Living with Disability in New Zealand

Date of publication: October 2004
ISBN 0-478-28305-9
HP 4002

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Table of Contents:
Index
Foreword
Acknowledgements
1 Introduction
2 Patterns of Disability
3 Support, Equipment and Services
4 Education
5 Employment and Income
6 House and Home
7 Travel and Transport
8 Māori and Disability
9 Pacific Peoples and Disability
10 Adults with Disability Living in Residential Facilities
11 Future Focus
Glossary
Appendix 1: Classification of Disability Type
Appendix 2: Relative Sampling Error (RSE) Cut-off Points Used for this Report and Appendix Tables
Appendix 3: Tables in Excel format
References

3 Support, Equipment and Services

Within this section:
Key points
Introduction
Help with everyday activities
Respite care
Equipment and technology
Disposable items
Special dietary items
Needs assessments
Health services
Medication
Comparing 2001 and 1996

Key points

This chapter describes the kinds of support, equipment and services used or needed by adults and children with disability living in New Zealand households. [All the information in this chapter refers to adults and children with disability living in households. Information on the support, equipment and services used or required by adults living in residential facilities is in chapter 10.]

Help with everyday activities

Adults

• Adults with disability living in households were asked if disability meant someone else carried out or helped them with various everyday activities like dressing, bathing, preparing meals, shopping and housework:

- 6 percent of adults with disability (an estimated 34,900 people) were getting help with personal care (for example, bathing, dressing or taking medication)

- 11 percent (67,400) were getting help with meal preparation

- 16 percent (99,700) were getting help with shopping (for example, for groceries)

- 21 percent (128,500) were getting help with everyday housework (for example, tidying up, cleaning or laundry)

- 30 percent (186,700) were getting help with heavy household work (for example, spring cleaning or gardening)

- 8 percent (51,300) were getting help with personal finances (for example, banking or paying bills)

- 6 percent (39,100) were getting help with communicating (for example, during doctor's visits or job interviews).

Children

• Parents or caregivers of an estimated 11,700 children with disability (13 percent) indicated they had needed help in the previous 12 months with their child's disability-related personal care or with household work connected to the child's disability-related needs.

Unmet need for help with everyday activities

Adults

• Adults with disability were asked to indicate whether, in the previous 12 months, they had experienced any unmet need for help with everyday activities such as disability-related personal care, housework, shopping or meal preparation:

- 2 percent of adults with disability reported needing help with disability-related personal care (for example, dressing or bathing) from providers other than family or friends, but being unable to get this help

- 4 percent of adults with disability reported needing help with tasks such as housework or shopping from providers other than family or friends, but being unable to get this help

- 4 percent of adults with disability reported needing help with home repairs or property maintenance, but being unable to get this help.

Children

• Parents or caregivers of children with disability were asked to indicate whether, in the previous 12 months, they had experienced any unmet need for help with everyday activities related to caring for their child:

- parents or caregivers of 5 percent of children with disability reported an unmet need for help with their child's disability-related personal care

- parents or caregivers of 4 percent of children with disability reported an unmet need for help with household tasks related to caring for their child with disability

- parents or caregivers of 5 percent of children with disability reported an unmet need for help with home repairs or home maintenance related to caring for their child with disability.

Respite care

• Respite care (carer support) is a period of alternative care that enables a usual caregiver to take a break from looking after a person with disability. It may include another caregiver staying with, or visiting, a person with disability in their home, or the person with disability staying temporarily in a hospital, a rest home or another service providing out-of-home care.

Adults

• An estimated 108,000 adults with disability living in households had someone who helped them or looked after them because of disability or health problem. Eight percent of this group (an estimated 9100 adults) received financial help from a government agency in the previous 12 months to pay for respite care. Five percent of this group (5100 adults) paid for respite care or carer support in the previous 12 months. Ten percent (10,300 adults) had needed respite care in the previous 12 months, but had been unable to get it.

Children

• Parents or caregivers of 18 percent of children with disability reported needing respite care or carer support in the previous 12 months. This was the parents or caregivers of an estimated 16,600 children.
• Parents or caregivers of children using technical aids were the most likely to need respite care (51 percent), while parents or caregivers of children with hearing disability were the least likely to need respite care (13 percent).
• Forty-eight percent of parents or caregivers of children with disability needing respite care in the previous 12 months had been unable to get this respite care. This was the parents or caregivers of an estimated 8000 children.

Equipment and technology

Adults

• In 2001 an estimated 207,200 adults with disability (33 percent) were using equipment or technology to assist themselves.
• The following types of equipment were being used by adults with disability:

- equipment or services for hearing - used by 36 percent of adults with hearing disability (an estimated 75,600 adults)

- equipment or services for seeing - used by 71 percent of adults with seeing disability (an estimated 49,200 adults)

- equipment and technology for speaking and being understood - used by 3 percent of adults with speaking disability (an estimated 1200 adults)

- equipment for moving about - used by 16 percent of all adults with disability (an estimated 99,300 adults)

- equipment for helping hands or arms - used by 2 percent of all adults with disability (an estimated 13,900 adults)

- other types of equipment such as shower stools, raised toilet seats, commode chairs, specialised cushions, respirators or ventilators - used by 4 percent of all adults with disability (an estimated 26,000 adults).

• Altogether, 27 percent of adults with disability, an estimated 171,000 people, used some kind of equipment because of disability in the previous 12 months.

Unmet need for equipment or technology

• In 2001, an estimated 77,100 (or 12 percent) of adults with disability reported an unmet need for at least one type of equipment or technology.
• Adults with disability indicated they did not have the following equipment or technology they considered they needed:

- equipment or services for hearing - needed by 21 percent of adults with hearing disability (an estimated 45,000 adults)

- equipment for speaking and being understood - needed by 3 percent of adults with speaking disability (an estimated 1400 adults)

- equipment or services for seeing - needed by 20 percent of adults with seeing disability (an estimated 14,000 adults)

- equipment for moving about - needed by 9 percent of adults already using this type of equipment (an estimated 8500 adults)

- equipment for helping hands or arms - needed by 16 percent of adults already using this type of equipment (an estimated 2700 adults)

- other types of equipment - needed by 2 percent of all adults with disability (an estimated 14,600 adults).

Children

• In 2001, an estimated 7700 children with disability (9 percent) were using equipment or technology to assist them.
• The following types of technical equipment were being used by children with disability:

- equipment for hearing - used by 9 percent of children with a hearing disability (an estimated 1600 children)

- equipment for seeing - used by 6 percent of children with a seeing disability (an estimated 700 children)

- equipment for communicating - used by 8 percent of children with a speaking disability (an estimated 1400 children).

• In addition, an estimated 4600 children, 5 percent of all children with disability, were classified as having the disability type 'use of technical aids'. This category of disability included children who used equipment or technology for moving around, standing, using their arms or hands, or for other reasons.

Unmet need for equipment

• In 2001, parents or caregivers of an estimated 7100 (or 8 percent) of children with disability reported their child had an unmet need for at least one type of equipment or technology.

Disposable items

Adults

• Eleven percent of adults with disability reported needing disposable items such as batteries, needles, incontinence pads or dressings in the previous 12 months because of disability. This was an estimated 71,500 adults.
• Of these 71,500 adults, 7 percent indicated they needed certain disposable items they did not have.

Children

• Eleven percent of children with disability needed disposable items such as batteries, needles, incontinence pads or dressings in the previous 12 months because of disability. This was an estimated 9600 children.
• Parents or caregivers of 1200 of these 9600 children (13 percent) reported being unable to get some of the disposable items their child needed in the previous 12 months.

Special dietary items

Adults

• Nine percent of adults with disability (an estimated 58,100 people) needed something special in their diet in the previous 12 months because of disability.
• Of the 58,100 adults needing special dietary items over this time, an estimated 10,400 (18 percent) reported being unable to get some of the dietary items they needed.

Children

• An estimated 12,900 children with disability (14 percent) had needed something special in their diet in the previous 12 months because of disability.
• Parents or caregivers of an estimated 4600 of these 12,900 children (36 percent) reported being unable to get some of the dietary items their child needed over this time.

Needs assessments

• During a needs assessment, a person with disability has their care and support needs for everyday living identified and prioritised by a needs assessor.

Adults

• Fifteen percent of adults with disability (an estimated 95,400 people) indicated they had received a needs assessment at some time. This included an estimated 54,900 (9 percent) who had received a needs assessment in the previous 12 months.
• Thirty-four percent of adults with disability indicated they had not had a needs assessment in the previous 12 months, because they did not know about needs assessments.

Children

• Fifteen percent of children with disability (an estimated 13,200 children) had received a needs assessment at some time. This included an estimated 8400 (9 percent) who had received a needs assessment in the previous 12 months.
• When the parents or caregivers of children with disability who had not had a needs assessment in the previous 12 months were asked the reasons for this, the most common reason was that they did not consider their child's disability to be serious enough to require a needs assessment. This reason was given by the parents or caregivers of an estimated 34,500 children; 38 percent of all children with disability.

Health services

• People with disability were asked how often they had consulted different types of health service in the previous 12 months. Consultations could have been for disability-related health care as well as for reasons unrelated to disability, such as immunisations, ante-natal care or treatment for short illnesses or minor accidents.

Adults

• In the previous 12 months, the most common health services that adults with disability used for any reason were:

- general practitioners (GPs) or family doctors - used at least once by 86 percent of adults with disability

- chemists or pharmacists - 76 percent

- medical specialists - 40 percent

- nurses (without also seeing a doctor) - 32 percent.

Children

• In the previous 12 months, the most common health services that children with disability used for any reason were:

- GPs or family doctors - used at least once by 88 percent of children with disability

- dentists or dental nurses - 71 percent

- chemists or pharmacists - 61 percent

- medical specialists - 42 percent

- nurses (without also seeing a doctor) - 30 percent.

Reported unmet need for health services

• Fifteen percent of adults with disability (an estimated 94,900 people) indicated there had been at least one time in the previous 12 months when they had needed to see a health professional, therapist or healer, but had been unable to.
• Parents or caregivers of 17 percent of children with disability indicated there had been at least one time in the previous 12 months when their child had needed to see a health professional, therapist or healer, but had been unable to. This was an estimated 15,500 children.

Medication

• The 2001 Household Disability Survey asked people with disability about their use of prescribed and non-prescribed medication. Survey questions were broad and covered use of medication for any reason, not just for disability-related conditions or health problems.
• Eighty percent of adults with disability and 76 percent of children with disability had taken some kind of prescribed or non-prescribed medication in the previous 12 months. This was an estimated 504,000 adults and 68,000 children.
• Sixty percent of adults with disability and 35 percent of children with disability took prescribed drugs daily.
• Fourteen percent of adults with disability and 4 percent of children with disability took non-prescribed drugs daily.
• Seven percent of adults with disability (an estimated 45,000 adults) reported needing medication at some time in the previous 12 months, but not being able to get it. Similarly, parents or caregivers of 10 percent of children with disability (an estimated 8800 children) reported needing medication for their child at some time in the previous year, but being unable to get it.

Introduction

This chapter describes the range of support, equipment and services used or needed by adults and children with disability living in New Zealand households.

As well as informal help from people such as family members and friends, people with disability can obtain assistance from a wide range of disability-related support and health services. Many of these services are government-funded or subsidised; others are run by voluntary or private organisations.

The first section of this chapter looks at how many adults and children with disability were getting informal and formal help with everyday activities such as personal care and housework.

Subsequent sections describe how many adults and children with disability used:

• respite care
• equipment and technology for moving about, seeing, hearing or communicating
• disposable items such as needles or dressings
• special dietary items
• needs assessments
• health services such as doctors or medical specialists
• medication.

The chapter also identifies how many people with disability reported unmet needs for certain kinds of support, equipment and services such as respite care or help with heavy household work. In addition, information is given on how many people with disability obtained financial assistance from government agencies to pay for services or items of equipment related to disability, and how many paid for these things themselves.

This information is relevant to several issues relating to the provision of services and support for people with disability highlighted in Objectives 7, 8 and 15 of the New Zealand Disability Strategy (Minister for Disability Issues 2001). [Disability Support Services: Increasing participation and independence(Ministry of Health 2002a) outlines current policy for the delivery of Disability Support Services (DSS) in New Zealand. It is available on the Ministry of Health's website: http://www.moh.govt.nz.] The issues include:

• improving access to appropriate assessment services, support services and health services for people with disability
• identifying the unmet needs experienced by people with disability and developing affordable solutions to meet these needs
• improving the resources and choices for families, whänau and other people who provide ongoing support for people with disability.

Help with everyday activities

Types of help

Adults

Adults with disability living in households were asked if their condition or health problem meant someone else carried out or helped them with the following everyday activities:

• personal care (for example, bathing, dressing or taking medication)
• meal preparation
• shopping (for example, for groceries)
• everyday housework (for example, tidying up, cleaning or laundry)
• heavy household work (for example, spring cleaning or gardening)
• personal finances (for example, banking or paying bills)
• communicating with others (for example, during doctor's visits or job interviews).

