Defining disability

In Australia, many data collections identify disability based on concepts from the World Health Organization’s (WHO)International Classification of Functioning, Disability and Health (ICF).

Under the ICF, a person’s functioning or disability—in terms of impairment, activity limitation, and/or participation restriction—is a dynamic interaction between a person’s health condition(s) and environmental and/or personal factors (Figure 1; WHO 2001).

All ICF components are distinct but interrelated. On the one hand, a person’s negative experience relating to a component may constitute disability. On the other hand, a person’s experience of disability is often complex and multidimensional, meaning that all components together may constitute disability.

Figure 1: International Classification of Functioning, Disability and Health

Source: WHO 2001.

In this way, disability exists in various degrees and combinations among individuals and can be considered as a continuum, from having no impairment or limitation to the complete loss of functioning or ability to complete a task. It can be the result of genetic disorders, illnesses, accidents, ageing, or a combination of these factors. Importantly, how people experience their disability is affected by environmental factors—including the opportunities, services and assistance provided to them—as well as by personal factors and community attitudes.

While disability identification in Australian data collections is generally based on the ICF, the actual definition and identification of disability used in each collection can vary, depending on the collection’s type and purpose. For instance, definitions in population surveys can vary between different types of surveys as well as from those used to determine eligibility for support services or payments. For example:

  • the Australian Bureau of Statistics’ Survey of Disability, Ageing and Carers uses a comprehensive set of questions to determine disability and is considered the gold standard of disability identification in Australia
  • other Australian Bureau of Statistics’ surveys, such as the National Health Survey, use a shorter set of questions to identify disability (the Short Disability Module)
  • the NDIS bases eligibility on a narrower concept of disability in terms of people who have a significant impairment to their functional capacity.

Some data collections, such as on hospital admissions, do not identify disability at all.

The incomplete and inconsistent identification of people with disability across data sources presents challenges to our understanding of disability, including the extent to which people with disability interact with mainstream and other services (see Key data gaps).

References

WHO (World Health Organization) 2001. International Classification of Functioning, Disability and Health (ICF). WHO. Geneva. https://www.who.int/classifications/icf/en/