."

Mick Dodson, Annual Report of the Aboriginal and Torres Strait Islander Social Justice Commissioner, 1993. [2]

Aboriginal and Torres Strait Islander people are more likely than other Australians to experience various forms of disadvantage, including higher unemployment rates, poverty, isolation, trauma, discrimination, exposure to violence, trouble with the law and alcohol and substance abuse. For some people, this disadvantage is coupled with impairments that result in disability.

In this article, people with disability or a restrictive long-term health condition are collectively referred to as 'people with disability', and those with a profound or severe core activity limitation are referred to as 'people with profound/severe disability'. It should be noted that survey information used to determine disability, and levels of disability, is self-reported and not independently verified. For more information on how disability is determined and defined in the NATSISS, see the Disability module in the Questionnaire and Disability Status entry in the Glossary.

Living with disability

Almost half (45%) of Aboriginal and Torres Strait Islander people aged 15 years and over were living with disability or a restrictive long-term health condition in 2014-15. Disability was more prevalent among females than males (47% compared with 43%) however overall rates were similar in non-remote and remote areas (45% and 44%, respectively). Reflecting general population trends, the likelihood of disability increased with age. For example, the proportion of Aboriginal and Torres Strait Islander 15-24 year olds with disability was 32%, around half the rate for those aged 55 years and over (66%) (Table 11.1).

Profound or severe disability

People with a profound or severe core activity limitation are at the high needs end of the disability spectrum; always or sometimes needing assistance with self care, mobility and/or communication. In 2014-15, one in thirteen (8%) Aboriginal and Torres Strait Islander people aged 15 years and over experienced profound or severe disability. Rates were similar for males and females and for people in non-remote and remote areas. Nationally, people with profound/severe disability accounted for one in six (17%) of all Aboriginal and Torres Strait Islander people with disability (Table 11.1).


Table 11.1. Disability status by sex, age and remoteness(a)
Has disability or restrictive long-term health condition
Profound/severe disability(b)
Moderate/mild
disability(b)
Other disability
Total with disability
No disability
Total
('000)
(%)
('000)
(%)
('000)
(%)
('000)
(%)
('000)
(%)
('000)
(%)
Males
15.0
7.1
28.4
13.4
47.7
22.5
91.2
42.9
121.3
57.1
212.6
100.0
Females
19.3
8.4
38.2
16.5
50.9
22.0
108.6
47.0
122.5
53.0
231.1
100.0
15-24
6.6
4.8
7.4
5.4
30.0
21.8
44.3
32.2
93.4
67.9
137.7
100.0
25-34
4.9
5.1
9.7
10.0
21.3
22.2
36.0
37.5
59.9
62.4
96.1
100.0
35-44
6.3
8.3
11.7
15.4
19.4
25.5
37.3
49.1
38.7
51.0
76.0
100.0
45-54
6.2
9.4
15.7
23.9
15.2
23.2
37.1
56.5
28.5
43.4
65.7
100.0
55 and over
9.7
14.2
22.5
33.0
12.8
18.8
44.8
65.8
23.1
33.9
68.1
100.0
Non-remote
27.0
7.8
56.8
16.4
73.4
21.2
157.3
45.4
189.9
54.8
346.8
100.0
Remote
7.3
7.5
9.9
10.3
25.2
26.0
42.5
44.0
54.4
56.2
96.7
100.0
Total
34.3
7.7
66.9
15.1
98.8
22.3
199.8
45.1
243.8
55.0
443.4
100.0
Cells in this table have been randomly adjusted to avoid the release of confidential data. Data discrepancies may occur between sums of the component items and totals.

(a) Aboriginal and Torres Strait Islander people aged 15 years and over.
(b) Core activity restrictions involving a limitation in the performance of one or more core activities such as self-care (eating, washing, dressing, toileting), mobility or communication.

Source(s): ABS 2014–15, National Aboriginal and Torres Strait Islander Social Survey, cat.no. 4714.0.

Disability type

In 2014-15, the majority (81%) Aboriginal and Torres Strait Islander people with profound or severe disability had a physical disability, almost half (47%) a sensory disability (problems with sight, hearing and/or speech), one-third an intellectual or psychological disability (33% for each) and 10% had suffered a head injury, stroke or brain damage. Almost three-quarters (73%) of those with profound/severe disability had two or more types of disability (Table 27). Most commonly these were a combination that included physical disability with: a sensory disability (37%); psychological disability (26%); or intellectual disability (22%).

More than half (60%) of Aboriginal and Torres Strait Islander people who had suffered a head injury, stroke or brain damage had profound/severe disability, followed by 31% of those with intellectual disability and 29% of those with psychological disability (Table 11.2).

