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Disability discrimination and avoidance in later life: prevalence, disability differentials and association with mental health

Published online by Cambridge University Press:  07 December 2018

Jeromey B. Temple Open the ORCID record for Jeromey B. Temple [Opens in a new window] ,
Margaret Kelaher  and
Ruth Williams
Jeromey B. Temple*
Affiliation:
Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
Margaret Kelaher
Affiliation:
Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
Ruth Williams
Affiliation:
Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
*
Correspondence should be addressed to: Jeromey B. Temple, Melbourne School of Population and Global Health, 207 Bouverie St, University of Melbourne, Melbourne, Victoria, 3010 Australia. Phone: +61 3 90359900. Email: [email protected].
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Abstract

Background:

Later life is a period of increased risk of disability, but there is little quantitative evidence regarding the exclusion of older people (through discrimination and avoidance) due to their health conditions. This study aims to (1) measure the prevalence of disability exclusion in later life, (2) examine how experiences of exclusion differ by disability type, and (3) investigate the association of exposure to exclusion with psychological distress.

Methods:

Using data from the 2015 ABS Survey of Disability, Ageing and Carers, we calculated the prevalence of people aged 55 years and over with a disability experiencing discrimination and engaging in avoidance behaviors, disaggregated by 18 detailed disability types. Modified Log-Poisson models were fitted to estimate Prevalence Ratios to measure the association between exclusion and psychological distress, stratified by disability type.

Results:

In 2015, about 5% of Australians aged 55 years and over with a disability reported experiencing an instance of disability discrimination, and one in four reported avoiding a situation or context due to their disability. Accounting for psychosocial comorbidities and with extensive demographic controls, exposure to disability avoidance (PR = 1.9, 95% CI 1.7, 2.1) or discrimination (PR = 1.7, 95% CI 1.4, 2.1) almost doubled the probability of experiencing psychological distress. Effects were heightened for individuals reporting specific disabilities including sensory and speech and physical disabilities as well as those reporting a head injury, stroke, or acquired brain injury.

Conclusions:

Despite protections against disability discrimination in legislation, discrimination and avoidance due to disability is prevalent and is associated with poor mental health outcomes.

Keywords

disabilitiesdiscriminationavoidancepsychological distress
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 9: Issue Theme: Self-Esteem, Resilience, and Emotional Intelligence , September 2019 , pp. 1319 - 1329
Copyright
© International Psychogeriatric Association 2018 

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