Table 3.1 shows the number and percentage of adults with disability estimated to be receiving help from someone with these activities.

Table 3.1: Number and percentage of adults with disability living in households who, because of disability, were receiving help with everyday activities, by activity type, 2001

	Number of adults with disability who were receiving this kind of help (estimate)	Percentage of adults with disability (%)
Personal care (for example, bathing, dressing or taking medication)	34,900	6
Meal preparation	67,400	11
Shopping (for example, for groceries)	99,700	16
Everyday housework (for example, tidying up, cleaning or laundry)	128,500	21
Heavy housework (for example, spring cleaning, gardening)	186,700	30
Personal finances (for example, banking or paying bills)	51,300	8
Communicating with others (for example, during doctor's visits or job interviews)	39,100	6
Total getting at least one type of assistance	244,700	39

Source: Statistics New Zealand, 2001 Household Disability Survey

Note: If individuals reported getting help with more than one everyday activity, they were counted in each applicable activity group.

At least one type of help

In 2001, an estimated 244,700 adults with disability (39 percent) were receiving at least one of the seven listed types of help with everyday activities, because of disability.

Older adults were more likely to be receiving help with everyday activities than younger adults. Over half (56 percent) of adults aged 65 and over with disability received help, compared with 30 percent of adults aged 45-64, 33 percent of adults aged 25-44 and 23 percent of adults aged 15-24.

Twenty-nine percent of men and 48 percent of women with disability were receiving help with everyday activities (calculated from Statistics New Zealand 2002a). [This is likely to be at least partially due to the older age profile of women with disability.] Overall, the proportions of Pacific (48 percent) and Asian/Other (50 percent) adults with disability receiving help were higher than the proportions of Mäori (37 percent) and European (39 percent) adults with disability receiving help (Figure 3.1).

Figure 3.1: Percentage of adults with disability living in households who, because of disability, were receiving help with everyday activities, by age and ethnicity, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey.

- Percentages too small to report (estimated frequencies outside the 70 percent relative sampling error cut-off point)

Note: Data in Appendix Table 3.1.

This difference was particularly marked among older adults. In the 65 and over age group, 72 percent of Pacific and 71 percent of Asian/Other adults with disability received help, compared with 55 percent of European and 61 percent of Mäori adults with disability.

In addition, Pacific adults aged 25-44 with disability were more likely than their counterparts in other ethnic groups to be receiving help (47 percent of Pacific adults aged 25-44, compared with 32 percent of Europeans and 31 percent of Mäori). [The number of Asian/Other adults with disability in this age group receiving assistance was too small to report.]

Personal care

An estimated 34,900 adults with disability (6 percent) were getting help with disability-related personal care, such as bathing, dressing or taking medication.

In terms of age, adults with disability in the 85 and over age group were the most likely to be getting this kind of help (20 percent). The percentage of adults aged 75-84 getting this kind of help was markedly lower (8 percent).

Adults with intellectual disability were most likely to be receiving help with personal care. Thirty-two percent of adults whose main disability was an intellectual disability got help with personal care. This compares with:

• 7 percent of adults whose main disability was an agility disability
• 6 percent of adults whose main disability was a mobility disability
• 6 percent of adults whose main disability was a seeing disability
• 6 percent of adults whose main disability was a psychiatric/psychological disability.

Thirty-five percent of adults with severe disability were getting help with personal care, compared with just 3 percent of adults with moderate disability. [The number of adults with mild disability receiving help with personal care was too small to report.]

Meal preparation

Eleven percent of adults with disability, an estimated 67,400 people, were getting help to prepare their meals, because of disability.

People with disability in the 85 and over age group were the most likely to be getting help with meal preparation, with 29 percent getting this kind of help. In the 75-84 age group, 13 percent were getting help with meal preparation.

Pacific adults with disability (25 percent) were more likely to receive help with meal preparation than Asian/Other (15 percent), Mäori (13 percent) and European (10 percent) adults with disability.

Adults whose main disability was an intellectual disability were the most likely to receive help with meal preparation (50 percent). This compares with:

• 12 percent of adults whose main disability was a mobility disability
• 12 percent of adults whose main disability was a seeing disability
• 11 percent of adults whose main disability was an agility disability
• 11 percent of adults whose main disability was a psychiatric/psychological disability
• 4 percent of adults whose main disability was a hearing disability.

Seventy-one percent of adults with severe disability had someone helping them with meal preparation because of their condition or health problem, compared with 5 percent of adults with moderate disability. [The number of adults with mild disability receiving help with meal preparation was too small to report.]

Shopping

Sixteen percent of adults with disability, an estimated 99,700 people, were getting help with shopping for groceries or other things they needed because of disability.

Older adults with disability were most likely to receive this kind of help, with 47 percent of people aged 85 and over getting help with shopping, compared with 22 percent of people aged 75-84 and 17 percent aged 65-74.

Women with disability (21 percent) were more likely than men with disability (10 percent) to receive help with shopping because of disability.

Asian/Other (32 percent) and Pacific (29 percent) adults with disability were more likely than Mäori (19 percent) or European (14 percent) adults with disability to receive help with shopping.

Adults whose main disability was an intellectual disability (53 percent) were the most likely to receive help with shopping, followed by adults whose main disability was a seeing disability (25 percent) and adults whose main disability was a mobility disability (22 percent). Adults whose main disability was a hearing disability (5 percent) were the least likely to receive help with shopping.

Seventy-three percent of adults with severe disability were getting help with shopping, compared with 16 percent of adults with moderate disability.

Everyday housework

Twenty-one percent of adults with disability, an estimated 128,500 people, were getting help with everyday housework such as tidying up, cleaning and laundry because of disability. This included 52 percent of adults with disability in the 85 and over age group and 38 percent in the 75-84 age group. By contrast, only 15 percent of adults with disability in the 25-44 and 45-64 age groups were getting this kind of help.

Twenty-seven percent of women with disability and 13 percent of men with disability were receiving help with everyday housework.

Adults whose main disability was an intellectual disability were the most likely to receive help with everyday housework (49 percent), followed by adults whose main disability was a mobility disability (28 percent), adults whose main disability was an agility disability (25 percent) and adults whose main disability was a seeing disability (25 percent).

Eighty-five percent of adults with severe disability received help with everyday housework, as did 23 percent of adults with moderate disability.

Heavy household work

Thirty percent of adults with disability, an estimated 186,700 people, were getting help with heavy household work such as spring cleaning, gardening or mowing lawns, because of disability.

Once again, older adults were more likely to be getting this kind of help than younger adults. In the 85 and over age group, 68 percent of adults with disability were getting help with heavy household work, as were 49 percent in the 75-84 age group.

Women with disability (37 percent) were more likely than men with disability (22 percent) to be getting help with heavy household work.

Fifty-seven percent of adults whose main disability was an intellectual disability and 44 percent of adults whose main disability was a mobility disability were getting help with heavy household work. This compares with just 16 percent of adults whose main disability was a psychiatric/ psychological disability and 9 percent of adults whose main disability was a hearing disability.

Eighty percent of adults with severe disability were getting help with heavy household work, compared with 35 percent of adults with moderate disability and 11 percent of adults with mild disability.

Personal finances

Eight percent of adults with disability, an estimated 51,300 people, were getting help with their personal finances such as banking or paying bills, because of disability. This included 28 percent of people with disability aged 85 and over and 10 percent aged 75-84.

Twenty-five percent of Asian/Other adults with disability were getting help with their personal finances, compared with 18 percent of Pacific, 11 percent of Mäori and 7 percent of European adults with disability.

Fifty-two percent of adults whose main disability was an intellectual disability were getting help with their personal finances, as were 17 percent of adults whose main disability was a seeing disability. This compared with 2 percent of adults whose main disability was a hearing disability and 6 percent of adults whose main disability was an agility disability.

Adults with severe disability (46 percent) were more likely to be getting help with their personal finances than adults with moderate disability (6 percent).

Communicating

Six percent of adults with disability, an estimated 39,100 people, were getting help when communicating such as during doctor's visits or at job interviews, because of disability. This included 13 percent of adults aged 85 and over with disability and 11 percent of people aged 15-24.

Asian/Other adults with disability were the most likely to be getting help with communicating. Twenty-one percent of Asian/Other adults with disability were getting this kind of help, compared with 15 percent of Pacific, 10 percent of Mäori and 5 percent of European adults with disability. [These results may have been influenced by respondents' ability to communicate in English.]

Adults with intellectual disability were the most likely to be getting help with communicating. Fifty-five percent of adults whose main disability was an intellectual disability were getting this kind of help compared with 3 percent of adults whose main disability was an agility disability, 4 percent of adults whose main disability was a mobility disability and 5 percent of adults whose main disability was a hearing disability.

In terms of disability cause, 17 percent of adults whose main disability was caused by a condition present at birth were getting help with communicating, compared with 8 percent or less of adults whose main disability was caused by disease/illness, accident/injury, or ageing.

Adults with severe disability (31 percent) were more likely than adults with moderate disability (6 percent) to be getting help with communicating.

Who provided help?

Adults with disability who were getting assistance with everyday activities were asked to indicate the kinds of people who were providing this help. The results are summarised below in Table 3.2.

Table 3.2: Number and percentage of adults with disability living in households who, because of disability, were receiving help with everyday activities, by type of activity and type of person providing help, 2001

	Husband/ male partner	Wife/ female partner	Daughter	Son	Mother	Father	Sister	Brother	Other family/ whanau member	Flatmate	Friend or neighbour	Voluntary organisation	Private organisation	Organisation, type unknown	Other paid person	Other person	Total
Personal care (for example, bathing, dressing, taking medication)	5,200 15%	7,100 20%	3,600 10%	1,400 4%	2,900 8%	- -	- -	- -	- -	- -	- -	- -	6,900 20%	2,100 6%	3,800 11%	2,100 6%	34,900 100%
Meal preparation	16,500 24%	12,500 19%	12,600 19%	4,600 7%	5,200 8%	- -	1,900 3%	- -	4,500 7%	2,600 4%	- -	3,400 5%	6,400 10%	- -	3,300 5%	2,200 3%	67,400 100%
Shopping (for example, for groceries)	23,100 23%	12,500 13%	23,800 24%	12,100 12%	5,900 6%	- -	3,000 3%	- -	8,500 9%	1,600 2%	6,200 6%	- -	5,200 5%	- -	3,500 3%	4,200 4%	99,700 100%
Everyday housework (for example, tidying up, cleaning or laundry)	22,700 18%	13,900 11%	13,300 10%	6,700 5%	4,800 4%	- -	2,300 2%	- -	6,000 5%	2,600 2%	3,900 3%	5,400 4%	23,600 18%	7,000 5%	23,400 18%	4,800 4%	128,500 100%
Heavy housework (for example, spring cleaning or gardening)	32,700 18%	16,400 9%	13,900 7%	19,100 10%	4,500 2%	2,500 1%	2,300 1%	2,900 2%	13,000 7%	2,300 1%	14,000 7%	3,000 2%	24,200 13%	4,800 3%	52,500 28%	6,100 3%	186,700 100%
Personal finances (for example, banking or paying bills)	8,900 17%	9,100 18%	10,800 21%	5,700 11%	4,500 9%	1,900 4%	1,700 3%	- -	2,700 5%	- -	2,100 4%	- -	2,100 4%	- -	- -	2,500 5%	51,300 100%

Source: Statistics New Zealand, 2001 Household Disability Survey

- Numbers too small to report (estimated frequencies outside the 70 percent relative sampling error cut-off point).

Note: If individuals reported getting help with more than one everyday activity or from more than one type of person, they were counted in each applicable activity and/or person group.

The results indicate that family members, especially spouses/partners and daughters, were the people most commonly helping with everyday activities.

Assistance with meal preparation, shopping and personal finances were most likely to be provided by spouses/partners or daughters. Help with everyday and heavy household work was most likely to come from husbands/male partners, a private organisation or another paid person. Adults with disability who received assistance with their personal care most often got this from spouses/partners or private organisations.

Analysis of these figures by age indicates that, as might be expected, daughters and sons had a more prominent role in the care of older rather than younger adults with disability. For example, 27 percent of people aged 75-84 with disability who got help with meal preparation were helped by their daughters, compared with just 11 percent of people aged 25-44.

Mothers were generally most prominent in the care of younger adults with disability. For example, 55 percent of people aged 15-24 who got help with meal preparation were helped by their mother, as were 14 percent of people aged 25-44. By contrast, the numbers of adults with disability in the older age groups whose mother helped them with meal preparation were too small to report.

How often was help received?

Adults with disability receiving help with everyday activities were asked to indicate how often they were getting this help from different types of people such as partners, family members, private organisations or others.

Frequency of help with personal care

Of adults with disability who got help with disability-related personal care (for example, bathing, dressing or taking medication):

• 70 percent who got this help from their wife or female partner were getting this help every day from that person
• 57 percent who got this help from their husband or male partner were getting this help every day from that person
• 63 percent who got this help from their daughter were getting this help every day from that person
• 55 percent who got this help from their mother were getting this help every day from that person.