Table 11.2. Disability status(a), by disability type
Has disability or restrictive long-term health condition
Profound/severe disability(c)
Moderate/mild disability(c)
Other disability
 Total with disability
('000)
(%)
('000)
(%)
('000)
(%)
('000)
(%)
Sight, hearing, speech
16.1
17.1
29.9
31.7
48.6
51.5
94.4
100.0
Physical
27.8
21.9
50.0
39.4
49.2
38.7
127.1
100.0
Intellectual
11.2
30.7
9.9
27.1
15.3
42.1
36.4
100.0
Psychological
11.3
29.1
13.8
35.6
13.9
35.7
38.9
100.0
Head injury, stroke or brain damage
3.4
60.1
1.8
32.5
0.6
10.4
5.6
100.0
Disability type not specified
16.2
28.7
25.3
44.7
15.1
26.6
56.6
100.0
Total with disability(b)
34.3
17.2
66.9
33.5
98.8
49.4
199.8
100.0
Cells in this table have been randomly adjusted to avoid the release of confidential data. Data discrepancies may occur between sums of the component items and totals.

(a) Aboriginal and Torres Strait Islander people aged 15 years and over.
(b) Sum of components will exceed total as some people have reported more than one type of disability.
(c) Core activity restrictions involving a limitation in the performance of one or more core activities such as self-care (eating, washing, dressing, toileting), mobility or communication.

Source(s): ABS 2014–15, National Aboriginal and Torres Strait Islander Social Survey, cat.no. 4714.0.

Factors which can enable the full participation of Aboriginal and Torres Strait Islander people with disability include paid employment, and access to education, social networks, affordable and secure housing, and culturally safe services and support. However, in some instances, people with disability may be less able than others to participate in the labour force, effectively interact in the community or access appropriate services due to the nature of their disability and/or lack of adequate support. The remainder of this article focuses on outcomes for Aboriginal and Torres Strait Islander people with profound/severe disability, compared with those who had no disability. However, it is worth noting that the poorer outcomes experienced by Aboriginal and Torres Islander people with profound/severe disability are generally consistent with results for all those with disability (including lower levels of disability).

Cultural identity

Connection to country, family and community can be significant factors for Aboriginal and Torres Strait Islander people. In 2014–15, similar proportions of Aboriginal and Torres Strait Islander people, with and without disability, recognised an area as homelands/traditional country, identified with a clan, tribal or language group and/or spoke an Indigenous language. Participation rates for cultural events, ceremonies or organisations in the last 12 months — such as NAIDOC week activities and art, craft, music or sporting festivals — were also similar (Table 28).

Family and community connections

Relationships and engagement with the community are important for wellbeing as they can lessen feelings of isolation and provide people with supportive networks. In 2014-15, the majority of Aboriginal and Torres Strait Islander people had participated in sporting, social or community activities in the last 12 months, irrespective of disability. Similarly, the experience of living with a disability (including profound/severe disability) did not lessen the likelihood of people providing support to relatives outside their household, caring for others with disability, or feeling they were able to have a say within the community on important issues (Table 27).

At least 90% of Aboriginal and Torres Strait Islander people received support in times of crisis from people living outside their household, however those with profound/severe disability were less likely to have received support from a family member (78%) or friend (55%), than were people with no disability (85% and 64%, respectively). They were instead, almost twice as likely to have received crisis support from more formal sources such as a community, charity or religious organisation (20% compared with 12%) and/or health, legal or financial professional (15% compared with 8%) (Table 28).

In 2014-15, Aboriginal and Torres Strait Islander people with profound/severe disability were less likely than people with no disability to be living in couple families (40% compared with 46%); and were instead more likely to live alone (14% compared 8%). Those with profound/severe disability were also less likely to have had daily face-to-face contact with family or friends outside their household (35%) than were people with no disability (45%) or to have accessed the internet at home (58% compared with 78%) (Table 27 and 28).

Health status and risk factors

In 2014–15, only one in seven (14%) Aboriginal and Torres Strait Islander people with profound/severe disability reported excellent or very good self-assessed health, around one-quarter of the rate reported by those with no disability (53%). They were also more likely than those with no disability to have been removed and/or had relatives removed from their natural family (50% compared with 37%) and to have experienced high or very high levels of psychological distress (57% compared with 23%) (Table 28).

Smaller proportions of Aboriginal and Torres Strait Islander people with profound/severe disability had exceeded the 2009 NHMRC alcohol consumption guidelines[3] for lifetime risk (11% and 14%) and single occasion risk (18% compared with 32%) in 2014–15, compared to those with no disability. However, the difference between rates for lifetime risk was not statistically significant (Table 28).

