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This page provides an introduction to disability and disability services in the Australian population, focusing on people with a disability that manifests before the age of 65 years.
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Disability is increasingly seen as something that affects most people in the population, to varying degrees and at different stages of their lives. Disability can be measured along a continuum and estimates of its prevalence vary with the particular definition used. The experience of disability is shaped by environmental factors.
The International Classification of Functioning, Disability and Health (ICF) recognises that the components of functioning and disability (body functions and structures, activities and participation) reflect an interaction between health conditions and the person's environment. This important conceptual framework underpins much Australian data.
Estimates of the prevalence of disability are based on the most recent Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers (SDAC).
According to the SDAC, in 2003:
The age-standardised rates of severe disabilities have not changed significantly in over 20 years. However, due to population growth and ageing, the actual number of people with these disabilities is rising.
Data on disability among Aboriginal and Torres Strait Islander people have been limited. Recent sources include the 2006 Census of Population and Housing and the 2002 National Aboriginal and Torres Strait Islander Social Survey. In 2002, 102,900 (37%) Indigenous Australians aged 15 years or over had disability or a long-term health condition. In general terms, the severe disability rates for Aboriginal and Torres Strait Islander people are more than double those of other Australians (2.1 to 2.4 times).
People with disability receive care and assistance from a range of sources including:
In 2003, Australians aged less than 65 years who needed help with self-care, mobility or communication received most of the assistance they needed from family and friends. Around 65% received informal assistance only; 26% received both formal and informal assistance; 3% received formal assistance only; and 6% had no provider of assistance.
Around 2.6 million carers in Australia provided unpaid assistance to people with disability or the aged in 2003. The person who provides the most assistance is known as the primary or principal carer. These carers made up around 20% of the 2.6 million carers. The remaining 80% were non-primary carers, sometimes called secondary carers.
Sources of income support include payments and allowances, concession schemes and compensation.
Some of the largest income support programs are:
From 1 January 2009, the National Disability Agreement (NDA) replaced the Commonwealth State/Territory Disability Agreement (CSTDA) for the provision of disability services in Australia. Services provided under the CSTDA were targeted at people with a need for ongoing support in everyday activities. Information about services provided, service outlets and service users are reported in the Disability Services National Minimum Data Set for 2009-10 onwards. From 1999 to 2008-09 they were reported in the CSTDA National Minimum Data Set.
In 2007-08, services provided under the CSTDA accounted for some $4.8 billion of government expenditure. Almost half this expenditure was used to fund accommodation support services ($2.3 billion; 48%).
Disability support services under the CSTDA were provided to 245,746 people during 2007-08. The most widely accessed service group was community support (used by 42% of service users), followed by employment (37%) and community access (22%). Accommodation support services were accessed by 15% of service users.
The Younger People with Disability in Residential Aged Care (YPIRAC) program is a five year agreement between the Australian Government and State and Territory governments. The program was established by the Council of Australian Governments (COAG) on 10 February 2006. Funding of up to $122 million from the Australian Government matched by up to $122 million from States and Territories is available.
This program aims to reduce the number of younger people with disability living in residential aged care, and to provide additional support to those who remain in residential aged care.
The AIHW was commissioned to develop a national data set and collection process relating to the YPIRAC program. Information about services provided and the people receiving services under the program during 2007-08 can be found in the YPIRAC 2007-08 MDS report .
The Home and Community Care program (HACC) provides services to frail older people, people with disability and their carers. HACC services aim to increase independence and prevent admission to residential care.
During 2006-07, there were 188,903 HACC clients under the age of 65 years (24% of the total 801,290).
Mainstream services accessed by people with disability include health services, public transport, education and training, employment assistance, and housing and accommodation assistance. However, people with disability may experience difficulty in accessing these services. For example, access to mainstream health services for people with disability is often restricted by issues such as insufficient training of the health workforce, communication difficulties and the misinterpretation of symptoms.
For further discussion, see Australia's welfare 2011.