Frequency of help with meals

Of adults with disability who got help preparing meals:

• 95 percent who got this help from their wife or female partner were getting this help every day from that person, as were 81 percent who got this help from their mother
• 60 percent who got this help from their husband or male partner were getting this help every day from that person, as were 60 percent who got this help from their daughter, 60 percent who got this help from their son, and 60 percent who got this help from other family or whänau members
• 59 percent who got this help from private organisations were getting this help every day from that source.

Frequency of help with shopping

Of adults with disability who got help with shopping:

• 94 percent who got help from their husband or male partner got this help once a week or more from that person, as did 89 percent who got this help from their wife or female partner
• 84 percent who got this help from their daughter got this help once a week or more from that person, as did 83 percent who got this help from their son
• 64 percent who got this help from their mother got this help once a week or more from that person.

Frequency of help with everyday housework

Of adults with disability who got help with everyday housework (for example, tidying, cleaning or laundry):

• 84 percent who got this help from their wife or female partner got this help every day from that person, as did 60 percent who got this help from their husband or male partner
• 57 percent who got this help from their daughter got this help every day from that person, as did 68 percent who got this help from their son
• 63 percent who got this help from a private organisation got this help once a week from this source; 13 percent got this help from a private organisation every day
• 52 percent who got this help from other paid people got this help from these people once a week; 6 percent got this help from these people every day.

Frequency of help with heavy household work

Of adults with disability who got help with heavy household work from:

• their husband or male partner, 71 percent were getting this help once a week or more
• their wife or female partner, 66 percent were getting this help once a week or more
• a private organisation, 40 percent were getting this help once a week or more and 58 percent were getting this help less than once a week
• other paid people, 28 percent were getting this help once a week or more and 70 percent were getting this help less than once a week.

Frequency of help with personal finances

Of adults with disability who got help with personal finances from:

• their daughter, 12 percent were getting this help every day, 36 percent once a week and 48 percent less than once a week
• their wife or female partner, 23 percent were getting this help every day, 48 percent once a week and 20 percent less than once a week.
• their husband or male partner, 20 percent were getting this help every day, 44 percent once a week and 25 percent less than once a week.

Children

Personal care and household work

Parents or caregivers were asked whether they had needed help with their child's personal care or household work in the previous 12 months because of their child's disability. [This question was intended to include help that was needed and received as well as help that was needed but not received.]

Parents or caregivers of an estimated 11,700 children with disability (13 percent) indicated they had needed this kind of help.

The need for this kind of help was related to the child's type of disability. Parents or caregivers of children using technical aids and children with intellectual disability were the most likely to need help with their child's personal care or with household work (44 percent and 33 percent respectively). Parents or caregivers of children with hearing disability (8 percent) and seeing disability (12 percent) were the least likely to need help with these activities (Figure 3.2).

Figure 3.2: Percentage of children with disability living in households whose parents or caregivers needed help with their child's personal care or household work in the previous 12 months, by disability type, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey

Notes:

- Data in Appendix Table 3.21.

- If individuals reported more than one disability type, they were counted in each applicable disability type group.

The likelihood that parents or caregivers would need help with personal care or household work was also strongly related to whether their child had one or more disabilities and the severity of their child's disability.

Parents or caregivers of children with multiple disabilities were three times as likely to need help with their child's personal care or household work as the parents or caregivers of children with a single disability (21 percent compared with 7 percent).

Parents or caregivers of nearly three-quarters of children with severe disability (72 percent) needed help with their child's personal care or with household work, compared with 5 percent of children with moderate disability. [By definition, children with severe disability needed daily assistance with some kind of everyday activities and children with mild disability needed no regular assistance.]

Unmet need for help with everyday activities

Adults

Unmet need for help with personal care

Two percent of adults with disability, an estimated 13,100 people, indicated they had needed help in the previous 12 months with personal care from providers other than family or friends, but had been unable to get this help.

Ninety-one percent of adults with disability indicated they had no unmet needs in the previous 12 months for personal care supplied by providers other than family or friends. [Information on unmet needs for personal care was not obtained from the remaining 7 percent of adults with disability.]

The most common reasons adults with disability gave for why they had unmet needs were:

• they did not know such a service was available (an estimated 3200 adults)
• they did not know they could apply for financial help for personal care or where to apply (an estimated 2800 adults)
• cost or affordability (an estimated 2200 adults).

Unmet need for help with housework and shopping

Four percent of adults with disability, an estimated 23,300 people, needed help in the previous 12 months with housework, shopping or other similar tasks from providers other than family or friends, but had been unable to get this help. This included 9 percent of adults with severe disability.

Unmet need for help with home repairs or property maintenance

Four percent of adults with disability, an estimated 26,400 people, reported they had needed help in the previous 12 months with repairs or maintenance to their home or property, but had been unable to get this help (Table 3.3).

Table 3.3: Unmet needs for help with everyday activities in the previous 12 months reported by adults with disability living in households, 2001

	Unmet need for help with personal care from providers other than family or friends	Unmet need for help with tasks such as housework or shopping from providers other than family or friends	Unmet need for help with home repairs or maintenance
Population estimate	13,100	23,300	26,400
Percentage of all adults with disability (%)	2	4	4

Source: Statistics New Zealand, 2001 Household Disability Survey

Note: If individuals reported an unmet need for help with more than one of these activities, they were counted in each applicable category.

Reasons for unmet need

More than half (54 percent) the adults with disability with unmet needs for home repairs or maintenance indicated cost or affordability as a reason for these unmet needs. Thirty-eight percent indicated they did not know they could apply for financial help for home repairs or maintenance or where to apply. Twelve percent indicated they had applied for financial help, but were not eligible (Table 3.4).

Table 3.4: Reasons adults with disability living in households gave for not being able to get the help they needed with everyday activities, by activity type, 2001

	Unmet need for help with personal care from providers other than family or friends	Unmet need for help with tasks such as housework or shopping from providers other than family or friends	Unmet need for help with home repairs or maintenance
Did not know there was such a service	3,200	6,300	N/A
Service not available in area	-	2,400	N/A
Too costly, could not afford	2,200	3,700	14,100
Applied for financial help, but not eligible	-	3,500	3,100
Did not know could apply for financial help or where to apply	2,800	4,600	9,800
Other	6,200	8,700	4,900
Total	13,100	23,300	26,400

- Numbers too small to report (estimated frequencies outside the 70 percent relative sampling error cut-off point).

N/A Not applicable.

Note: If individuals reported more than one reason, they were counted in each applicable category.

Children

Parents or caregivers who had needed help with their child's disability-related personal care or other household work were asked if there had been occasions in the previous 12 months when they had been unable to get this help. These results are summarised in Table 3.5.

Table 3.5: Unmet needs for help with everyday activities in the previous 12 months reported by parents or caregivers of children with disability living in households, 2001

	Unmet need for help with personal care	Unmet need for help with tasks such as housework or shopping	Unmet need for help with home repairs or maintenance
Population estimate	4100	3600	4300
Percentage of all children with disability whose parents or caregivers reported these unmet needs (%)	5	4	5

Source: Statistics New Zealand, 2001 Household Disability Survey

Unmet need for help with personal care

Parents or caregivers of an estimated 4100 children with disability indicated they had needed help with their child's personal care for disability in the previous 12 months, but had been unable to get this help. This was the parents or caregivers of 5 percent of all children with disability.

Parents or caregivers of 16 percent of children with severe disability reported having an unmet need for help with their child's personal care for disability. This compared with the parents or caregivers of 5 percent of children with moderate disability. [By definition, children with mild disability did not require regular personal care.]

Unmet need for help with household tasks

The parents or caregivers of an estimated 3600 children with disability reported being unable to get the help they needed in the previous 12 months with household tasks such as housework or shopping associated with their child having a disability. This was the parents or caregivers of 4 percent of all children with disability.

Parents or caregivers of children with severe disability (13 percent) were more likely to report having an unmet need for help with household tasks than parents or caregivers of children with moderate disability (4 percent). [By definition, the families of children with mild disability did not require regular help with household tasks.]

Unmet need for help with home repairs or maintenance

Parents or caregivers of an estimated 4300 children with disability indicated that in the previous 12 months they had been unable to get the help they needed with home repairs or maintenance associated with their child having a disability. This was the parents or caregivers of 5 percent of children with disability.

Parents or caregivers of 14 percent of children with severe disability reported an unmet need for help with home repairs or maintenance associated with their child having a disability. This compared with parents or caregivers of 5 percent of children with moderate disability.

Reasons for unmet need

The most common reason parents or caregivers gave for being unable to get the help they needed with various types of everyday activity was cost, followed by a lack of knowledge that they could apply for help (Table 3.6).

Table 3.6: Reasons reported by parents or caregivers of children with disability for why they were unable to get the help they needed for everyday activities, 2001

	Reasons for unmet need for help with personal care	Reasons for unmet need for help with household tasks (for example, housework and shopping)	Reasons for unmet need for help with home repairs or maintenance
Too costly, could not afford	1600	1000	1900
Applied for financial help, but were not eligible	1000	600	-
Did not know could apply, or where to apply	1000	1800	1400
Other	1700	1100	1100
Total	4100	3600	4300

Source: Statistics New Zealand, 2001 Household Disability Survey

- Numbers too small to report (estimated frequencies outside the 70 percent relative sampling error cut-off point).

Note: If individuals reported more than one reason, they were counted in each applicable category.

Payment and subsidies for help with everyday activities

Adults

Payment for family, friends and other informal helpers or carers

The 2001 Household Disability Survey examined whether the family, whänau, friends, flatmates and neighbours who helped adults with disability with different types of everyday activity got paid for providing this help and by whom. Results for these questions are summarised in Table 3.7.

Table 3.7: Payment and payment sources for family, whänau, friends, flatmates, neighbours or other informal carers providing help for adults with disability living in households, by type of help, 2001

Type of help	Total number of adults with disability whose family, friends or other informal helpers were being paid for their help (estimate)	Percentage where helper paid by a government agency (estimate) (%)	Percentage where helper paid by the person with disability or their family (estimate) (%)
Personal care	2,800	89	-
Meals	3,700	-	95
Shopping	4,300	55	40
Everyday housework	8,700	50	48
Heavy household work	15,600	26	64

Source: Statistics New Zealand, 2001 Household Disability Survey

- Numbers too small to report (estimated frequencies outside the 70 percent relative sampling error cut-off point).

Note: If individuals reported receiving more than one type of help or more than one type of payment source, they were recorded in each applicable category.

Personal care

An estimated 20,500 adults with disability were getting help with disability-related personal care from family, whänau, friends, flatmates, neighbours or other informal helpers. In the case of 2800 or 13 percent of these adults, the person or people providing this help were paid - by a government agency in 89 percent of cases.

Meals

An estimated 53,400 adults with disability were getting help with preparing meals from family, whänau, friends, flatmates, neighbours or other informal carers. In the case of 3700 or 7 percent of these adults, the person or people providing this help were paid - nearly always by the adults with disability or their families (95 percent).

Shopping

An estimated 85,800 adults with disability were getting help with shopping from family, whänau, friends, flatmates, neighbours or other informal carers. In the case of 4300 or 5 percent of these adults, the person or people providing this help were paid - by a government agency (55 percent) or the adults with disability or their families (40 percent).

Everyday housework

An estimated 67,500 adults with disability were getting help with everyday housework from family, whänau, friends, flatmates, neighbours or other informal carers. In the case of 8700 or 13 percent of these adults, the person or people providing this help were paid - by a government agency (50 percent) or the adults with disability or their families (48 percent).

Heavy household work

An estimated 103,900 adults with disability were getting help with heavy household work from family, whänau, friends, flatmates, neighbours or other informal carers. In the case of 15,600 or 15 percent of these adults with disability, the person or people providing this help were paid - mostly by the adults with disability or their families (64 percent).

Personal finances

An estimated 30,200 adults with disability were getting help with personal finances from family, whänau, friends, flatmates, neighbours or other informal carers. In the case of 1800 or 6 percent of these adults, the person or people providing this help was paid.

Receipt of government-funded home support services

An additional survey question asked adults with disability whether, in the previous 12 months, government agencies had provided them with any home support services or the money to pay for these services. [The results described in the previous section refer to payment forcurrenthelp with different types of everyday activity.]

Home support services provide help with everyday activities like personal care or housework. These services are often funded by government agencies such as the Ministry of Health or Accident Compensation Corporation (ACC).

In the previous 12 months, 8 percent of adults with disability, an estimated 50,600 people, received home support services or the money to pay for such services from a government agency.

Adults with disability aged 75-84 and 85 and over were more likely than younger adults with disability to receive government funded home support (18 percent and 26 percent respectively).

Twenty percent of adults with severe disability received government-funded home support, compared with 12 percent of adults with moderate disability and 1 percent of adults with mild disability.

Adults with disability who paid for help themselves

In the previous 12 months, 2 percent of adults with disability, an estimated 15,400 people, received help with their personal care related to disability that they paid for themselves. [These figures exclude people who paid for personal care, but reclaimed the money they paid from a government agency or medical insurer.]