Aboriginal and Torres Strait Islander people with profound/severe disability were more likely than those with no disability to be a daily smoker (42% compared with 36%), but were less likely to report both smoking and exceeding the alcohol guidelines for single occasion risk (12% compared with 17%). Aboriginal and Torres Strait Islander people with profound/severe disability reported higher rates of illicit substance use (33%) than those with no disability (28%), however the difference in rates was not statistically significant (Figure 11.1 and Table 28).

Figure 11.1. Smoking and substance use(a), by disability status — 2014–15

Graph Image for Smoking and substance use(a), by disability status, 2014-15

Footnote(s): (a) Aboriginal and Torres Strait Islander people aged 15 years and over. (b) Proportions are calculated on persons who completed the substance use module. (c) Differences between rates for profound/severe disability and no disability are not statistically significant.

Source(s): 2014–15 National Aboriginal and Torres Strait Islander Social Survey

In 2014–15, most (83%) Aboriginal and Torres Strait Islander people with profound/severe disability had experienced one or more stressors in the last 12 months, compared with 63% of those with no disability. People with disability were significantly more likely than those without disability to have experienced multiple stressors. For example, one in eight (12%) of those with disability (and 19% of people with profound/severe disability) reported four or more stressors, compared with one in twenty (5%) people with no disability (Table 28).

Most of the more commonly reported stressors were more prevalent among Aboriginal and Torres Strait Islander people with profound/severe disability than among those with no disability, including:

  • death of a family member or close friend — 37% compared with 25%;
  • serious illness — 26% compared with 8%;
  • mental illness — 26% compared with 5%;
  • drug-related problems — 9% compared with 3%;
  • being treated badly/discrimination — 9% compared with 3%; and
  • alcohol-related problems — 8% compared with 5% (Table 28).


Access to health services

In 2014–15, Aboriginal and Torres Strait Islander people with profound/severe disability were more likely to have experienced problems accessing one or more health services (27%) than were people with no disability (11%) however, people with profound/severe disability were also more likely to have sought access to health services. The relative disparity in access was apparent across the majority of health services, including doctors, dentists and hospitals (Figure 11.2 and Table 28).

Figure 11.2. Difficulty accessing selected health services(a), by disability status — 2014–15

Graph Image for Difficulty accessing selected health services(a), by disability status, 2014-15

Footnote(s): (a) Aboriginal and Torres Strait Islander people aged 15 years and over. (b) Also includes Medicare, Aboriginal and Torres Strait Islander health workers, disability, mental health and alcohol/drug services.

Source(s): 2014–15 National Aboriginal and Torres Strait Islander Social Survey


Trust in own doctor was lower for Aboriginal and Torres Strait Islander people with profound/severe disability (76%) than for people with no disability (82%), with a more pronounced difference for trust in hospitals (54% compared with 70%) (Table 28).

Educational attainment

In 2014–15, Aboriginal and Torres Strait Islander people with profound/severe disability were less likely than those with no disability to be studying (14% compared with 25%). In addition, smaller proportions of those with profound/severe disability had attained a Certificate III or higher qualification (19% compared with 34%), Year 12 (11% and 15%) or Year 11 (7% compared with 12%). However, the difference between Year 12 attainment rates was not statistically significant. Conversely, Aboriginal and Torres Strait Islander people with profound/severe disability were more than twice as likely as those with no disability to have reported educational attainment below Year 10 (42% compared with 18%). As well as showing the effect that disability can have on educational outcomes, these results also reflect differences in the age profile of the two groups being compared and normative changes in minimum levels of educational attainment over time (Table 27).

Employment

Paid employment provides income and is an important source of self-esteem and economic security. It can provide opportunities for social engagement and can improve access to a range of health goods and services. In 2014–15, Aboriginal and Torres Strait Islander people aged 15-64 years with profound/severe disability were significantly less likely than people with no disability to be participating in the labour force (31% compared with 68%), primarily due to much lower employment rates (19% compared with 55%). In addition, the unemployment rate (the unemployed as a proportion of labour force participants) was almost twice as high for those with profound/severe disability as it was for people with no disability (34% compared with 19%) (Figure 11.3 and Table 27).

Figure 11.3. Selected labour force characteristics(a), by disability status — 2014–15

Graph Image for Selected labour force characteristics(a), by disability status, 2014-15

Footnote(s): (a) Aboriginal and Torres Strait Islander people aged 15–64 years. (b) Unemployed persons as a proportion of all persons in the labour force. (c) Differences between rates for disability and no disability are not statistically significant.

