Components of disability exclusion: Discrimination, avoidance and accessibility in later life

Abstract

Objective: Examine the prevalence and context of disability exclusion reported by people with disability, with and without communication and mobility problems.Methods: The 2015 Survey of Disability Ageing and Carers was used to measure the prevalence of reported exclusion. Tests of proportions were used to examine differences in prevalence rates. Proportional Venn diagrams were used to examine the intersection of measures of exclusion.Results: Approximately 53% of those with a communication or mobility difficulty reported at least one measure of exclusion. Among this group, 7% reported an instance of discrimination, 44% reported avoidance and 29% reported an accessibility problem.The levels of discrimination and avoidance for those without communication or mobility difficulties was approximately half this level (16% avoidance and 3% discrimination). Avoidance and discrimination reduced with age, but accessibility was age-invariant. Exclusion measures intersected and occurred in a variety of contexts.Conclusion: Despite protections provided in Australian law, disability exclusion persists and is high among those with communication and mobility difficulties.

Is disability exclusion associated with experiencing an unmet need for health care?

“…This finding is consistent with the finding elsewhere in this special feature showing that avoidance of healthcare due to disability had a significantly lower prevalence rate than discrimination in healthcare settingsindicating that some people with disabilities have no option but to expose themselves to contexts in which they may experience discrimination to attend to their healthcare [5]. Moreover, hospital visits by their nature, are generally more acute, rather than chronic.…”

“…A considerable evidence base exists on the high levels of stigma faced by people living with disability [1][2][3]. Australian studies have estimated population-level prevalence rates of disability discrimination (unfair treatment attributed to disability specifically) in the working age population (14%), in later life (4.5%) and across the full life course (9%) [4][5][6]. Levels of discrimination more generally (attributed to a range of characteristics, eg.…”

“…Moreover, recent research evidence suggests that as many as 1 in 4 older people with a disability avoid contexts or situations due specifically to their disabilities [4]. This may occur because of previous or anticipated experiences of discrimination, or accessibility barriers that prevent them from engaging in a range of situations or contexts, including accessing healthcare [5].…”

Discrimination and disability: Types of discrimination and association with trust, self‐efficacy and life satisfaction among older Australians

“…In contrast, a lower percentage of older Australians who reported no disability reported experiencing discrimination (9%). The finding that people with disabilities, and in particular more severe disabilities, are at a higher risk of experiencing any type of discrimination (relative to those without disabilities) is not surprising and is consistent with a large evidence base on disability stigma [16][17], and growing evidence base on disability discrimination specifically [9][10][11][12][13].…”

“…One group of Australians that have been cited as particularly prone to discrimination and at risk of social exclusion are people living with disabilities [8][9][10][11]. To date, there is scant population-level evidence on the types of discrimination reported by older people living with disabilities.…”