Variation by socioeconomic area
Generally, people in lower socioeconomic groups are at greater risk of poor health, have higher rates of illness, disability and death, and live shorter lives than people from higher socioeconomic groups (see Health across socioeconomic groups). This ‘wealth-health gradient’ becomes more pronounced as people age (McMaughan et al. 2020), and lower neighbourhood-level socioeconomic status has been shown to be associated with poorer cognition and higher dementia risk (Pase et al. 2022).
People in lower socioeconomic groups often have:
- higher rates of modifiable risk factors for dementia (Livingstone et al. 2020) (see also Dementia burden due to risk factors)
- higher rates of cardiovascular disease, diabetes and other comorbidities (AIHW 2022) that can lead to deterioration in health and the need for hospitalisation
- symptoms of dementia for a longer period of time before seeking healthcare advice and/or receiving a diagnosis (Bryant et al. 2021; Greenway-Crombie et al. 2012). This delayed diagnosis may occur after the early stages of dementia, when dementia-specific medications are most beneficial
- lower access to health services due to cost, transport or other factors such as low health literacy (AIHW 2020).
This page presents a summary of geographical variation in the use of health services and residential respite care among people living with dementia by socioeconomic area, based on the 2016 Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-economic Disadvantage (IRSD) quintiles.
To examine the effect of socioeconomic disadvantage in metropolitan and rural areas, data are presented for the total dementia study cohort, and for socioeconomic areas within Major cities and Outside major cities (which is an aggregate of Inner regional, Outer regional, Remote and Very remote Australia).
As health service use changes after a person enters permanent residential aged care, results are shown by whether people living with dementia were living in the community or living in permanent residential aged care.
See the Technical guide for more information on the study cohorts, geographies and services examined.
AIHW (Australian Institute of Health and Welfare) (2020) Coordination of health care: experiences of barriers to accessing health services among patients aged 45 and over, AIHW, Australian Government, accessed 27 June 2023.
AIHW (2022) Health across socioeconomic groups, AIHW, Australian Government, accessed 17 August 2023
Bryant J, Noble N, Freund M, Rumbel J, Eades S, Sanson-Fisher R, Lowe M, Walsh J, Piterman L, Koch S, Meyer C, Todd E (2021) ‘How can dementia diagnosis and care for Aboriginal and Torres Strait Islander people be improved? Perspectives of healthcare providers providing care in Aboriginal community controlled health services’, BMC Health Services Research, 21:699.
Greenway-Crombie A, Snow P, Disler P, Davis S, Pond D (2012) ‘Influence of rurality on diagnosing dementia in Australian general practice’, Australian Journal of Primary Health 18(3):178-184, doi:10.1071/PY12008.
Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S et al. (2020) Dementia prevention, intervention, and care: 2020 report of the Lancet commission, doi: 10.1016/S0140-6736(20)30367-6.
McMaughan D, Oloruntoba O, Smith M (2020) ‘Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging’, Frontiers in Public Health, volume 8, doi: 10.3389/fpubh.2020.00231.
Pase M, Rowsthorn E, Cavuoto M, Lavale A, Yassi N, Maruff P, Buckley R, Lim Y (2022) ‘Association of neighborhood-level socioeconomic measures with cognition and dementia risk in Australian adults’, JAMA Network Open, 5(3):e224071, doi:10.1001/jamanetworkopen.2022.4071.