Health of people with disability is an Australia's health topic

Disability and health have a complex relationship – long-term health conditions might cause disability, and disability can contribute to health problems. The nature and extent of a person’s disability can also influence their health experiences. For example, it may limit their access to, and participation in, social and physical activities. Social, cultural and economic determinants of health can be of particular importance for people with disability (see Social determinants of health and What are determinants of health?).

An estimated 1 in 6 people in Australia (17.7% or 4.4 million people) had disability in 2018, including about 1.4 million people (5.7% of the population) with severe or profound disability (ABS 2019) (see People with disability in Australia, Defining disability).

In general, people with disability report poorer general health and higher levels of psychological distress than people without disability. They also have higher rates of some modifiable health risk factors and behaviours, such as poor diet and tobacco smoking, than people without disability.

This page looks at the health of people with disability and their health risk factors.

Measuring and defining disability

There are many different concepts and measures of disability, making comparisons across different data sources challenging. The AIHW promotes measures based on the International Classification of Functioning, Disability and Health (WHO 2001), which underpins the disability categories used here.

The data used on this page are primarily from the Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers (SDAC) 2018 and 2022 National Health Survey (NHS). The SDAC is conducted somewhat infrequently, with data from the 2022 iteration of the survey not expected to be released until July 2024.

Definitions of disability differ across surveys. The SDAC is the most detailed and comprehensive source of disability prevalence in Australia. To identify disability, the SDAC asks participants if they have at least one of a list of limitations, restrictions or impairments, which has lasted, or is likely to last, for at least 6 months and that restricts everyday activities.

The limitations are grouped into 10 activities associated with daily living, and a further 2 life areas in which people may experience restriction or difficulty as a result of disability – schooling and employment.

The level of disability is defined by whether a person needs help, has difficulty, or uses aids or equipment with 3 core activities – self-care, mobility, and communication – and is grouped for mild, moderate, severe, and profound limitation. People who ‘always’ or ‘sometimes’ need help with one or more core activities, have difficulty understanding or being understood by family or friends, or can communicate more easily using sign language or other non-spoken forms of communication are referred to in this section as ‘people with severe or profound disability’. All other people with disability are referred to in this section as ‘people with other disability’.

The NHS uses the ABS Short Disability Module to identify disability, including restrictive long-term health conditions. While this module provides useful information about the characteristics of people with disability relative to those without, it is not recommended for use in measuring disability prevalence.

Unlike the SDAC, the NHS does not report on people living in institutional settings, such as aged care facilities. However, the NHS provides data on people without disability as well as those with disability, enabling comparisons between the 2 groups.

Profile of people with disability

The disability population is diverse. It encompasses people across all parts of Australian society. Knowing how many Australians have disability, and their characteristics, can help us to plan and provide the supports, services and communities that enable people with disability to participate fully in everyday life.

While the number of people with disability in Australia increased to an estimated 4.4 million in 2018 (up from an estimated 4.0 million in 2009), the estimated prevalence rate has decreased over this period (18.5% of the population in 2009 down to 17.7% in 2018) (ABS 2019).

Overall, the likelihood of experiencing disability increases with age. This means the longer people live, the more likely they are to experience some form of disability. For more information on the prevalence of disability, see People with disability in Australia, Prevalence of disability.

General health

Self-assessed health status is a commonly used measure of overall health in which a person is asked to compare their own health with others around them. The measure reflects a person's perception of their own health at a given point and provides a broad picture of a population's overall health. Adults with disability are more likely to report poorer general health. In 2022:

  • adults with other disability were less likely to assess their health as ‘very good or excellent’ than adults without disability (35% compared with 69%) (AIHW analysis of ABS 2023)
  • adults with severe or profound disability (68%), were 12 times as likely as adults without disability (5.6%), and more than twice as likely as adults with other disability (28%) to assess their health as fair or poor (AIHW analysis of ABS 2023) (Figure 1).

Figure 1: Adults living in households, by self-assessed health status, and disability status and severity, 2022

Adults with severe or profound disability are less likely than those with other disability or those without disability to report their general health as excellent or very good (12% compared with 35% and 69%, respectively).



Notes

  1. Data are for people aged 18 and over.
  2. ’Self-assessed health status’ is a person's general assessment of their own health against a five-point scale from excellent through to poor. Collected for people aged 15 and over.
  3. ‘Severe or profound disability’ means severe or profound core activity limitation – always or sometimes needing assistance or supervision with self-care, mobility, and/or communication.
  4. ‘Other disability’ – disability with status other than severe or profound core activity limitation.

Source: AIHW analysis of ABS 2023.

For more information, see People with disability in Australia, Health status.

Mental health

Mental health conditions can be both a cause and an effect of disability, and often involve activity limitations and participation restrictions beyond the ‘core’ areas of communication, mobility and self-care – for example, in personal relationships.

Almost 1 in 2 (48%) people with severe or profound disability, and 37% of people with other forms of disability, self-reported anxiety disorders such as feeling anxious, nervous or tense, in the 2022 NHS. This compares with 14% of people without disability (AIHW analysis of ABS 2023).

An estimated 41% of people with severe or profound disability self-reported that they had mood (affective) disorders such as depression, compared with 29% of people with other forms of disability, and 7.3% of people without disability (AIHW analysis of ABS 2023).

Self-reported psychological distress is an important indication of the overall mental health of a population. Higher levels of psychological distress indicate that a person may have, or is at risk of developing, mental health issues. Adults with disability are more likely to experience high or very high levels of psychological distress than adults without disability – 28% compared with 6.8% of those for whom the distress score is known (Figure 2). This is particularly true for adults with severe or profound disability (46% of those for whom the distress score is known) (AIHW analysis of ABS 2023). Note, the psychological distress score was not known for 13% of adults with severe or profound disability.

