More than 1.4 million Australians receive the Disability Support Pension (DSP) or the Newstart Allowance (NSA). The annual cost to government of benefit payments alone to these two groups exceeds $27 billion. Global evidence shows that people receiving such social assistance benefits have poorer health on average than other working age people in paid employment. There is also evidence that changes in benefit scheme design and procedures can contribute to changes in health. There have been many changes to process and to policy in the Australian benefit system, administered by Centrelink, over the past decade. There are also very few recent studies focused on the health status and health service use of Australians receiving the DSP or the NSA.

Highlights:

1. This study analysed self-reported health and health service use data from 638 Disability Support Pension (DSP) recipients, 442 Newstart Allowance (NSA) recipients and 8440 wage earners who completed the 2014/15 National Health Survey.
2. 38% of DSP recipients rated their health as good, very good or excellent, compared with 67% of NSA recipients and 91% of wage earners.
3. Despite 16% of DSP recipients in this study reporting psychological disability as their main disability type, 69% reported experiencing a mental or behavioural problem. People receiving the DSP reported a much higher prevalence of mood disorders, anxiety disorders, depression, obsessive compulsive disorder, alcohol and drug problems, post-traumatic stress disorder and problems of psychological development than wage earners.
4. The same pattern was observed among NSA recipients, where 8% reported psychological disability as their main disability, yet 48% reported experiencing a mental or behavioural problem.
5. People receiving the DSP and the NSA were more likely than wage earners to report health problems across a range of other disease categories. Both DSP and NSA groups were at greater risk of multimorbidity (presence of multiple health conditions) than wage earners.
6. The rate of health service use was much higher in DSP recipients than wage earners. For example, more than two in every five (42.6%) DSP recipients visited a General Practitioner more than 10 times in the previous 12 months, compared to less than 5% of wage earners and 19% of NSA recipients.
7. More than one quarter (26%) of DSP recipients reported being admitted as a hospital inpatient in the previous 12 months and nearly one-quarter (23%) reported at least one visit to an emergency department. DSP recipients were at 2 to 3 times the risk of visiting a hospital than wage earners, while NSA recipients were at 1.5 to 2 times increased risk compared with wage earners.