Health status

24% of adults

with disability rate their health as excellent or very good (65% of adults without disability)

42% of adults

with disability rate their health as fair or poor (7.0% of adults without disability)

32% of adults

with disability experience a high or very high level of psychological distress (8.0% without disability)

Introduction

One way to measure health is to ask people how they feel about their health, their state of mind and their life in general. This section looks at the health status of Australians with disability based on 2 common survey tools:

  • self-assessed health status
  • Kessler Psychological Distress Scale (K10).

These indicate that people with disability experience poorer general health and higher levels of psychological distress than people without disability.

National Health Survey 

The data used in this section are largely from the Australian Bureau of Statistics’ (ABS) 2017–18 National Health Survey (NHS). The NHS was designed to collect information about the health of people, including:

  • prevalence of long-term health conditions
  • health risk factors such as smoking, overweight and obesity, alcohol consumption and physical activity
  • demographic and socioeconomic characteristics (ABS 2018a).

The NHS uses the ABS Short Disability Module to identify disability. 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.

While the module applies criteria similar to those used to identify disability in the ABS Survey of Disability, Ageing and Carers (SDAC), it uses a reduced set of questions and is not considered as effective in identifying disability. In particular, it overestimates the number of people with less severe forms of disabilities (ABS 2018b).

The Short Disability Module produces an estimate of disability known as ‘disability or restrictive long-term health condition’. In this section, people with disability or restrictive long-term health condition are referred to as ‘people with disability’.

The NHS considers that a person has disability if they have one or more conditions which have lasted, or are likely to last, for at least 6 months and restrict everyday activities.

Disability is further classified by whether a person has a specific limitation or restriction and then by whether the limitation or restriction applies to core activities or only to schooling or 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 reported for mild, moderate, severe, and profound limitation. People who always or sometimes need help with one or more core activities are referred to in this section as ‘people with severe or profound disability’.

The NHS collects data from people in private dwellings and does not include people living in institutional settings, such as aged care facilities. It may underestimate disability for some groups, such as people aged 65 and over, and those with severe or profound disability.

ABS SDAC

The ABS SDAC also collects information on the health status of people with disability. It does not, however, for people without disability, so comparisons between people with and without disability cannot be made. Data using the SDAC are included in the supplementary data tables for reference.


General health

An estimated two-thirds (65%) of adults without disability consider their health excellent or very good (Figure STATUS.1). This is not the case for people with disability, with only one-quarter (24%) rating their health as excellent or very good.

Self-assessed health status

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. It has some limitations, including being influenced by factors such as a person’s access to health services (for example, to diagnosis and treatment), and level of education.

In the ABS NHS, self-assessed health status is collected for people aged 15 and over against a 5-point scale from excellent to poor. The supplementary data tables accompanying this section include data for adults, as presented on this page, and those aged 15 and over.

In general, adults with disability rate their health as poorer than adults without disability:

  • Adults with disability (42%) are 6 times as likely as those without disability (7.0%) to assess their health as fair or poor.
  • Adults with severe or profound disability (62%), are almost 9 times as likely as adults without disability (7.0%), and almost twice as likely as adults with other disability (37%) to assess their health as fair or poor.
  • Men with disability (44%) are around 6 times as likely as men without disability (7.9%) to assess their health as fair or poor.
  • Women with disability (40%) are around 7 times as likely as women without disability (6.0%) to assess their health as fair or poor (Figure STATUS.1).

There was little difference between self-assessed health status of older (aged 65 and over) and younger (aged 18–64) adults with disability (Figure STATUS.1).

Figure STATUS.1: Self-assessed health status of adults, by disability status, age group and sex, 2017–18
Stacked column chart showing 3 categories of health status for men, women and all adults, with and without disability. The reader can select to display the chart by disability status, age group and sex. The chart shows adults with severe or profound disability are more likely (62%) to rate their health status as fair or poor than adults without disability (7%). 


Mental health

Self-reported psychological distress is an important indication of the overall mental health of a population. Most (an estimated 70%) adults without disability experience a low level of psychological distress (Figure STATUS.2). This is not the case for adults with disability, of whom less than half (42%) experience a low level of psychological distress.

Kessler Psychological Distress Scale (K10)

The Kessler Psychological Distress Scale (K10) is a set of 10 questions used to measure non-specific psychological distress in people. The questions ask about negative emotional states that participants in the survey may have experienced in the 4 weeks leading up to their interview. Higher levels of psychological distress indicate that a person may have, or is at risk of developing, mental health issues.

