Disability Transitions Across the Life Course: Preliminary Data from Australia

The aim of this working paper is to present preliminary analyses of longitudinal data from Australia that addresses various aspects of the dynamic nature of disability over time. Disability research is dominated by cross-sectional studies that have examined the prevalence and correlates of disability at a particular point in time. As a result, little is known about the duration of disability or the factors that may be associated with disability offset. This reliance on cross-sectional data has served to reinforce the notion that disability once acquired is a relatively permanent state. In recent years, the increasing availability of longitudinal data (especially from well-constructed population-based surveys) has opened up new opportunities for disability research. These have included the possibility of investigating the dynamic nature of disability over time. The data presented in this working paper are based on analysis of ten years of data collected by the study of Household Income and Labour Dynamics in Australia (HILDA). Our analyses focused on the most recent consecutive five year period in which the study participants provided information on their disability status.Centre for Disability Research and Polic

LEFT BEHIND: 2013 MONITORING THE SOCIAL INCLUSION OF YOUNG AUSTRALIANS WITH SELF-REPORTED LONG TERM HEALTH CONDITIONS, IMPAIRMENTS OR DISABILITIES 2001 - 2011

Disabled Australian adolescents and young adults are more likely to experience social exclusion than their non-disabled peers. The gap between the two actually widened between 2001 and 2011. Social exclusion in adolescence leads to poor outcomes, such as lower educational achievement and unemployment, in adulthood. It affects not only the health and wellbeing of the individual; it also impacts on their family and the wider community. The inability of people with disabilities to participate socially and economically is a loss to the whole of society. This report maps the extent of social inclusion or exclusion of young disabled Australians, aged between 15 and 29, over the years 2001 to 2011. It found that although the social inclusion of young disabled Australians increased on a number of key indicators, the gap between disabled and non-disabled young Australians actually increased over the 11 year period. On 13 key indicators of social inclusion including employment, living in a jobless household, having support from family or friends in times of crisis and feeling safe, young disabled Australians are now more disadvantaged compared to their non-disabled peers than they were in 2001.Centre for Disability Research and Polic

The Well-being of Children with Disabilities in the Asia Pacific Region: Analysis of UNICEF MICS 3 Survey Data from Bangladesh, Lao PDR, Mongolia and Thailand

In this report we have used data from the third round of UNICEF’s Multiple Indicator Cluster Surveys (MICS) conducted 2005-8 to describe the relative well-being of disabled and non-disabled children in four South Asian/Pacific countries: Bangladesh, Lao PDR, Mongolia and Thailand. Indicators of well-being were extracted to address issues such as the child’s right to education, health and a standard of living adequate for the child's physical, mental, spiritual, moral and social development. Our main findings were: In all four countries children with disabilities were markedly more disadvantaged than their non-disabled peers on the majority of the indicators available. In all four countries children with disabilities were markedly more disadvantaged than their non-disabled peers on indicators relating to the child’s right to education, health and an adequate standard of living. In all four countries there were notable differences between disabled children regarding the extent of disadvantage they faced. In both Bangladesh and Lao PDR, for example, children with sensory impairments fared particularly poorly. In Thailand, by contrast, children with cognitive delay fared particularly poorly. These data are important on three counts. First, they demonstrate the viability of using simple items in population surveys to identify and characterize the well-being of disabled children. Second, they add to the limited evidence base on the well-being of children with disabilities in low and middle income countries. Third, they illustrate the importance of disaggregating disability information by type of impairment. UNICEF is working to establish a rigorous and systematic process for collecting data about children with disabilities, preferably as part of all ongoing data collections about children and young people locally, at national level and globally. This is critical to ensuring disabled children are not invisible in attempts to monitor global progress in improving the lives of children. The MICS module despite some limitations was an excellent first step in collecting data on children with disabilities as: (1) MICS is one of the main vehicles for monitoring progress toward achievement of the Millennium Development Goals;4 and (2) there is a growing consensus that achieving the Millennium Development Goals and reducing global inequalities in health and well-being will not be possible unless attention is paid to the specific situation of children with disabilities and other vulnerable groups.Centre for Disability Research and Polic

LEFT BEHIND: MONITORING THE SOCIAL INCLUSION OF YOUNG AUSTRALIANS WITH SELF- REPORTED LONG TERM HEALTH CONDITIONS, IMPAIRMENTS OR DISABILITIES 2001 - 2009

Adolescents and young adults with disabilities are at heightened risk of social exclusion. Exclusion leads to poor outcomes in adulthood which in turn affects individuals’ health and wellbeing and that of their families and society through loss of productive engagement in their communities. Australia’s Social Inclusion Indicators Framework provides indices in domains of participation, resources and multiple and entrenched disadvantage to monitor and report on social inclusion. The Household Income and Labour Dynamics in Australia survey provides data over time on households in Australia. Using these tools we report here on the extent of social inclusion/exclusion of young disabled Australians over the past decade. Relative to their non-disabled peers, young disabled Australians are significantly less likely to do well on participation indicators.Centre for Disability Research and Polic

Youth with Disabilities are More Likely than their Peers to Engage in Hazardous Child Labour