Figure 2: Adults living in households, by psychological distress level and disability status, 2022

Adults with disability are less likely than those without disability to report their psychological distress level as low (44% compare with 69%).



Notes

  1. Data are for people aged 18 and over who completed the Kessler Psychological Distress Scale module.
  2. Psychological distress level is measured using the Kessler Psychological Distress Scale (K10), a survey device for measuring non-specific psychological distress in people. K10 uses 10 questions about negative emotional states that participants in the survey may have had in the 4 weeks leading up to their interview. K10 was collected for people aged 15 and over who were present at interview.
  3. The psychological distress score was not known (not collected or not able to be determined) for 4.2% of people aged 18 and over with disability, and 5.2% of people aged 18 and over without disability. People for whom the score is not known are excluded from calculation.
  4. ‘With disability’ includes people with disability or restrictive long-term health condition.

Source: AIHW analysis of ABS 2023.

For more information, see People with disability in Australia, Health status.

Main conditions of people with disability

For about 3 in 4 (77%) Australians with disability in 2018, their main health condition (the one causing the most problems) was physical. Musculoskeletal disorders were the most commonly reported (30%) physical disorders, and include conditions such as arthritis and related disorders (13%), and back problems (13%) (ABS 2019).

Mental or behavioural disorders were reported as the main condition by almost one-quarter (23%) of people with disability. The most common mental or behavioural disorders were psychoses and mood disorders (7.5%), and intellectual and development disorders (6.5%) (ABS 2019).

For more information on the prevalence of disability within specific health conditions, see People with disability in Australia, Chronic conditions and disability.

Psychosocial disability

In 2018, 26% of all people with disability in Australia had psychosocial disability, that is disability related to nervous or emotional condition, mental illness or condition, memory problems or periods of confusion, or social or behavioural difficulties. For 59% of people with psychosocial disability, their disability is severe or profound (ABS 2020).

Health risk factors

People with disability generally have higher rates of some modifiable health risk factors and behaviours than people without disability. There can be particular challenges for people with disability in modifying some risk factors; for example, where extra assistance is needed to achieve a physically active lifestyle, or where medication increases appetite or affects drinking behaviours.

The 2022 NHS shows that 53% of people with disability aged 2 and over reported eating insufficient serves of fruit and vegetables per day (AIHW analysis of ABS 2023) (Figure 3). This is similar for people without disability (49%).

Figure 3: People aged 2 and over living in households, by whether fruit and vegetable consumption meets recommended guidelines and disability status, 2022

People with disability are more likely than those without disability to not meet recommended guidelines for fruit or vegetable consumption (53% compared with 49%).



Notes

  1. Fruit and vegetable consumption guidelines are based on 2013 National Health and Medical Research Council (NHMRC) Australian Dietary Guidelines. Collected for people aged 2 and over.
  2. ‘With disability’ includes people with disability or restrictive long-term health condition.

Source: AIHW analysis of ABS 2023.

Adults (aged 18 and over) with severe or profound disability are more likely than those with other disability or without disability to report an insufficient level of physical activity in the last week (89%, compared with 76% and 74%, respectively) (AIHW analysis of ABS 2023) (Figure 4).

Figure 4: Adults living in households, by whether met guidelines for physical activity including strengthening in the last week, and disability status and severity, 2022

Adults with severe or profound disability are more likely than those with other disability or those without disability to not meet recommended guidelines for physical activity (89%, compared with 76% and 74%, respectively).



Notes

  1. Data are for people aged 18 and over.
  2. Physical activity guidelines are based on 2014 Australia’s Physical Activity and Sedentary Behaviour Guidelines. For ages 18–64, the guidelines recommend 150 to 300 minutes of moderate intensity physical activity or 75 to 150 minutes of vigorous intensity physical activity (or an equivalent combination) over 5 or more days in the last week, and muscle strengthening activities on at least 2 days in the last week. For adults aged 65 and over, the guidelines recommend 30 minutes or more of physical activity on each day in the last week. Collected for people aged 15 and over.
  3. ‘Severe or profound disability’ means severe or profound core activity limitation – always or sometimes needing assistance or supervision with self-care, mobility, and/or communication.
  4. ‘Other disability’ – disability with status other than severe or profound core activity limitation.

Source: AIHW analysis of ABS 2023.

Additionally, in 2022, compared with adults without disability, adults with disability were more likely to:

  • be considered overweight or obese, with a Body Mass Index over 25 (72% compared with 62%)
  • report daily smoking (14% compared with 8.6%)
  • have uncontrolled high blood pressure (29% compared with 20%) (ABS 2022).

For more information, see People with disability in Australia, Health risk factors and behaviours.

Reporting on health and wellbeing of people with disability for Australia’s Disability Strategy

Australia’s Disability Strategy 2021–2031 (the Strategy) is Australia’s national disability policy framework. It sets out a plan for continuing to improve the lives of people with disability in Australia through to 2031.

The Strategy is supported by an Outcomes Framework. The Outcomes Framework is a key initiative under the Strategy to measure, track and report on the outcomes for people with disability across 7 outcome areas.

One of these outcome areas is Health and Wellbeing. This outcome area is about making it easier for people with disability to get good health care and services when they need it. It includes 4 priorities with a total of 11 measures that are used to track what changes over time. The priorities are:

  • Health and wellbeing
  • Prevention and early intervention
  • Mental health
  • Emergency responses.

For more information, see Reporting on Australia’s Disability Strategy 2021–2031.

Where do I go for more information?

For more information on the health of people with disability, see:

For more on this topic, see Disability.