The ABS NHS K10 is collected for people aged 18 and over, excluding interviews conducted with proxy respondents (where the selected respondent is not able to answer for themselves).

In general, adults with disability experience higher levels of psychological distress than those without disability. This is particularly true for those with severe or profound disability. For example, high or very high levels of psychological distress are more likely to be experienced by:

  • adults with disability (32%) – 4 times as likely as those without disability (8.0%)
  • adults with severe or profound disability (40%) – compared with adults with other forms of disability (30%)
  • men with disability (31%) – around 5 times as likely as those without disability (6.8%)
  • women with disability (32%) – around 3 times as likely as women without disability (9.2%) (Figure STATUS.2).

Younger adults (aged 18–64) with disability are more likely to experience a higher level of psychological distress than older adults (aged 65 and over) with disability (Figure STATUS.2).

Figure STATUS.2: Psychological distress (K10 score) for adults, by disability status, age group and sex, 2017–18
Stacked column chart showing 4 categories of psychological distress for adults with and without disability. The reader can select to display the chart by disability status, by age groups 18–64, 65 and over, or all adults, and by sex. The chart shows adults with severe or profound disability aged 18–64 are more likely (17%) to experience very high levels of psychological distress than those aged 65 and over (5%). 

Disability group

Disability group is a broad categorisation of disability. It is based on underlying health conditions and on impairments, activity limitations and participation restrictions. It is not a diagnostic grouping, nor is there a one-to-one correspondence between a health condition and a disability group

Looking at disability groups, the most likely to experience a high or very high level of psychological distress are adults with:

  • psychological disability (76%)
  • intellectual disability (60%)
  • head injury, stroke or brain damage (55%).

The least likely to experience this are adults with:

  • sensory disability (sight, hearing or speech) (28%)
  • physical disability (33%) (ABS 2019).

Health satisfaction

Household, Income and Labour Dynamics in Australia Survey

Data in this section are sourced from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The HILDA Survey is a nationally representative, household-based longitudinal study of Australian households and individuals conducted in annual waves since 2001. Members of selected households who are Australian residents and aged 15 or over are invited to participate in a personal face-to-face interview. This section presents cross-sectional analyses of the 17th wave (2017). In 2017 almost 18,000 people from around 10,000 households participated in the HILDA Survey.

The HILDA Survey defines disability as an impairment, long-term health condition or disability that restricts everyday activities and has lasted, or is likely to last, for 6 months or more. This is similar to the definition of disability used by the ABS Short Disability Module. In this section people who always or sometimes need help or supervision with at least one core activity because of their disability are referred to as people with ‘severe or profound disability’. Core activities include self-care, mobility and communication. People who have a disability but do not always or sometimes need help or supervision with at least one core activity are referred to as people with ‘other disability’. The HILDA Survey does not collect information on level of disability in every wave. The most recent collection was in the 17th wave (2017) (Summerfield et al. 2019; Wilkins et al. 2019).

Disability group

Disability group is a broad categorisation of disability. It is based on underlying health conditions and on impairments, activity limitations and participation restrictions. It is not a diagnostic grouping, nor is there a one-to-one correspondence between a health condition and a disability group.

The HILDA Survey collects information on 17 disability types, which have been combined into the following 6 disability groups:

  • sensory: includes sight, hearing, and speech problems
  • intellectual: includes difficulty learning or understanding things
  • physical: includes difficulty breathing, blackouts, chronic pain, limited use of arms or fingers, difficulty gripping things, limited use of feet or legs, physical restrictions, and disfigurement or deformity
  • psychosocial: includes nervous or emotional conditions, and mental illness
  • head injury, stroke or other brain damage
  • other: includes long-term conditions that are restrictive despite treatment or medication, and other long-term conditions.

Health satisfaction

In 2017, HILDA Survey participants were asked to rate their satisfaction with their own health on a scale from 0 to 10. Ten represents the highest level of satisfaction and 0 the lowest (DSS and MIAESR 2019). In this analysis, people who indicate a satisfaction level between 6 and 10 are referred to as being satisfied or somewhat satisfied with their health.

More than 9 in 10 (92%) people aged 15–64 without disability are satisfied or somewhat satisfied with their health. This is not the case for people with disability, with only 6 in 10 (59%) being satisfied or somewhat satisfied. Of people with disability aged 15–64:

  • those with severe or profound disability are less likely (27%) to be satisfied or somewhat satisfied with their health than those with other disability status (63%)
  • those with psychosocial disability are less likely (42%) than those with sensory disability (61%) (DSS and MIAESR 2019).