Source(s): 2014–15 National Aboriginal and Torres Strait Islander Social Survey

Household and personal income

Equivalised gross household income provides an indication of how much money is likely to be available to each person in a given household, assuming that income is shared, and taking into account the combined income, size and composition of the household in which they live. In 2014–15, Aboriginal and Torres Strait Islander people with profound/severe disability were more likely than those with no disability to be living in households in the lowest income quintile (47% compared with 32%), and were twice as likely to be reliant on government pensions or allowances as their main source of personal income (73% compared with 37%) (Table 27).

Crime and safety

In 2014–15, Aboriginal and Torres Strait Islander people with profound/severe disability were more likely than those with no disability to have experienced threatened physical violence (25% compared with 14%) and/or physical violence in the last 12 months (19% compared with 11%). For more than half of those who had experienced physical violence, alcohol and/or other substances were contributing factors in the most recent incident, reported by 12% of people with profound/severe disability and 8% of people with no disability (Table 28).

Consistent with a greater likelihood of having experienced physical violence, a smaller proportion of people with profound/severe disability said they felt safe at home alone after dark (71%) or safe walking alone in their local area after dark (38%) than was the case for people with no disability (87% and 59%, respectively) (Table 28).

Housing mobility and impermanence

In 2014–15, Aboriginal and Torres Strait Islander people with profound/severe disability were less likely than those with no disability to have moved house in the last five years (53% compared with 62%), however this may be partly due to the older age profile of those with profound/severe disability (Table 27).

A higher proportion of people with profound/severe disability had experienced a lack of somewhere permanent to live at some time in their life (50%) than was the case for people with no disability (35%). Reasons for housing impermanence more commonly reported by Aboriginal and Torres Strait Islander people with profound/severe disability than those with no disability included:

  • family/friend/relationship problems — 23% compared with 13%;
  • violence/abuse/neglect — 12% compared with 4%;
  • a tight housing/rental market/not enough housing — 11% compared with 5%; and
  • financial problems — 9% compared with 5% (Table 27).

In addition, Aboriginal and Torres Strait Islander people with profound/severe disability were almost twice as likely as those with no disability to have ever experienced homelessness (41% compared with 22%) (Table 27). For more information about how homelessness is defined in the NATSISS, see the Glossary.

Overall life satisfaction

Overall life satisfaction is a summary measure of wellbeing, based on self-reported ratings on a scale from 0 'not at all satisfied' to 10 'completely satisfied'.

In 2014–15, around one in five (18%) Aboriginal and Torres Strait Islander people with profound/severe disability reported an overall life satisfaction rating at the lower end of the scale (0–4), compared with 5% of people with no disability. Conversely, those with no disability were significantly more likely to have said they were completely satisfied with their life (20% compared with 12%) (Figure 11.4 and Table 27).

Figure 11.4. Overall life satisfaction rating(a)(b), by disability status — 2014–15

Graph Image for Overall life satisfaction rating(a)(b), by disability status, 2014-15

Footnote(s): (a) From zero 'not at all satisfied' to 10 'completely satisfied'. (b) Aboriginal and Torres Strait Islander people aged 15 years and over. (c) Differences between rates for profound/severe disability and no disability are not statistically significant. (d) Differences between rates for disability and no disability are not statistically significant.

Source(s): 2014–15 National Aboriginal and Torres Strait Islander Social Survey



Summary

There are significant differences between the experiences of persons with and without disability across many areas as indicated in this article. The lower rates of educational attainment, coupled with poor employment outcomes contribute to lower life satisfaction. These factors along with a lack of adequate support impact on Aboriginal and Torres Strait Islander people with profound/severe disability and curtail their capacity to effectively interact in the community or access appropriate services.

On the other hand, an Aboriginal and Torres Strait Islander person’s cultural connections cannot be underestimated and appears to provide a levelling factor in one’s lived experiences where very little difference exists between peoples’ experiences regardless of their level of disability or activity restriction. These connections to culture, family and the community alongside active participation in cultural activities can help lessen feelings of isolation and provide people with supportive networks. Understanding the benefits of connection to culture and giving it due consideration can only assist in improving the services provided to Aboriginal and Torres Strait Islander peoples with disability and their access to and trust in such services.

ENDNOTES

1 First Peoples Disability Network, <http://fpdn.org.au/>, accessed 08/02/2017

2 http://nationalcongress.com.au/wp-content/uploads/2016/10/The-Redfern-Statement-9-June-2016.pdf; last accessed 08/02/2017; <http://fpdn.org.au/>

3 National Health and Medical Research Council (NHMRC), 2009. Australian guidelines to reduce health risks from drinking alcohol, Canberra: NHMRC. <http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/ds10-alcohol.pdf>; last accessed 19/04/2016