In the previous 12 months, 5 percent of adults with disability, an estimated 31,400 people, received help with tasks such as housework or shopping that they paid for themselves. [These figures exclude people who paid for help with housework or shopping, but reclaimed the money they paid from a government agency or medical insurer.] Adults with disability aged 75-84 and 85 and over were more likely than younger adults with disability to pay for help with housework or shopping because of disability (10 percent and 15 percent respectively).

Children

Receipt of home support services

In the previous 12 months, parents or caregivers of an estimated 3000 children with disability (3 percent of all children with disability) received home support for their child or money for home support services for their child from a government agency. Home support services included help with a child's personal care such as bathing and dressing, or help with household work.

Parents or caregivers of children who used technical aids were most likely to have received home support (22 percent), followed by parents or caregivers of children with intellectual disability (14 percent). Parents or caregivers of children with seeing disability were the least likely to have received home support (5 percent). [The number of children with hearing disability who received home support was too small to report.]

Payments by parents and caregivers

In the previous 12 months, parents or caregivers of an estimated 3500 or 4 percent of children with disability paid for help with their child's disability-related personal care. [This excludes parents or caregivers who paid for this help, but reclaimed the money they paid from a government agency or medical insurer.]

Over the previous 12 months, the parents or caregivers of an estimated 2600 or 3 percent of children with disability paid for someone to help them with tasks such as housework or shopping associated with their child's condition of health problem. [This excludes parents or caregivers who paid for this help, but reclaimed the money they paid from a government agency or medical insurer.]

Respite care

Respite care services and carer support services enable a caregiver to take a break from looking after a person with disability. A substitute caregiver may be assigned to stay with or visit the person with disability in their home, or the person with disability may go to stay in a hospital, a rest home or another service providing out-of-home care.

Adults

The 2001 Household Disability Survey did not ask adults with disability if they had ever used respite care. Instead, it was first determined how many adults with disability had someone who helped them or looked after them because of disability. Those adults who had someone helping them or looking after them were then asked if they had paid for respite care or received financial help from a government agency to pay for respite care in the previous 12 months. They were also asked if they had experienced any unmet need for respite care over this period.

Government help to pay for respite care

Of the estimated 108,000 adults with disability who had someone helping or looking after them because of disability, 9100 or 8 percent had received financial help from a government agency in the previous 12 months to pay for respite care. This included an estimated 5900 adults with severe disability.

In terms of disability type, adults with intellectual disability (14 percent) were the most likely to have received financial help from a government agency for respite care.

Self-funded respite care

Of the 108,000 adults with disability who had someone helping them or looking after them because of disability, 5100 or 5 percent had paid for respite care in the previous 12 months. [This excludes adults who paid for respite care, but reclaimed the money they paid from a government agency or medical insurer.] This included an estimated 2700 adults with severe disability.

Adults with intellectual disability (8 percent) were more likely to pay for respite care than adults with psychiatric/psychological disability (3 percent), mobility disability (1 percent) or agility disability (1 percent). [Adults with a main disability that was an intellectual disability were the most likely to have someone helping them or looking after them (53 percent) compared with 22 percent for psychiatric/ psychological disability, 20 percent mobility disability, 19 percent seeing disability, 16 percent agility disability and 12 percent hearing disability.]

Unmet need for respite care

Of the 108,000 adults with disability who had someone who helped them or looked after them because of disability, an estimated 10,300 or 10 percent reported an unmet need for respite care in the previous 12 months. This is the equivalent of 2 percent of all adults with disability.

An estimated 8000 adults with severe disability, 11 percent of all adults with severe disability, reported an unmet need for respite care in the previous 12 months.

Reasons for unmet need for respite care

Of the 10,300 adults with disability who reported unmet needs for respite care, more than half (60 percent) indicated they did not get the respite care they needed because they did not know they could apply for free respite care or where to apply for it.

Thirty-one percent indicated they did not get the respite care they needed because respite care was unaffordable, while 14 percent indicated they had applied for free respite care but found they were not eligible for it.

Children

Parents or caregivers of 18 percent of children with disability living in households indicated that, in the previous 12 months, they had needed respite care or carer support, so they or other people usually caring for their child could take a break. [Whether or not they had received this. 'Need' was self-reported.] This was the parents or caregivers of an estimated 16,600 children with disability.

Parents or caregivers of 26 percent of children with disability living in the Southern region reported they had needed respite care in the previous 12 months, compared with 14 percent of children in the Midland region, 15 percent of children in the Central region and 17 percent of children in the Northern region.

Parents or caregivers of 25 percent of children with disability from the lowest income households ($15,000 and under per year) indicated they had needed respite care in the previous 12 months, compared with 13 percent of children from the highest income households ($50,001 and over per year).

Parents or caregivers of children using technical aids were most likely to report a need for respite care (51 percent); while parents or caregivers of children with hearing disability were least likely to need respite care (13 percent) (Figure 3.3).

Figure 3.3: Percentage of children with disability living in households whose parents or caregivers had needed respite care in the previous 12 months, by disability type, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey.

Notes:

- Data in Appendix Table 3.52.

- If individuals reported more than one disability type, they were counted in each applicable disability type group.

Parents or caregivers of children with multiple disabilities were much more likely than the parents or caregivers of children with a single disability to need respite care (30 percent compared with 9 percent).

Parents or caregivers of the majority of children with severe disability (72 percent) said they needed respite care, as did the parents or caregivers of 17 percent of children with moderate disability. [The number of children with mild disability requiring respite care was too small to report.]

Government help to pay for respite care

In the previous 12 months, parents or caregivers of an estimated 7300 children with disability reported that a government agency, hospital or Ministry of Health service helped to pay for respite care or carer support services. This was 44 percent of the estimated 16,600 children with disability whose parents or caregivers reported needing respite care over this period.

Parents or caregivers who paid for respite care

In the previous 12 months, parents or caregivers of an estimated 4200 children with disability paid for respite care. [This excludes parents or caregivers who paid for respite care, but reclaimed the money they paid from a government agency or medical insurer.] This was 5 percent of all children with disability or 25 percent of the estimated 16,600 children with disability whose parents or caregivers reported needing respite care over this period.

Free respite care

Parents or caregivers of 6100 children with disability reported receiving some respite care for free in the previous 12 months. This was 37 percent of the estimated 16,600 children with disability whose parents or caregivers reported needing respite care over this period.

Unmet need for respite care

Of the 16,600 children with disability whose parents or caregivers reported they had needed respite care in the previous 12 months, nearly half (48 percent, equivalent to the parents or caregivers of an estimated 8000 children with disability) had been unable to get this respite care.

Parents or caregivers of children with psychiatric/psychological disability were most likely to report an unmet need for respite care (22 percent), followed by parents or caregivers of children using technical aids (18 percent) and parents or caregivers of children with intellectual disability (17 percent). Parents or caregivers of children with hearing disability or seeing disability were the least likely to report an unmet need for respite care (7 percent each).

Parents or caregivers of 14 percent of children with multiple disabilities reported an unmet need for respite care, compared with parents or caregivers of 4 percent of children with a single disability.

Reasons for unmet need for respite care

The most common reason given by parents or caregivers of children with disability for why they did not get the respite care they considered they needed was that they did not know they could apply for free respite care or where to apply for it. This applied to the parents or caregivers of an estimated 3300 children with disability.

The next most common reason was the cost or affordability of respite care (2200), followed by the lack of availability of appropriate respite care in the local area (1200).

Other less common reasons given were that parents or caregivers had applied for financial help but were not eligible (800), and that parents or caregivers did not like the respite care services available (600).

Equipment and technology

Use of equipment and technology

Adults

In 2001 an estimated 207,200 adults with disability (33 percent) were using equipment or technology to assist themselves.

Thirteen percent of adults aged 15-24 with disability used equipment and technology, as did 18 percent of adults aged 25-44, 27 percent of adults aged 45-64 and 54 percent of adults aged 65 and over.

One-third (33 percent) of both males and females with disability were using equipment or technology to help them (calculated from Statistics New Zealand 2002a).

Use of equipment and services for hearing

Adults defined as having a hearing disability were asked to specify the equipment, technology and services they currently used for people who were deaf or hard of hearing.

In the 2001 Household Disability Survey, if an adult had a hearing disability but could hear easily because the hearing disability had been corrected with a hearing aid or some other device, they were not defined as having a hearing disability. Therefore, they were not asked about the types of equipment or services they used for people who were deaf or hard of hearing. This means the information in this section covers equipment and services used by adults with only uncorrected hearing disability.

Of the estimated 212,500 adults with uncorrected hearing disability, some 64 percent or 136,900 were not using any equipment or services for people who were deaf or hard of hearing.

Younger adults were more likely than older adults not to be using any hearing equipment or services, with 80 percent of adults aged 15-44 with hearing disability not using any hearing equipment or services, compared with 41 percent of adults aged 75 and over.

Ten percent of adults with uncorrected hearing disability, an estimated 22,100 adults, used a hearing aid with a T-switch. Eighteen percent, an estimated 39,200 adults, used another type of hearing aid.

Other commonly used types of hearing equipment were:

• volume control telephones, used by 10 percent of adults with hearing disability, an estimated 20,900 adults
• teletext, used by 3 percent of adults with hearing disability, an estimated 6700 adults
• fax machines, used by 2 percent of adults with hearing disability, an estimated 3500 adults
• flashing alarms or visual alarms, used by 1 percent of adults with hearing disability, an estimated 3000 adults
• hearing loop, FM or infrared systems, used by 1 percent of adults with hearing disability, an estimated 2500 adults
• computers to communicate, used by 1 percent of adults with hearing disability, an estimated 2000 adults.

Adults with hearing disability were also asked if they used interpreters or different sign languages and if they could lip read.

Interpreters

The number of adults with uncorrected hearing disability who used a sign language interpreter was too small to report.

Lip reading

Of the estimated 212,500 adults with uncorrected hearing disability, 51,000 or 24 percent could lip read.

Younger adults with hearing disability were more likely than older adults with hearing disability to be able to lip read. For example, 36 percent of adults aged 25-44 with hearing disability could lip read compared with 10 percent of people aged 85 and over.

New Zealand Sign Language and Signed English

Of the estimated 212,500 adults with hearing disability, 6900 or 3 percent used New Zealand Sign Language and an estimated 2400 or 1 percent used Signed English. [New Zealand Sign Language and Signed English are two kinds of sign language used in New Zealand.]

Use of equipment for speaking and being understood

Of the estimated 42,500 adults with speaking disability (that is, difficulty speaking and being understood), 1200 or 3 percent used equipment to assist them to speak and be understood.

Because of small numbers, it is not possible to report the kinds of equipment for speaking and being understood used most commonly by adults with speaking disability.

Use of equipment and services for adults with seeing disability

In the 2001 Household Disability Survey, if an adult had a seeing disability but could see easily because the seeing disability had been corrected with glasses, contact lenses or some other device, they were not defined as having a seeing disability. Therefore they were not asked about the types of equipment or services they used for people who were blind or visually impaired. This means the information in this section covers equipment and services used by adults with only uncorrected seeing disability.

Of the estimated 69,300 adults with uncorrected seeing disability, some 49,200 or 71 percent used equipment, technology or services for people who were blind or vision impaired. The remaining 20,100 or 29 percent did not use any of these kinds of equipment, technology or services.

The most commonly used types of equipment were glasses or contact lenses, used by an estimated 39,900 or 58 percent of adults with uncorrected seeing disability.

Other equipment, technology or services used were, in order of frequency:

• handheld or desk-mounted magnifiers, used by 26 percent of adults with seeing disability, an estimated 18,200 adults
• large print reading material, used by 18 percent of adults with seeing disability, an estimated 12,600 adults
• audio reading materials such as talking books, used by 8 percent of adults with seeing disability, an estimated 5500 adults
• white canes, used by 6 percent of adults with seeing disability, an estimated 4100 adults
• readers, [The disability surveys' manuals for survey interviewers defined 'readers' as people who read out loud for people with seeing disability. There are also 'screen readers' which assist people witih seeing disability to use computers through a speech synthesiser or through an image magnification and enhancement process.] used by 4 percent of adults with seeing disability, an estimated 2900 adults
• computers, including voice synthesis computers, used by 3 percent of adults with seeing disability, an estimated 1800 adults
• recording equipment, used by 2 percent of adults with seeing disability, an estimated 1600 adults.

Membership of Royal New Zealand Foundation for the Blind

Adults with uncorrected seeing disability were also asked if they were a member of the Royal New Zealand Foundation for the Blind.

Of the estimated 69,300 adults with uncorrected seeing disability, 8500 or 12 percent were registered members of the Foundation. [The name of the foundation was changed to the Royal New Zealand Foundation of the Blind in December 2002. However, the previous name is used here, as it was used in the 2001 Household Disability Survey.]

Use of equipment for moving about

Sixteen percent of adults with disability, an estimated 99,300 adults, used or needed some kind of equipment to help them move about, such as a walking stick or wheelchair.

