Is Life Getting Better or Worse for People with Disabilities?

Without data, it is not possible to know whether initiatives are really making a positive difference to people’s lives, write Eric Emerson, George Disney, Nicola Fortune, and the NHMRC Centre of Research Excellence in Disability and Health Research Group.

Over the past decade we have seen a host of important government commitments to improve the lives of Australians with disabilities.

In 2008, Australia ratified the UN Convention on the Rights of Persons with Disabilities, undertaking an international obligation to realise the rights of people with disabilities and eliminate discrimination. The National Disability Strategy was launched in 2011, to achieve “an inclusive Australian society that enables people with disability to fulfil their potential as equal citizens”. In 2013, the National Disability Insurance Scheme (NDIS) Act was passed and roll-out of the scheme began in 2016.

How do we know whether major government initiatives such as these deliver real, meaningful change to improve people’s lives? Is life getting better or worse for people with disabilities?

A recent study from our Centre of Research Excellence in Disability and Health (CRE-DH) has confirmed what we already know: people with disabilities experience discrimination and disadvantage in many areas of their lives.

But our study findings are especially worrying because they suggest that, in most aspects of life, inequities between working-age Australians with and without disabilities are persisting, and in some areas growing.

Using data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, we looked at trends in disadvantage for Australians with disabilities aged 15 to 64 years (working age), between 2001 and 2016. Over the 16-year period, on average, 21 per cent of working-age people had a disability.

We examined how people with disability fared in comparison with their non-disabled peers across 12 aspects of life.

The results showed that, between 2001 and 2016, there were improvements in life outcomes for people with disabilities on six of the 12 indicators.

However, there was a narrowing of the gap between people with and without disability in only three areas: health (measured as self-rated health status), safety (measured as experience of physical assault in the previous 12 months), and “a fair go” (measured as household financial stress).

The gap between people with and without disability increased for three of the indicators: close relationships (measured as people who disagree with the statement “I don’t have anyone that I can confide in”), learning and knowledge (measured as people with a vocational or higher education qualification), and opportunities (measured as people with a Certificate III or above or employed in a skilled occupation).

What is needed now

As a society, we need to know whether the programs and initiatives our governments invest in really work.

Good quality data is crucial. As well as the HILDA survey, many excellent sources of national data are available to inform debate and policy action. However, there is no mechanism in place for using this data to monitor progress on reducing inequities for people with disabilities.

In the National Disability Strategy 2010-2020, all Australian governments made a commitment to “a unified, national approach to improving the lives of people with disability”. The strategy set out six areas of policy action and promised that a high-level report would be produced every two years “to track progress for people with disability at a national level” in each of these areas. Regrettably, this reporting has not occurred.

Without data, it is not possible to know whether initiatives such as the National Disability Strategy are really making a positive difference to people’s lives.

We are developing a new monitoring framework and indicators to report baseline data and track change over time in health-related inequities for working-age Australians with disabilities.

Crucially, people with lived experience of disability are having input. This will ensure that all the health, social, economic and wellbeing issues that are important to people with disabilities are included. Regular reporting of data against the indicators will be valuable for focusing and informing public discussion, and showing where action is required to promote the health and flourishing of people with disabilities.

You can access the full A Fair Go? report here.

For inquiries contact Nicola Fortune on 0401 643 483 or email: nicola.fortune@sydney.edu.au

About the authors: The Centre of Research Excellence in Disability and Health is an NHMRC-funded, interdisciplinary research initiative that aims to build knowledge and gather the evidence needed to guide social and health policy reform for people with disabilities in Australia.

Eric Emerson is professor of disability population health at the Centre for Disability Research and Policy at the University of Sydney, where he leads the centre’s stream of work on disability and disadvantage. He is also emeritus professor of disability and health research at the Centre for Disability Research, Lancaster University, UK and formerly the founding director of the English specialist Public Health Observatory on intellectual disabilities.

George Disney is a research fellow working on the social determinants of health for people with disabilities, based at the Centre for Health Equity, University of Melbourne. He has a background in demography and social statistics. His research interests are in examining how socioeconomic inequality in society affects population health and population statistics including their uncertainty.

Nicola Fortune is a research fellow at the Centre for Disability Research and Policy at the University of Sydney, working on the development of a monitoring framework and indicators for reporting on the health of working-age adults with disabilities. Nicola’s background is in disability and health data, and the development of health classifications.