Disability affects most people directly or indirectly, to varying degrees and at different life stages.[46] People living with disability are diverse; they have different types and levels of disability, live in a variety of circumstances, and require various forms of assistance.
Around one in six people in Australia (18%, or about 4.4 million people) live with disability.[46]
The longer people live the more likely they are to experience some form of disability, with one in two people (50%) over 65 years of age in Australia living with disability.[46][47]
Among people living with disability in Australia[46]:
People identifying as belonging to diverse populations may identify across multiple priority population groups. This intersectionality can result in compounding impacts of social, cultural, commercial and environmental determinants of health on cancer experiences and outcomes.
There are no nationally available cancer data for people living with disability and cancer; however, from 2009–2010 to 2013–2014, 13% of people aged 65 years or younger entering aged care reported cancer as their main condition.[48] Cancer survivors are more likely to experience disability and poorer wellbeing outcomes than those without cancer, particularly for people experiencing other chronic conditions, and for people living with incurable metastatic disease.[49] The formal classification of disability as a result of a cancer diagnosis or its treatment is an emerging issue in Australia.
Schemes such as the National Disability Insurance Scheme (NDIS) provide funding to eligible people with disability and connect them to services in their community. When a person acquires a disability due to their cancer experience, navigating support systems can be difficult and confusing.
People living with disability report poorer general health and higher levels of psychological distress than people without disability.[46] They often have higher rates of some cancer risk factors and behaviours than people without a disability, such as smoking and lower physical activity.[46] People living with disability often experience more barriers and have poorer access to preventive care and cancer screening services, potentially leading to underestimation of cancer risk behaviours and disease detection.[50][51]
People living with disability may not always be involved in conversations and decisions regarding their care. Increasing health provider awareness and understanding of the needs of people living with disability, and their decision makers, is important to improving health outcomes for this population group.[50][52]
The Australian Cancer Plan aims to improve equity in cancer experience and outcomes for people living with disability.
This includes increasing support to enable people with disability to be actively involved in health care decisions, improving access to cancer care, and co-designing and integrating education and training for healthcare providers. This will improve understanding and enhance cancer care for people living with disability.
Disability caused by a cancer diagnosis or treatment requires further policy consideration.
Year: 2021
Author: The Department of Social Services, Australian Government
Australia's Disability Strategy 2021–2031 aims to provide national leadership towards a more inclusive and accessible Australian society where all people living with disability can fulfil their potential as equal members of the community.
Year: 2021
Author: The Department of Health and Aged Care, Australian Government
The National Roadmap for Improving the Health of People with Intellectual Disability provides a pathway to improve the health of people with intellectual disability by addressing the health inequities faced by people with intellectual disability.
Year: In development
Author: Australian Centre for the Prevention of Cervical Cancer
The National Strategy for the Elimination of Cervical Cancer will aim to eliminate cervical cancer for all people with a cervix across the diverse communities in Australia.
Year: 2021
Author: The Department of Social Services, Australian Government
Australia's Disability Strategy 2021–2031 aims to provide national leadership towards a more inclusive and accessible Australian society where all people living with disability can fulfil their potential as equal members of the community.
Year: 2021
Author: The Department of Health and Aged Care, Australian Government
The National Roadmap for Improving the Health of People with Intellectual Disability provides a pathway to improve the health of people with intellectual disability by addressing the health inequities faced by people with intellectual disability.
Year: In development
Author: Australian Centre for the Prevention of Cervical Cancer
The National Strategy for the Elimination of Cervical Cancer will aim to eliminate cervical cancer for all people with a cervix across the diverse communities in Australia.
People living with disability often experience barriers to accessing preventive care. Stakeholders advised that communications and resources relating to preventive health are not always accessible: for example, they should be spoken and written in plain English.
People living with disability often experience barriers to accessing preventive care. Stakeholders advised that communications and resources relating to preventive health are not always accessible: for example, they should be spoken and written in plain English.
Stakeholders noted the need for effective communication between healthcare providers and people living with disability when giving complex information relevant to their cancer care. Opportunities exist to strengthen communication through audiovisual support tools and ensuring the presence of a carer or support worker.
Stakeholders identified the importance of empowering people living with disability to be partners in their care by involving them in conversations and enabling them to make informed decisions about their cancer care needs.
Disability support workers perform an enabling role in improving experiences with, and navigating access to, cancer care services for people living with disability.
People living with disability have a variety of care needs. People living with disability can experience difficulties navigating the cancer care system and are not always supported to participate in conversations and decisions regarding their care. It is important to adopt a person-centred approach, and to understand each person’s disability and their individual needs, throughout their care pathway.
Innovative, evidence-based models of care that include multidisciplinary teams for people living with disability including practitioners with expertise in relevant disabilities, and/or teams with an existing relationship to the consumer, including their carers and families.
Innovative, evidence-based models of care that include multidisciplinary teams for people living with disability including practitioners with expertise in relevant disabilities, and/or teams with an existing relationship to the consumer, including their carers and families.
Consistent and high-quality data collection approaches are required to identify people living with disability who are navigating the cancer care system.
Stakeholders emphasised the importance of the cancer care workforce involving people living with disability in conversations about their cancer care, to strengthen patient-centred cancer care and informed decision making.
Opportunities exist to upskill the cancer care workforce to ensure that health professionals understand the needs of people living with disability, such as disability awareness training.
The Australian Cancer Plan considers an intersectional and health equity approach for Aboriginal and Torres Strait Islander people. This is more than recognising the multiple backgrounds, experiences, and ways Aboriginal and Torres Strait Islander people identify. This approach addresses the way membership of multiple groups may impact people's health and wellbeing needs and ability to access care.
Implementation of each action should consider the compounding impacts of intersectionality across other priority population groups.