The Centre of Research Excellence in Disability and Health (CRE-DH) is conducting a five-year Delphi study (2017-21) to perform multiple iterations of data collection with an expert panel of key stakeholders involved in disability and health policy. Data collection will take place twice yearly, consisting of an in-person or phone interview and an online survey. The Delphi study expert panel functions as a “Policy Lab” to identify stakeholder issues, map current and emerging policy concerns, and allow for the development of innovative ideas on policy reform.
The purpose of this report is to provide a descriptive account of the findings from the first round of interviews conducted through the Policy Lab in October-December 2017. These interviews focused on three critical areas:
- Health inequities experienced by working-age (15 to 64 years) Australians with disability
- Current effectiveness of policy in this area
- Proposed policy objectives to address identified issues
This section provides a summary of the key themes and issues raised by Policy Lab Members in the first round of interviews.
Five areas were explored in the interviews namely health inequities, social determinants of health, the evidence base
in disability and health, effectiveness of current policy, and future policy objectives in disability and health.
The Policy Lab unanimously agreed that working-age Australians with disability experience significant health inequities that are related to a number of social determinants of health. The term health inequality is generically used to describe differences or variations in the health of individuals or groups. Any measurable aspect of health that differs between individuals or across socially relevant groups can be termed a health inequality. Health inequity on the other hand refers to inequalities in health that are not only unnecessary and avoidable but are also deemed unfair or unjust. Access to health services and experience when using health services for people with disability was the key theme to emerge from the discussion on health inequities. This is impacted by a range of factors which can be grouped into three sub-themes:
- Geographical factors
- Living in rural/remote regions
- Physical accessibility issues
2. Demographic factors
- Socio-economic disadvantage
- Aboriginal and Torres Strait Islander people experience greater inequities
- People from culturally and linguistically diverse backgrounds experience greater inequities
- Impairment type
3. Organisational factors
- Hospital care issues
- Supported care issues
- Health professional training and communication
- Health promotion/preventative health
Policy Lab Members agree that these factors contextualise and go some way to explaining why people with disability have poorer health outcomes than those without disability. Compared with non-disabled people, people with disability have more co-morbidities not necessarily related to impairment (i.e. diabetes, obesity, smoking related diseases) and lower life expectancy.