Research Paper
Intersections between disability, type of impairment, gender and socio-economic disadvantage in a nationally representative sample of 33,101 working-aged Australians

https://doi.org/10.1016/j.dhjo.2014.08.008Get rights and content

Abstract

Background

People with disabilities are socio-economically disadvantaged and have poorer health than people without disabilities; however, little is known about the way in which disadvantage is patterned by gender and type of impairment.

Objectives

1. To describe whether socio-economic circumstances vary according to type of impairment (sensory and speech, intellectual, physical, psychological and acquired brain injury). 2. To compare levels of socio-economic disadvantage for women and men with the same impairment type.

Methods

We used a large population-based disability-focused survey of Australians, analyzing data from 33,101 participants aged 25–64. Indicators of socio-economic disadvantage included education, income, employment, housing vulnerability, and multiple disadvantage. Stratified by impairment type, we estimated: the population weighted prevalence of socio-economic disadvantage; the relative odds of disadvantage compared to people without disabilities; and the relative odds of disadvantage between women and men.

Results

With few exceptions, people with disabilities fared worse for every indicator compared to people without disability; those with intellectual and psychological impairments and acquired brain injuries were most disadvantaged. While overall women with disabilities were more disadvantaged than men, the magnitude of the relative differences was lower than the same comparisons between women and men without disabilities, and there were few differences between women and men with the same impairment types.

Conclusions

Crude comparisons between people with and without disabilities obscure how disadvantage is patterned according to impairment type and gender. The results emphasize the need to unpack how gender and disability intersect to shape socio-economic disadvantage.

Section snippets

Disability and socio-economic disadvantage

Australians with disabilities have higher levels of socio-economic disadvantage than people with disabilities in economically similar countries. For example, adult Australians with a disability earn on average 68% of the income of those without disabilities – the lowest relative income of the 27 countries in the Organisation for Economic Cooperation and Development (OECD).1

Gender and disability

Although the overall prevalence of disabilities is similar for women and men in Australia (women 19%, men 18%),22 disabilities are gendered in their acquisition and possibly their enactment.23 For example, dominant norms of masculinity, such as risk-taking, place men at higher risk of accidents that may result in physical impairments. Men are more likely to be employed in manual jobs and so have higher risk of exposure to physical and chemical hazards.24 Women have higher rates of depression

Data source

We analyzed the Confidentialised Unit Record File (CURF) of the 2009 SDAC survey, a cross-sectional national survey conducted by the Australian Bureau of Statistics (ABS) from April to December 2009.42 The primary objective of the survey was to collect data on people who had a disability or long-term health condition and people aged 60 years and over, through face-to-face interviews with trained interviewers. The SDAC was conducted using a stratified multi-stage sample of individuals living in

Results

The sample consisted of 33,101 people (16,533 women and 16,568 men).

Statement of principal findings

People with disabilities fared worse for every indicator of socio-economic disadvantage compared to people without disability, with the exception of housing vulnerability for women and men with sensory and speech impairments, and low income for women with intellectual impairments. Women and men with intellectual and psychological impairments and acquired brain injuries were at particularly high risk of disadvantage. There were extremely high levels of inequality in paid employment; for example

Conclusion

In sum, we found that levels of socio-economic disadvantage were high for people with all impairment types, with those with psychological and intellectual impairments and acquired brain injuries being most disadvantaged. The areas of most concern are education and employment, which have flow-on effects to income, housing and health. From a public health perspective, improving the socio-economic conditions of people with disabilities should reduce disability-based health inequalities and reduce

Acknowledgments

We thank our partners Women with Disabilities Victoria, Hanover Welfare Services and VicHealth for their input into this work.

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    Conflict of interest statement: All authors have read and agreed to the final manuscript, have no conflicts of interest. The manuscript has not been submitted elsewhere.

    Funding: This research is funded by the Australian Research Council Linkage Grants “The importance of gender and socio-economic disadvantage for the mental health of people living with disabilities” (grant LP100200545), “New directions in health inequalities research: Understanding the intersection between housing, employment and health in Australia” (grant LP100200182) and an Australian National Health and Medical Research Council Strategic Award “Changing Patterns of Work: Impacts on Physical and Mental Health and the Mediating Roles of Resiliency and Social Capital” (grant 375196).

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