Use, or need for, this kind of equipment was heavily age-related, with only 6 percent of people aged 25-44 with disability using or needing equipment for moving about, compared with 37 percent of people aged 75-84 and 56 percent of people aged 85 and over.

In terms of disability type, 27 percent of adults whose main disability was a mobility disability, 19 percent of adults whose main disability was a seeing disability and 17 percent of adults whose main disability was an agility disability used or needed equipment to help move about. By contrast, just 6 percent of adults whose main disability was a hearing disability used or needed equipment to help move about.

Adults whose main disability was caused by disease/illness (22 percent) or ageing (23 percent) were more likely to use or need equipment to help move about than adults whose main disability was caused by accident/injury (14 percent) or a condition present at birth (8 percent).

The rate of use of, or need for, equipment for moving about was greater among adults with multiple disability (24 percent) than among adults with a single disability (4 percent).

It was also greater among adults with severe disability (43 percent) than among adults with moderate disability (24 percent). The percentage of adults with mild disability using or needing equipment to move about was too small to report.

Walking sticks were the type of equipment used most commonly for moving about. Twelve percent of adults with disability, an estimated 74,200 adults, used walking sticks. Older adults with disability were more likely than younger adults with disability to use walking sticks, with 45 percent of the 85 and over age group using walking sticks, compared with 3 percent of the
25-44 age group and 7 percent of the 45-64 age group.

Three percent of adults with disability, an estimated 15,800 people, used walking frames ('walkers'). This included 14 percent of the 85 and over age group and 7 percent of the 75-84 age group.

An estimated 10,300 adults with disability used crutches and 10,200 used a manual wheelchair.

Equipment used less commonly for moving about included:

• scooters, used by an estimated 4400 adults with disability
• back or leg braces, used by an estimated 3000 adults with disability
• motorised wheelchairs, used by an estimated 1700 adults with disability. [The number of adults using an artificial foot or leg or orthopaedic footwear was too small to report.]

Use of equipment for helping hands or arms

Two percent of adults with disability, an estimated 13,900 adults, used special equipment to support, replace or help them to use their hands or arms.

Of this group, an estimated 2300 used arm braces and 11,200 used other kinds of equipment to help hands or arms.

Use of other equipment

Four percent of adults with disability, an estimated 26,000 adults, used other kinds of equipment because of disability. This is equipment apart from the equipment used for moving about, or to assist hands or arms, covered above.

Of this group, an estimated 3300 used shower stools and 2700 used raised-up toilet seats. The numbers of people using commode chairs, specialised cushions, respirators or ventilators were too small to report.

Overall use of equipment in the previous 12 months

Twenty-seven percent of adults with disability, an estimated 171,000 adults, used some kind of equipment because of disability in the previous 12 months. This included equipment for seeing, hearing, speaking and moving around or to assist hands or arms.

Equipment use was highly age-related, with 53 percent of adults aged 75-84 and 65 percent of adults aged 85 and over with disability using some kind of equipment in the previous 12 months, compared with just 11 percent of adults aged 15-24 and 16 percent of adults aged 25-44.

Rates of equipment use were highest among adults whose main disability was a seeing disability (57 percent), a mobility disability (31 percent), an agility disability (29 percent) or a hearing disability (28 percent). The rate was lowest among adults whose main disability was a psychiatric/psychological disability (8 percent).

Forty-seven percent of adults with severe disability and 45 percent of adults with moderate disability used disability-related equipment in the previous 12 months, compared with just 5 percent of adults with mild disability.

Children

In 2001, an estimated 7700 children with disability (9 percent) were using equipment or technology to assist them.

Use of equipment for seeing

In the 2001 Household Disability Survey, children who used equipment such as glasses that corrected a seeing limitation were not defined as having a seeing disability.

Of the estimated 13,200 children with uncorrected seeing disability, an estimated 700 or 6 percent currently used equipment for seeing, other than glasses or contact lenses.

Use of equipment for hearing

In the 2001 Household Disability Survey, children who wore a hearing aid were defined as having a hearing disability, irrespective of whether the hearing aid corrected their hearing limitation. However, children using other devices, such as grommets, that completely corrected their hearing problem, were not defined as having a hearing disability. [Readers are reminded that different definitions of hearing disability were used for adults and children in the 2001 Household Disability Survey. See the Glossary.]

Of the estimated 18,300 children defined as having a hearing disability, an estimated 1600 or 9 percent currently used equipment for hearing, such as a hearing aid or an FM system.

Use of equipment for communicating

Of the estimated 17,400 children with a speaking disability, 1400 or 8 percent currently used equipment for communicating such as a Macaw, communication board or computer.

Use of technical aids

All children participating in the 2001 Household Disability Survey were asked if they currently used various types of special, technical or medical equipment, such as a wheelchair or an artificial arm, hand or foot. They were also asked if they used a special buggy or trolley, a standing frame, a brace, crutches, walking sticks, a walking frame, other kinds of walking aids or any other kind of equipment because of a long-term condition or health problem. ['Other' types of equipment included modified beds, specialised seating, medical aids, special eating utensils, lifts and hoists, modified shoes, nebulisers, blood glucose meters, gym equipment and hand rails. The category excluded equipment that completely corrected a limitation or was for a minor condition such as asthma inhalers, dental braces or grommets. Note that only a minority of children with disability who indicated in previous questions that they used equipment for seeing, hearing or communication (such as hearing aids or computers) said they used 'other equipment' in this part of the survey. This means a sizeable proportion of children with hearing, seeing or speaking disabilities who used special equipment to help them with these disabilities were not classified as 'using technical aids'. The disability type category 'uses technical aids' thus includes children who used only a specific sub-set of disability-related equipment.] These questions were used to identify the children with the disability type classified as 'uses technical aids'. Results are summarised in Table 3.8.

Table 3.8: Current use of technical aids because of a long-term condition or health problem, children with disability living in households, 2001

	Estimated number of children	Percentage of children using technical aids (%)
Special buggy or trolley	1100	25
Standing frame	900	20
Brace (not dental brace)	1000	21
Wheelchair	1100	24
Crutches, walking sticks, walking frame or other walking aid	1100	24
Artificial arm, hand or foot	900	20
Other kind or equipment	2000	44
Total (at least one of these types of equipment)	4600	100

Source: Statistics New Zealand, 2001 Household Disability Survey

Note: If individuals reported using more than one type of equipment, they were counted in each applicable group.

An estimated 4600 children used at least one of these kinds of special, technical or medical equipment. This was 5 percent of all children with disability. The three kinds most commonly used (by 1100 children each) were wheelchairs; special buggies and trolleys; and crutches, walking sticks and walking frames. Other commonly-used items were braces (1000), standing frames (900) and artificial limbs (900).

Children using technical aids were more likely than other children with disability to also have the disability type 'chronic condition/health problem' (71 percent of children using technical aids compared with 32 percent of other children with disability). They were also more likely than children not using technical aids to have an intellectual disability (36 percent compared with 13 percent) or a special education disability (52 percent compared with 39 percent).

Nearly half (49 percent) of children using technical aids had a disability caused by disease/ illness, compared with 32 percent of other children with disability. They were also more likely than other children to have had a disability since birth (71 percent compared with 40 percent).

Compared with other children with disability, children using technical aids were more likely to have multiple disabilities. Eighty-six percent of children using technical aids had multiple disabilities, compared with 43 percent of other children with disability.

Children using technical aids (55 percent) were also more likely than other children with disability (13 percent) to have a severe disability.

Need for equipment in the previous 12 months

The 2001 Household Disability Survey also asked if children with disability had needed equipment such as special chairs or blood glucose meters in the previous 12 months. [This question was asked in the Content questionnaire for children. It included equipment already mentioned by some respondents in the screening questionnaire (in the 'other equipment' sub-category of the disability type category 'uses technical aids'). Unlike the questions in the Screening questionnaire, it included equipment that had been used at any time in the previous 12 months, not just equipment that was being used currently. Further explanation of what equipment was intended to be included in this question was not given in the survey questionnaire or field manual.]

An estimated 8800 children, 10 percent of all children with disability, had needed these kinds of equipment in the previous 12 months.

Children using technical aids (48 percent) were the ones most likely to have needed this kind of equipment. [Just over half of the children currently using technical aids said they had not needed this kind of equipment in the previous 12 months. Therefore, it appears survey participants interpreted this question in different ways.] Children with intellectual disability were the next most likely to have done so (19 percent). Children with hearing disability (6 percent) and seeing disability (7 percent) were the least likely to have needed this kind of equipment in the previous 12 months.

Children with severe disability (25 percent) were more likely than children with moderate (10 percent) or mild (4 percent) disability to have needed this kind of special equipment in the previous 12 months.

Unmet need for equipment and technology

In 2001, an estimated 84,200, or 12 percent of, people with disability reported an unmet need for at least one type of equipment or technology. [These figures referring to unmet need forat least one typeof equipment or technology are based on a summary variable derived by Statistics New Zealand.]

An estimated 77,100 (or 12 percent) of adults with disability reported an unmet need for at least one type of equipment or technology.

Parents or caregivers of an estimated 7100 (or 8 percent) of all children with disability reported such an unmet need.

Among adults, unmet need for equipment and technology tended to increase with age. Five percent of adults aged 15-24 and 14 percent of adults aged 65 and over reported an unmet need.

Adults

Unmet need for hearing equipment and services

Twenty-one percent of adults with hearing disability, an estimated 45,000 adults, indicated they had unmet needs for equipment or services for people who were deaf or hard of hearing. This included an estimated:

• 17,500 adults with hearing disability who said they needed, but did not have, hearing aids with a T-switch
• 17,000 adults with hearing disability who said they needed, but did not have, another type of hearing aid
• 5000 adults with hearing disability who said they needed, but did not have, a volume control telephone.

Men with hearing disability (24 percent) were more likely than women with hearing disability (18 percent) to report unmet needs for hearing equipment or services.

In terms of age, rates of reported unmet need among adults with hearing disability varied from a high of 26 percent in adults aged 45-64 to a low of 11 percent in adults aged 25-44.

Affordability was the most common reason adults with hearing disability gave for why they had unmet needs for hearing equipment and services, with an estimated 23,000 reporting unmet needs for this reason. As well, an estimated:

• 7000 had unmet needs, because they had never been assessed
• 5900 had unmet needs, because they did not know they could apply for financial help or where to apply
• 4100 had unmet needs, because they did not know where to get the equipment or services they needed.

Unmet need for equipment for speaking and being understood

Of the estimated 42,500 adults with speaking disability, 1400 or 3 percent reported they needed, but did not have, equipment for people who had difficulty speaking and being understood.

Unmet need for equipment or services for adults with seeing disability

Of the estimated 69,300 adults with seeing disability, 14,000 or 20 percent, indicated they had unmet needs for equipment or services for blind or vision impaired adults.

More than two-thirds of this group, an estimated 10,700 adults, had unmet needs for glasses or contact lenses.

The numbers of adults with unmet needs for other types of equipment or services for blind or vision impaired adults, such as large print reading materials or guide dogs, were too small to report.

Cost or affordability was the most common reason adults with seeing disability gave for why they did not have the seeing equipment or services they needed. More than half (58 percent) of adults with unmet needs gave this as a reason for their unmet need.

Twenty percent, an estimated 2800 adults with seeing disability, indicated they had unmet needs because they had never been assessed; while 19 percent, an estimated 2700 adults with seeing disability, indicated they had unmet needs because they did not know they could apply for financial help or where to apply.

Unmet need for equipment for moving about

Of the estimated 99,300 adults with disabilitywho used equipment to move about, 8500 or 9 percent indicated they had unmet needs for additional mobility aids and equipment, including an estimated:

• 2200 who said they needed, but did not have, manual wheelchairs
• 1600 who said they needed, but did not have, scooters
• 1400 who said they needed, but did not have, motorised wheelchairs.

Unmet need for equipment for helping hands or arms

An estimated 2200 adults with disability reported they needed, but did not have, equipment to support, replace or help them to use their hands or arms. This was 16 percent of the adults already using this type of equipment. Of this group, 75 percent needed other kinds of equipment. Sixty-eight percent cited affordability as a reason why they did not have the equipment they needed.

Unmet need for other equipment

Two percent of adults with disability, an estimated 14,600 people, indicated they needed, but did not have, other kinds of equipment for disability that had not been identified in previous questions in the 2001 Household Disability Survey. This included equipment such as shower stools, raised-up toilet seats, commode chairs, specialised cushions, respirators or ventilators. [It is not possible to report the number of people requiring the individual items of equipment in this list, as in all cases the numbers were too small to be reliable.]

Of those who reported unmet needs for these other kinds of equipment, 56 percent cited affordability as a reason for this unmet need. Twenty-two percent indicated that they did not know they could apply for financial help or where to apply, and 17 percent indicated they did not know where to get the equipment they needed.