BackgroundLittle is known about the extent to which children and adolescents with disabilities are exposed to child labour.ObjectiveTo estimate prevalence rates and adjusted rate ratios of exposure to child labour among children and adolescents with/without disability in middle‐ and low‐income countries and to determine whether these rates vary between functional limitations associated with disability.Participants and SettingNationally representative samples involving 142,499 children aged 5–14 from 15 countries.MethodsSecondary analysis of data collected in UNICEF's Multiple Indicator Cluster Surveys.ResultsOverall children and youth with disability were not at significantly greater risk of exposure than children without disability to child labour when demographic and contextual factors were taken into account. However, children and youth with disability were at significantly greater risk of exposure than children without disability to hazardous child labour (adjusted relative risk [ARR] = 1.15 [1.10–1.21], P < 0.001). Specifically, children and youth with impairments related to poorer mental health or cognitive functioning were at significantly greater risk of exposure to hazardous child labour (e.g., ARR for learning impairment = 1.27 [1.14–1.42], P < 0.001). In contrast, children with impairments related to sensory functioning, mobility and expressive communication were at no greater risk of exposure than children with no disability.ConclusionsChildren and youth with disability are at greater risk of exposure to hazardous child labour than children with no disability in middle‐ and low‐income countries. Responses to eradicate hazardous child labour need to take account of the situation of children and youth with disability

Perceptions of safety and exposure to violence in public places among working age adults with disabilities or long-term health conditions in the UK:cross sectional study

ObjectivesTo examine perceptions of safety and exposure to violence in public places among working age adults with and without disabilities in the UK and to assess the extent to which any between-group differences may be moderated by gender and socio-economic situation.  Study designCross-sectional study. MethodsSecondary analysis of data collected in Wave 3 (2011-13) of Understanding Society. Data were extracted on a subsample of 5,069 respondents aged 16 to 64 (28% of whom had a disability/long-term health condition) who were administered a questionnaire module addressing experiences of harassment. Between-group comparisons were made on four self-reported indicators of safety. ResultsRespondents with disabilities/long-term health conditions were significantly more likely to have been attacked (adjusted OR 2.30, 95%CI(1.17-4.50), p<0.05), insulted (adjusted OR 1.48, 95%CI (1.16-1.90), p<0.01) and to feel unsafe in public places (adjusted OR 1.32, 95%CI(1.16-1.56), p<0.01) over the previous 12 months. There were no statistically significant differences between groups with regard to self-reported avoidance of public places. These associations were moderated by both gender and poverty status, with the increased risk of exposure to violence among people with disabilities being greater for both women and people living in poverty. ConclusionsThe data add further support to the growing evidence base suggesting that people with a disability/long-term health condition are at significantly increased risk of exposure to interpersonal violence, particularly if they are living in poverty or are women. As such, there is a clear need to develop interventions that are targeted to the particular circumstances and needs of these high risk groups

Prevalence of underweight, wasting and stunting among young children with a significant cognitive delay in 47 low and middle-income countries

Background Undernutrition in early childhood is associated with a range of negative outcomes across the lifespan. Little is known about the prevalence of exposure to undernutrition among young children with significant cognitive delay. Method Secondary analysis of data collected on 161 188 three‐ and four‐year‐old children in 47 low‐income and middle‐income countries in Rounds 4–6 of UNICEF's Multiple Indicator Cluster Surveys. Of these, 12.3% (95% confidence interval 11.8–12.8%) showed evidence of significant cognitive delay. Results In both middle‐income and low‐income countries, significant cognitive delay was associated with an increased prevalence of exposure to three indicators of undernutrition (underweight, wasting and stunting). Overall, children with significant cognitive delay were more than twice as likely than their peers to be exposed to severe underweight, severe wasting and severe stunting. Among children with significant cognitive delay (and after controlling for country economic classification group), relative household wealth was the strongest and most consistent predictor of exposure to undernutrition. Conclusions Given that undernutrition in early childhood is associated with a range of negative outcomes in later life, it is possible that undernutrition in early childhood may play an important role in accounting for health inequalities and inequities experienced by people with significant cognitive delay in low‐income and middle‐income countries

Significant cognitive delay among 3- to 4-year old children in low- and middle-income countries:prevalence estimates and potential impact of preventative interventions

Background We sought to: (i) estimate the prevalence of significant cognitive delay (a marked delay in the development of general cognitive functioning) among nationally representative samples of young children in middle- and low-income countries; (ii) estimate the total number of children under 5 years of age with significant cognitive delay living in low- and middle-income countries; and (iii) estimate the potential impact of five preventative interventions. Methods Secondary analysis of data collected in Rounds 4 and 5 of UNICEF’s Multiple Cluster Indicators Surveys in 51 countries involving 163 293 3- to 4-year-old children. Adjusted population-attributable fractions were used to estimate the potential impact of five interventions based on Sustainable Development Goals (SDGs). Results The prevalence of significant cognitive delay in 3- to 4-year-old children in middle- and low-income countries was 10.1% (95% confidence interval 9.7–10.4%). Prevalence was strongly inversely related to country economic wealth. The estimated total number of children under 5 with significant cognitive delay living in low- and middle-income countries was just under 55 million. This number could be reduced by over 60% if three separate SDGs were achieved; every mother had secondary-level education, every household had access to improved water and sanitation, and every child had an acceptable level of home stimulation. Conclusions Our results provide additional evidence in support of a range of specific preventative interventions in early childhood to reduce the loss of developmental potential among children in low- and middle-income countries

Adolescents’ Self-Report of School Satisfaction:The Interaction Between Disability and Gender

School satisfaction is a critical aspect of well-being for every child and adolescent. Yet studies have rarely investigated whether school satisfaction varies depending upon participant characteristics and school-related social factors. Here we investigated whether disability and gender moderate adolescents’ self-report of school satisfaction. We also explored the role of mediating variables such as teacher support, parent support, and relationships with peers (including friendships and also bullying). Our analysis of data from 3,830 adolescents revealed a significant interaction between disability and gender. Girls with disabilities reported the lowest school satisfaction, an effect that appeared to be more strongly mediated by perceived lack of teacher support than other variables. Our findings are novel in disaggregating school satisfaction data by both disability and gender to reveal an interaction between these variables and in investigating the role of mediating variables relating to school-related social factors