Children

Current unmet need for equipment

Parents or caregivers of children with disability taking part in the 2001 Household Disability Survey were asked if their child currently needed any disability-related equipment that they did not have. An estimated 5500 children with disability were reported to not have equipment they needed. This was 6 percent of all children with disability.

Children already using technical aids were most likely to have an unmet need for equipment (24 percent). Thirteen percent of children with hearing disability had an unmet need for equipment, as did 10 percent of children with seeing or intellectual disability, and 7 percent of children with a chronic condition/health problem. Six percent of children with a psychiatric/ psychological disability and 6 percent of children with a special education disability had an unmet need for equipment.

The most commonly reported unmet need was for equipment to help with hearing (Table 3.9).

Table 3.9: Reported unmet need for equipment, children with disability living in households, 2001

	Estimated number of children with disability
Unmet need for equipment to help with seeing	1000
Unmet need for equipment to help with hearing	1600
Unmet need for equipment to help with speaking or communicating	1000
Unmet need for equipment to help with standing or moving around	1100
Unmet need for another type of equipment	1200
Total with unmet need for equipment	5500

Source: Statistics New Zealand, 2001 Household Disability Survey

Note: If individuals reported an unmet need for more than one type of equipment, they were counted in each applicable group.

The most common reason given for why children with disability did not have the equipment they needed was affordability. This applied to an estimated 2500 children with disability.

Other common reasons were that parents or caregivers:

• did not know where to get the equipment their child needed (applicable to an estimated 1000 children with disability)
• did not know they could apply for financial help or where to apply for financial help to buy the equipment their child needed (applicable to an estimated 900 children with disability).
• had not had their child assessed (applicable to an estimated 900 children with disability).

Unmet need for equipment in the previous 12 months

Parents or caregivers of the 8800 children with disability who had needed special equipment such as a special chair or blood glucose meter in the previous 12 months, were asked if their children had an unmet need for this kind of equipment during this time.

Parents or caregivers of 30 percent of these children reported they had an unmet need for equipment in the previous year. This was an estimated 2700 children, or 3 percent of all children with disability.

In the previous year, the most common reason for not being able to get special equipment was affordability, cited by the parents or caregivers of an estimated 1400 children with disability. The next most common reason was that parents or caregivers did not know they could apply for financial help or where they could apply (an estimated 700 children).

Payment and subsidies for equipment

Adults

Received government assistance for equipment

Of the 171,000 adults with disability who had used some kind of equipment because of disability in the previous 12 months, an estimated 47,500 or 28 percent had obtained at least some of this equipment on loan or free from a government agency.

An estimated 12,500 or 7 percent had received financial help from a government agency in the previous 12 months, so they could lease or buy disability-related equipment.

Self-funded equipment

Of the 171,000 adults with disability who had used some kind of disability-related equipment in the previous 12 months, an estimated 38,800 or 23 percent bought or leased at least some of this equipment themselves. [This excludes people who paid for equipment, but reclaimed the money they paid from a government agency or medical insurer.]

Children

Received government assistance for equipment

Parents or caregivers of children with disability who had needed any equipment in the previous 12 months were asked if their child had received a Special Needs Grant over this time to pay for any disability-related equipment. The number of children who received a Special Needs Grant for this reason was too small to report.

Parents or caregivers of children with disability who had needed any equipment in the previous 12 months were also asked if, over this time, they had received any other financial help from a government agency to lease or buy equipment related to their child's condition or health problem.

The parents or caregivers of an estimated 1000 children (12 percent of all children with disability needing special equipment) had received this kind of financial help in the previous 12 months.

Equipment paid for by parents or caregivers

In the previous 12 months, parents or caregivers of an estimated 3100 children with disability paid for disability-related equipment for their child themselves. [This excludes parents or caregivers who paid for equipment, but reclaimed the money they paid from a government agency or medical insurer.] This was the parents or caregivers of 35 percent of the children with disability needing disability-related equipment.

Disposable items

Use of disposable items

Adults

Eleven percent of adults with disability, an estimated 71,500 adults, needed disposable items in the previous 12 months for their condition or health problem. Examples of disposable items include batteries, needles, incontinence pads, colostomy bags and catheters.

Older adults were more likely than younger adults to need disposable items, with 17 percent of adults aged 75-84 and 24 percent of adults aged 85 and over with disability needing disposable items, compared with 7 percent of adults aged 15-24 and 9 percent aged 25-44 and 45-64.

Children

Eleven percent of children with disability, an estimated 9600 children, had needed disposable items such as hearing aid batteries, needles or dressings in the previous 12 months because of their condition or health problem.

Children with disability aged 0-4 (18 percent) were more likely to have needed disposable items than children aged 5-9 (9 percent) and 10-14 (9 percent).

Children using technical aids (38 percent) were the most likely to have needed disposable items in the previous year, while children with seeing disability (9 percent) were the least likely.

Nineteen percent of children with severe disability had needed disposable items in the previous year, compared with 11 percent of children with moderate disability and 7 percent of children with mild disability.

Unmet need for disposable items

Adults

Of the 71,500 adults with disability who required disposable items for their condition or health problem in the previous 12 months, an estimated 4900 or 7 percent reported they currently needed certain disposable items but did not have them. This was 1 percent of all adults with disability.

Affordability was the most common reason for not having these disposable items, cited by 62 percent of adults with an unmet need for disposable items. The next most common reason was not knowing they could apply for financial help or where to apply, cited by 29 percent.

Children

An estimated 1200 children with disability had needed certain disposable items in the previous year, but had not been able to get them. This was 13 percent of all children requiring disposable items in the previous year and 1 percent of all children with disability.

The most common reason given by parents or caregivers for why these children were not able to get the disposable items they needed was affordability. This applied to an estimated 800 children.

Payment and subsidies for disposable items

Adults

Of the estimated 71,500 adults with disability needing disposable items in the previous 12 months, some 11,900 or 17 percent received financial help from a government agency to buy disposable items. Some 47,800 or 67 percent paid for disposable items themselves over this time. [The estimate of 47,800 excludes people who paid for disposable items, but reclaimed the money from a government agency or medical insurer.]

Children

Of the 9600 children with disability needing disposable items in the previous year, 4100 or 43 percent received financial help from a government agency to pay for disposable items. The parents or caregivers of an estimated 4900 or 51 percent of the children paid for disposable items themselves. [The estimate of 4900 excludes children or their families who paid for disposable items, but reclaimed the money they paid from a government agency or medical insurer.]

Special dietary items

Need for special diets

Adults

Nine percent of adults with disability, an estimated 58,100 people, had needed something special in their diet in the previous 12 months because of disability. [No examples of special dietary items were given in the survey questionnaires or the survey field manual. However, the items are likely to include food for people with food allergies (for example, dairy-free food), or food for people who needed special diets because of a gastro-intestinal condition or medication they were taking.]

The need for special dietary items varied by age, ranging from a high of 13 percent in the adults aged 15-24 to 7 percent in the adults aged 75-84.

Children

In the previous 12 months, 14 percent of all children with disability, an estimated 12,900 children, needed something special in their diet because of their condition or health problem.

Children using technical aids (34 percent) and children with chronic conditions/health problems (26 percent) were most likely to have needed special dietary items. Children with hearing disability (7 percent) were least likely to have needed special diets.

Children with severe disability (30 percent) were more likely than children with moderate (14 percent) or mild (10 percent) disability to have needed special diets.

Unmet need for dietary items

Adults

Of those adults needing special dietary items because of their condition or health problem in the previous 12 months, an estimated 10,400 or 18 percent were unable to get some of the dietary items they needed over this time.

The most common reason adults with disability had unmet dietary needs was affordability. This reason was cited by 91 percent of adults with disability with unmet dietary needs.

Children

In the previous year, the parents or caregivers of 36 percent of children with disability who had needed special dietary items had been unable to get these items. This was 4600 children or 5 percent of all children with disability.

By far the most common reason identified for why children were unable to get the special dietary items they needed was affordability. This reason was given by parents or caregivers of an estimated 3200 children with disability.

Payment and subsidies for dietary items

Adults

Government assistance for dietary items

Of the estimated 58,100 adults with disability who had needed something special in their diet in the previous 12 months as a result of disability, 5500 or 9 percent received financial help from a government agency to buy these special items.

Paid for dietary items

An estimated 40,500 or 70 percent of adults with disability who needed something special in their diet in the previous 12 months paid for these special items over this time. [This excludes people who paid for special dietary items, but reclaimed the money they paid from a government agency or medical insurer.]

Children

Government assistance for dietary items

Parents or caregivers of an estimated 2400 children with disability received financial help in the previous 12 months from a government agency to pay for their child's disability-related dietary needs. This was the parents or caregivers of 18 percent of children with disability-related dietary needs.

Dietary items paid for by parents or caregivers

Over the same time, parents or caregivers of 2600 children with disability-related dietary needs paid for special dietary items for their child. [This excludes parents or caregivers who paid for special dietary items, but reclaimed the money they paid from a government agency or medical insurer.] This was the parents or caregivers of 20 percent of all children with disability-related dietary needs.

Needs assessments

A needs assessment is a process in which all of a person's care and support needs for everyday living are identified and prioritised with a needs assessor. This includes needs for home help, personal care, respite care, equipment, technology and building modifications.

At the time of the 2001 Household Disability Survey, needs assessments could be carried out by needs assessors from agencies funded by the Ministry of Health (for example, community-based Needs Assessment and Service Co-ordination agencies), Special Education Services (SES)and Child, Youth and Family. [The 2001 Household Disability Survey field manual, used by interviewers, stated that Health Funding Authority (HFA) providers carried out needs assessments. However, by the time the survey was conducted, the Ministry of Health had taken over these HFA functions.] , [Needs assessments provided by the ACC were excluded from questions in the 2001 Household Disability Survey.]

After they have been assessed, people with disability are provided with the most appropriate services and support options, depending on the funding and services available in their area.

Adults

Fifteen percent of adults with disability, an estimated 95,400 adults, had received a needs assessment.

Adults with disability in the older age groups were more likely to have received a needs assessment - 24 percent of adults aged 75-84 and 37 percent of adults aged 85 and over (Figure 3.4).

Figure 3.4: Percentage of adults with disability living in households who had ever received a needs assessment, by age, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey.

Note: Data in Appendix Table 3.137.

Eighteen percent of women and 12 percent of men with disability had received needs assessments.

European (16 percent) and Mäori (15 percent) adults with disability were more likely to have received a needs assessment than Pacific (8 percent) or Asian/Other (8 percent) adults with disability.

Almost half (48 percent) of all adults whose main disability was an intellectual disability had received a needs assessment, compared with:

• 20 percent of adults whose main disability was a mobility disability
• 17 percent of adults whose main disability was a seeing disability
• 16 percent of adults whose main disability was a psychiatric/psychological disability
• 15 percent of adults whose main disability was an agility disability
• 6 percent of adults whose main disability was a hearing disability.

(See Figure 3.5.)

Figure 3.5: Percentage of adults with disability living in households who had ever received a needs assessment, by main disability, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey.

Note: Data in Appendix Table 3.137.

More than a third (36 percent) of adults with severe disability had had a needs assessment, compared with 19 percent of adults with moderate disability and 6 percent of adults with mild disability.

When were needs assessments done?

Almost a third (31 percent) of the adults with disability who had received a needs assessment had received their most recent assessment in the previous six months. A further 26 percent had received their most recent assessment between 6 and 11 months ago.

The remaining 42 percent, an estimated 40,200 adults with disability, had received their most recent needs assessment 12 months ago or more.

Booked in for a needs assessment

The 2001 Household Disability Survey asked adults with disability who had never had a needs assessment or had had their most recent needs assessment 12 months ago or more, if they were booked in to have a needs assessment. An estimated 8700 of the adults in this group were booked in to have a needs assessment, the equivalent of 1 percent of all adults with disability living in households. [Because adults who had had a needs assessment less than 12 months ago were not asked if they were booked to have another needs assessment, the figure of 8700 may be an underestimate of the true number of adults with disability booked in to have a needs assessment.] An estimated 521,100 were not booked in.

Intention to have a needs assessment

Of the 521,100 not booked in to have a needs assessment, an estimated 27,400 (5 percent) indicated they intended to have a needs assessment. [This question was asked only of adults who were not already booked in for a needs assessment and who had never had a needs assessment or had had their last needs assessment 12 months ago or more. It was not asked of adults who had had a needs assessment less than 12 months ago.]

Reasons for not having a needs assessment recently

Thirty-four percent of adults with disability indicated they had not had a needs assessment recently (that is, less than 12 months ago) because they did not know about needs assessments. This included 32 percent of adults aged 65-74, 29 percent of adults aged 75-84 and 33 percent of adults aged 85 and over. [All adults with disability who had not had a needs assessment within the previous 12 months were asked why they had not had an assessment recently. The question was not put to those who had had an assessment less than 12 months ago or who were booked in to have a needs assessment.]

Pacific adults with disability (50 percent) were most likely to indicate they had not had a needs assessment recently because they did not know about them, followed by Asian/Other (44 percent), Mäori (41 percent) and European (33 percent) adults with disability.

Adults with hearing disability (36 percent) were most likely to report they had not been assessed recently because they did not know about needs assessments, and adults with intellectual disability were least likely to say this was so (23 percent).

Lack of awareness or knowledge of needs assessments varied little by the severity of disability. Thirty-four percent of adults with severe disability indicated they had not had a needs assessment recently because they did not know about needs assessments, as did 35 percent of adults with moderate disability and 34 percent of adults with mild disability.

Thirty-three percent of adults with disability, an estimated 209,100 people, indicated they had not had a needs assessment recently because they did not consider their disability to be serious enough. Even 15 percent of adults with severe disability indicated they had not had a needs assessment recently for this reason.

Three percent had not had a needs assessment recently because they considered their needs had not changed since their last assessment. Approximately 1 percent, an estimated 6600 adults with disability, indicated they had declined to have a needs assessment when it had been offered to them.

Children

Fifteen percent of children with disability, an estimated 13,200 children, had received a needs assessment. This was the same as the proportion of adults with disability who had received a needs assessment.

Eighteen percent of European children with disability had received a needs assessment, compared with 10 percent of Mäori and 11 percent of Pacific children. [The number of Asian/Other children was too small to report.]

Children with disability in the Southern region were most likely to have had a needs assessment (24 percent), compared with 8 percent of children in the Midland region, 13 percent in the Northern region and 14 percent in the Central region.

The likelihood of ever having received a needs assessment also varied by the type of disabilities children had. For example, over half the children using technical aids (56 percent) had received a needs assessment, compared with just 9 percent of children with hearing disability (Figure 3.6).

Figure 3.6: Percentage of children with disability living in households who had ever received a needs assessment, by disability type, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey.

Notes:

- Data in Appendix Table 3.142.

- If individuals reported more than one disability type, they were counted in each applicable disability type group.

Children with multiple disabilities were more than four times as likely as children with a single disability to have received a needs assessment (25 percent compared with 6 percent).

Nearly half (48 percent) of children with severe disability had received a needs assessment, compared with 14 percent of children with moderate disability and 3 percent of children with mild disability.

When were needs assessments done?

Just over a third (35 percent) of children with disability who had received a needs assessment had received their most recent assessment within the previous 6 months. A further 29 percent had received their most recent assessment 6 to 11 months ago, while the remaining 36 percent had received their most recent assessment 12 months ago or more.

Booked in for a needs assessment

At the time of the 2001 Household Disability Survey, an estimated 1100 children, or 1 percent of all children with disability, were booked in to have a needs assessment. This included children scheduled to have a needs assessment for the first time and children who had had a needs assessment before.

Intention to have a needs assessment

Parents or caregivers of an estimated 8300 children with disability who had not had a needs assessment in the previous year and were not already booked in for another assessment indicated they intended to have another assessment done for their child. This was equivalent to 9 percent of all children with disability.

Reasons for not having a needs assessment recently

When the parents or caregivers of children with disability who had not had a needs assessment recently were asked the reasons for this, the most common reason given was that they did not consider their children's disability to be serious enough to require a needs assessment. This reason was given by the parents or caregivers of an estimated 34,500 children; 38 percent of all children with disability. [Statistics presented here on reasons for not having a needs assessment recently exclude children who had not had a needs assessment recently, but who were booked in to have one.]

Parents or caregivers of children from higher-income households were more likely than those of children from lower-income households to consider their child's condition to be not serious enough for a needs assessment (47 percent of children with households incomes of $50,001 and over per year, compared with 31 percent of children from households with incomes of $15,000 and under per year).

Similarly, parents or caregivers of children with disability living in the least socioeconomically deprived areas of New Zealand were more likely than those living in the most socioeconomically deprived areas to consider their child's condition was not serious enough for a needs assessment. This applied to 46 percent of children living in NZDep2001 areas 1-2 (the least deprived), compared with 35 percent of children living in NZDep2001 areas 9-10 (the most deprived).

Parents and caregivers of children with seeing and hearing disabilities were most likely to say their child's condition was not serious enough for a needs assessment (38 percent and 36 percent respectively). The parents and caregivers of children with intellectual disability and children who used technical aids were the least likely to say this was so (16 percent and 18 percent respectively).

Having a condition not serious enough for a needs assessment was more common among children with a single disability (50 percent) compared with children with multiple disabilities (24 percent). As might be expected, it was also more common among children with mild disability (52 percent) than among children with moderate or severe disability (34 percent and 14 percent respectively).

The second most common reason for not having needs assessments was that parents or caregivers did not know about needs assessments. This reason was given by the parents or caregivers of 35 percent of all children with disability; an estimated 31,900 children.

Not knowing about needs assessments was a reason given more commonly by parents or caregivers of Mäori (43 percent), Pacific (47 percent) and Asian/Other children with disability (50 percent) than by parents or caregivers of European children with disability (30 percent).

Parents or caregivers of children with disability from the Midland region were most likely to say they did not know about needs assessments (42 percent). Parents or caregivers of children with disability living in the Southern region were least likely to say they did not know about needs assessments (27 percent). Thirty-five percent of parents or caregivers of children with disability from both the Northern and Central regions were unaware of needs assessments.

A lack of knowledge of needs assessments was also more common among parents or caregivers of children with disability from low income households than among parents or caregivers of children with disability from high-income households. Parents or caregivers of 38 percent of children with disability who had household incomes of $15,000 and under per year did not know about needs assessments, compared with parents or caregivers of 25 percent of children with disability who had household incomes of $50,001 and over per year.

Similarly, parents or caregivers of children with disability living in the most socioeconomically deprived areas of New Zealand (NZDep2001 areas 9-10 - 43 percent) were more likely to be unaware of needs assessments than parents or caregivers of children with disability living in the least socioeconomically deprived areas (NZDep2001 areas 1-2 - 26 percent).

Other reasons were also given for why some children with disability had not had a recent needs assessment. In the case of an estimated 2600 children, their parents or caregivers considered the child's needs had not changed since their last assessment. In the case of an estimated 1100 children, their parents or caregivers indicated that needs assessments were not available to them.

Health services

In the 2001 Household Disability Survey, people with disability were asked questions about the health services they had used or needed in the previous 12 months. [The 2001 Household Disability Survey did not ask peoplewithoutdisability these questions. However, the questions were similar to those used in the 1996/97 New Zealand Health Survey, results of which are published inTaking the Pulse(Ministry of Health 1999). A further national health survey was conducted in 2003, with results to be published in 2004.] This included asking how often they had consulted with different types of health worker such as GPs or family doctors, chemists or pharmacists, medical specialists, and nurses.

When considering the results for these and other questions in this section, it is important to remember that they refer to consultations with health services for any reason, not just consultations specifically relating to disability. Non-disability related consultations could be for routine screening, ante-natal care, immunisations, or for treatment for short-term illnesses or minor accidents.

Use of different kinds of health care worker

The four types of health worker most commonly consulted by adults with disability were:

• GPs or family doctors, consulted at least once in the previous 12 months by 86 percent of adults with disability
• chemists or pharmacists, consulted at least once in the previous 12 months by 76 percent of adults with disability
• medical specialists, consulted at least once in the previous 12 months by 40 percent of adults with disability
• nurses (without also seeing a doctor), consulted at least once in the previous 12 months by 32 percent of adults with disability.

Similarly, most children with disability (88 percent) had consulted a GP or family doctor at least once in the previous 12 months. Children were next most likely to have consulted a dentist or dental nurse (71 percent), followed by a chemist or pharmacist (61 percent), a medical specialist (42 percent) and a nurse without also seeing a doctor (30 percent) (Figure 3.7).

Figure 3.7: Percentage of people (adults and children) with disability using different types of health services in the previous 12 months, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey

Notes:

- Data in Appendix Tables 3.150 and 3.151.

- If individuals reported using more than one type of health service, they were counted in each applicable service category.

Use of general practitioners or family doctors

Adults

At least one consultation

As already indicated, 86 percent of adults with disability had consulted a GP or family doctor at least once in the previous 12 months. [Provisional results for the 2002/2003 New Zealand Health Survey show that 80 percent ofall New Zealand adults had visited their GP in the previous year (Ministry of Health 2003b).] This was an estimated 541,000 adults with disability.

Older adults were slightly more likely than younger adults to have consulted a GP or family doctor. Ninety-one percent of adults aged 65 and over consulted a GP or family doctor, compared with 84 percent of adults aged 15-64.

Eighty-eight percent of women and 85 percent of men had consulted a GP or family doctor at least once in the previous 12 months.

Ninety percent of adults whose main disability was a mobility disability consulted a GP or family doctor at least once in the previous 12 months, as did 90 percent of adults whose main disability was an agility disability. Adults whose main disability was a hearing disability had the lowest rate of GP contact, with 79 percent consulting a GP or family doctor at least once in the previous 12 months.

Virtually all adults with severe (97 percent) or moderate (92 percent) disability consulted a GP or family doctor at least once in the previous 12 months. By contrast, only 78 percent of adults with mild disability consulted a GP or family doctor over this period.

More than 10 consultations

Eighteen percent of adults with disability, an estimated 111,700 people, consulted a GP or family doctor more than 10 times in the previous 12 months.

Asian/Other adults with disability were more likely than European, Mäori and Pacific adults with disability to have consulted with a GP or family doctor more than 10 times (Figure 3.8).

Figure 3.8: Percentage of adults with disability who consulted a general practitioner or family doctor more than 10 times in the previous 12 months, by ethnic group, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey.

Note: Data in Appendix Table 3.152.

Twenty-two percent of adults whose main disability was a psychiatric/psychological disability and 20 percent of adults whose main disability was a mobility disability consulted a GP or family doctor 10 times or more in the previous 12 months. By contrast, just 9 percent of adults whose main disability was a hearing disability consulted a GP or family doctor 10 times or more.

Children

At least one consultation

As already indicated, most children with disability (88 percent) consulted a GP or family doctor at least once in the previous 12 months. This was an estimated 78,800 children with disability.

Virtually all children aged 0-4 consulted a GP or family doctor (97 percent), but children aged 5-9 and 10-14 had lower rates of contact (88 percent and 83 percent respectively).

Children using technical aids were most likely to consult a GP or family doctor in the previous year (95 percent), followed by children with chronic conditions or health problems (92 percent). Children with hearing disability (84 percent) and children with a special education disability (84 percent) were the least likely to consult a GP or family doctor over this period.

Children with a disability caused by disease/illness were most likely to have consulted a GP or family doctor in the previous 12 months (94 percent), compared with 86 percent of children with a disability caused by accident/injury, 89 percent of children with a disability caused by a condition present since birth and 81 percent of children whose disability was caused by 'other' factors.

Compared with children with moderate (87 percent) or mild (86 percent) disability, a greater proportion of children with severe disability (96 percent) had consulted a GP or family doctor in the previous year.

More than 10 consultations

Fifteen percent of all children with disability had consulted a GP or family doctor more than 10 times in the previous 12 months. This was an estimated 13,600 children.

Children with disability aged 0-4 were nearly three times more likely than children with disability aged 5-9 to have consulted a GP or family doctor more than 10 times in the previous 12 months (37 percent compared with 13 percent). Children with disability aged 10-14 were the least likely to have consulted a GP or family doctor more than 10 times (8 percent).

One in four children using technical aids (25 percent) consulted a GP or family doctor more than 10 times in the previous 12 months, as did 24 percent of children with chronic conditions or health problems. By contrast, just 11 percent of children with special education disability and 12 percent of children with seeing disability consulted a GP or family doctor this often.

Twenty-four percent of children whose disability was caused by disease/illness consulted a GP or family doctor at least 10 times in the previous 12 months, compared with 17 percent of children whose disability had existed since birth (Figure 3.9). [The number of children with disability caused by accident/injury who consulted a GP or family doctor more than 10 times was too small to report.]

One in four children with severe disability (25 percent) consulted a GP or family doctor more than 10 times in the previous 12 months. This was higher than the rates for children with moderate (13 percent) and mild (13 percent) disability.

Figure 3.9: Percentage of children with disability who consulted a general practitioner or family doctor more than 10 times in the previous 12 months, by disability type, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey.

Notes:

- Data in Appendix Table 3.153.

- If individuals reported more than one disability type, they were counted in each applicable disability type group.

Use of chemists or pharmacists

Adults

At least one consultation

Seventy-six percent of adults with disability, an estimated 473,700 adults, consulted a chemist or pharmacist for health advice or to get medication at least once in the previous 12 months.

Adults with disability aged 85 and over (80 percent) were slightly more likely to consult a chemist or pharmacist for health advice or medication than in younger adults.

Asian/Other adults with disability (65 percent) were less likely than European adults with disability (77 percent) to consult a chemist or pharmacist.

Eighty-four percent of adults with a main disability caused by disease/illness consulted a chemist or pharmacist in the previous 12 months, compared with 70 percent of adults with a main disability caused by ageing and 64 percent of adults with a main disability caused by a condition present at birth.

Adults with severe (82 percent) and moderate (81 percent) disability were more likely than adults with mild disability (68 percent) to consult a chemist or pharmacist.

More than 10 consultations

Twenty-four percent of adults with disability, an estimated 148,700 adults, consulted a chemist or pharmacist for health advice or to get medication more than 10 times in the previous 12 months.

In terms of age, adults aged 75-84 were the most likely to consult a chemist or pharmacist more than 10 times in the year (30 percent). Adults aged 15-24 were the least likely to do so (10 percent).

A third (33 percent) of adults whose main disability was caused by disease/illness consulted a chemist or pharmacist more than 10 times in the previous 12 months, compared with 19 percent of adults whose main disability was caused by ageing, and 16 percent of adults whose main disability was caused by a condition present at birth.

Thirty-seven percent of adults with severe disability consulted a chemist or pharmacist more than 10 times in the year, compared with 28 percent of adults with moderate disability and 16 percent of adults with mild disability.

Children

At least one consultation

The parents or caregivers of 61 percent of children with disability, an estimated 54,900 children, consulted a chemist or pharmacist for health advice or medication for their child in the previous 12 months.

Parents or caregivers of children aged 0-4 with disability (73 percent) were more likely to have consulted a chemist or pharmacist than parents or caregivers of children aged 5-9 (61 percent) or aged 10-14 with disability (56 percent).

In terms of disability type, parents or caregivers of children with chronic conditions or health problems were the most likely to have consulted a chemist or pharmacist about their child in the previous 12 months (77 percent). Parents or caregivers of children with seeing disability were the least likely to have done so (51 percent) (Figure 3.10).

Figure 3.10: Percentage of children with disability who consulted a chemist or pharmacist at least once in the previous 12 months, by disability type, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey

Notes:

- Data in Appendix Table 3.155.

- If individuals reported more than one disability type, they were counted in each applicable disability type group.

Parents or caregivers of nearly three-quarters (74 percent) of children with disability caused by disease/illness consulted a chemist or pharmacist about their child, compared with 61 percent of parents or caregivers of children with disability caused by a condition present since birth, 48 percent of parents or caregivers of children with disability caused by accident/injury, and 56 percent of parents or caregivers of children with disability caused by 'other' factors.

More than 10 consultations

The parents or caregivers of 14 percent of children with disability, an estimated 12,400 children, had consulted a chemist or pharmacist more than 10 times in the previous 12 months on their child's behalf.

Parents or caregivers of children aged 0-4 (22 percent) were more likely than parents or caregivers of children aged 10-14 (11 percent) to consult a chemist or pharmacist this frequently.

Parents or caregivers of children using technical aids were most likely to have seen a chemist or pharmacist more than 10 times in the previous 12 months (25 percent). Parents or caregivers of children with seeing disability were least likely to have done so (10 percent).

Parents or caregivers of children with disability caused by disease/illness (22 percent) were most likely to have consulted a chemist or pharmacist more than 10 times, followed by parents or caregivers of children with disability caused by a condition present at birth (15 percent) and parents or caregivers of children who had a disability from 'other' causes (11 percent). [The number of children with disability caused by accident/injury was too small to report.]

The parents or caregivers of more than a quarter of children with severe disability (27 percent) had seen a chemist or pharmacist about their child more than 10 times in the previous 12 months. By contrast, just 13 percent of parents or caregivers of children with moderate disability and 10 percent of parents or caregivers of children with mild disability had seen a chemist or pharmacist this often.

Use of medical specialists

Adults

At least one consultation

Forty percent of adults with disability, an estimated 252,600 adults, consulted a medical specialist in the previous 12 months. Medical specialists are doctors specialising in certain areas of medicine, for example, cardiology, general surgery, obstetrics or psychiatry.

Adults with disability aged between 45 and 74 were the most likely to consult a medical specialist, with 45 percent of adults aged 45-64 and 43 percent of adults aged 65-74 seeing a specialist in the previous 12 months. This compared with 29 percent of adults aged 15-24 and 38 percent of adults aged 75-84.

Forty-one percent of women and 40 percent of men had consulted a medical specialist in the previous 12 months.

Compared with European adults with disability (42 percent), smaller proportions of Pacific (29 percent) and Mäori (35 percent) adults with disability consulted a medical specialist at least once in the previous 12 months.

Adults from the lowest income households ($15,000 and under per year) were the least likely to consult a medical specialist (33 percent), compared with 42 percent of adults from the highest income households ($70,001 and over per year), 43 percent of adults with household incomes of $15,001-$30,000 and $30,001-$50,000 per year, and 38 percent of adults with household incomes of $50,001-$70,000 per year.

Just over half of adults with a main disability caused by disease/illness (51 percent) consulted a medical specialist at least once in the previous 12 months, compared with 27 percent of adults whose main disability was caused by a condition present since birth.

Thirty-nine percent of adults with a main disability caused by accident/injury consulted a medical specialist, as did 30 percent of adults with a main disability caused by ageing and 37 percent of adults with a main disability caused by 'other' factors.

Adults with multiple disability were more likely (45 percent) than adults with a single disability (33 percent) to consult a medical specialist.

Similarly, 56 percent of adults with severe disability consulted a medical specialist, compared with 44 percent of adults with moderate disability and 32 percent of adults with mild disability.

More than 10 consultations

Two percent of adults with disability, an estimated 14,900 adults, consulted a medical specialist more than 10 times in the previous 12 months.

Children

At least one consultation

Forty-two percent of children with disability, an estimated 32,800 children, consulted a medical specialist such as a paediatrician or surgeon at least once in the previous 12 months.

A much larger proportion of younger than older children with disability consulted a medical specialist. Sixty-three percent of children aged 0-4 consulted a specialist, compared with 38 percent of children aged 5-9 and 10-14.

Forty-seven percent of European children with disability consulted a medical specialist, compared with 36 percent of Mäori and 37 percent of Pacific children.

Children with disability from higher income households were slightly more likely than children from lower income households to have consulted a medical specialist. Forty percent of children with disability who had the lowest household incomes ($15,000 and under per year) had seen medical specialists, compared with 47 percent of children with the highest household incomes ($50,001 and over per year).

Children using technical aids were particularly likely to have seen a medical specialist in the previous year (79 percent). Children with seeing disability were the least likely to have done so (40 percent) (Figure 3.11).

Figure 3.11: Percentage of children with disability who consulted a medical specialist at least once in the previous 12 months, by disability type, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey

Notes:

- Data in Appendix Table 3.157.

- If individuals reported more than one disability type, they were counted in each applicable disability type group.

Children with multiple disabilities were more likely to consult a medical specialist than children with a single disability (49 percent compared with 36 percent).

Two-thirds of children with severe disability (67 percent) consulted a medical specialist, compared with 42 percent of children with moderate disability and 33 percent of children with mild disability.

More than 10 consultations

Four percent of children with disability, an estimated 3800 children, consulted a medical specialist more than 10 times in the previous 12 months.

Eleven percent of children aged 0-4 consulted a medical specialist this often, compared with 2 percent of children aged 5-9 and 3 percent aged 10-14.

Children using technical aids were most likely to consult a medical specialist more than 10 times in the previous 12 months (11 percent), compared with 4 to 7 percent of children with other types of disability such as seeing, hearing, intellectual or psychiatric/psychological disability.

Eleven percent of children with severe disability consulted a medical specialist more than 10 times in the previous 12 months, compared with 3 percent of children with moderate or mild disability.

Use of nurses

The results in this section relate to when people consulted or were treated by a nurse without seeing a doctor, that is, they do not include consultations with a doctor when a nurse was also present. [The type of nurse was not specified by the survey questionnaire.]

Adults

At least one consultation

Thirty-two percent of adults with disability, an estimated 198,400 adults, consulted with a nurse in the previous 12 months.

Women with disability (35 percent) were more likely than men with disability (28 percent) to consult a nurse in the previous 12 months.

Mäori (33 percent) and European (32 percent) adults with disability were more likely than Pacific (25 percent) and Asian/Other (22 percent) adults with disability to consult a nurse.

Adults with disability living in the Southern (37 percent), Midland (35 percent) and Central (31 percent) regions were more likely to consult a nurse than adults with disability living in the Northern region (26 percent).

More than 10 consultations

Five percent of adults with disability, an estimated 33,900 adults, consulted a nurse more than 10 times in the previous 12 months.

In terms of age, adults aged 85 and over were most likely to consult a nurse more than 10 times in the previous 12 months (15 percent).

Twelve percent of adults with severe disability consulted a nurse more than 10 times in the year, compared with just 2 percent of adults with mild disability.

Children

At least one consultation

Thirty percent of children with disability, an estimated 27,200 children, consulted a nurse in the previous 12 months.

The likelihood of children with disability consulting a nurse reduced with age. Forty-three percent of children aged 0-4 year olds had seen a nurse, compared with 32 percent of children aged 5-9 and 23 percent aged 10-14.

Nearly half (48 percent) of children using technical aids consulted a nurse, compared with 26 percent of children with a special education disability (Figure 3.12).

Figure 3.12: Percentage of children with disability who had seen a nurse at least once in the previous 12 months, by disability type, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey

Notes:

- Data in Appendix Table 3.159.

- If individuals reported more than one disability type, they were counted in each applicable disability type group.

Children with disability caused by accident/injury (30 percent) and children with disability caused by a condition present at birth (28 percent) were less likely to consult a nurse than children with disability caused by disease/illness (36 percent) or 'other' causes (38 percent).

Thirty-six percent of children with severe disability consulted a nurse in the previous 12 months, compared with 32 percent of children with moderate disability and 27 percent of children with mild disability.

More than 10 consultations

Three percent of children with disability, an estimated 2900 children, had seen a nurse more than 10 times in the previous 12 months.

Unmet need for health services

Adults

Fifteen percent of adults with disability, an estimated 94,900 adults, indicated there had been a time in the previous 12 months when they had needed to see a health professional, therapist or healer but had not been able to.

Younger adults with disability were more likely than older adults with disability to report an unmet need for health services (Figure 3.13). In the 25-44 age group, 24 percent had an unmet need for health services, compared with just 6 percent of adults aged 85 and over.

Figure 3.13: Percentage of adults with disability who reported having an unmet health services need in the previous 12 months, by age, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey

Note: Data in Appendix Table 3.160.

Mäori adults with disability (23 percent) were more likely than Pacific (17 percent), Asian/Other (15 percent) and European (14 percent) adults with disability to report an unmet need for health services.

Thirty-one percent of adults whose main disability was a psychiatric/psychological disability reported an unmet need for health services, compared with 17 percent of adults whose main disability was an agility disability and 13 percent of adults whose main disability was a mobility disability.

The lowest rates of unmet need for health services were reported by adults whose main disability was a hearing disability (8 percent) and adults whose main disability was a seeing disability (9 percent).

Adults with severe disability (22 percent) were more likely than adults with moderate (16 percent) or mild (12 percent) disability to report an unmet need for health services.

Children

Parents or caregivers of 17 percent of children with disability, an estimated 15,500 children, reported their child had needed to see a health professional, therapist or healer in the previous 12 months, but had been unable to.

Children with disability from the lowest income households ($15,000 and under per year) were most likely to have experienced an unmet need for these health services (29 percent), compared with 11 percent of children from the highest income households ($50,001 and over per year).

Children with disability living in the most socioeconomically deprived areas were most likely to have an unmet need for health services. Twenty-two percent of children living in NZDep2001 areas 9-10 (the most deprived areas) had an unmet need for health services, compared with 11 percent of children living in NZDep2001 areas 1-2 (the least deprived areas).

Children with psychiatric/psychological disability (27 percent), with intellectual disability (26 percent) and using technical aids (26 percent) were the most likely to have an unmet need for health services. Children with seeing disability were the least likely to have these unmet needs (12 percent).

The chances of having an unmet need for health services increased with the severity of disability. Thirty-one percent of children with severe disability had an unmet need, compared with 19 percent of children with moderate disability and 10 percent of children with mild disability.

Seven percent of children with disability, an estimated 6500 children, had an unmet need for a consultation with a medical specialist.

Five percent of children with disability, an estimated 4400 children, had an unmet need for a consultation with a GP or family doctor. Two percent, an estimated 2000 children, had an unmet need for a consultation with a counsellor, social worker or psychologist.

Fewer children with disability were estimated to have an unmet need for a consultation with an optician or optometrist (1100), dentist or dental nurse (1000), speech therapist (800) or Mäori or Pacific health worker (700).

Payment and subsidies for health services

Payment and subsidies for health services are discussed in chapter 5.

Medication

Use of medication

The 2001 Household Disability Survey asked people with disability about their use of prescribed and non-prescribed medication. Questions referred to all kinds of medication used, not just medication used for disability-related conditions or health problems. Therefore, caution is necessary when interpreting these results.

Adults

Eighty percent of adults with disability, an estimated 504,000 adults, had taken some kind of prescribed or non-prescribed medication in the previous 12 months.

Thirteen percent of adults with disability had not used any medication over this period. The medication use of the remaining 7 percent of adults with disability was not identified.

Use of medication was somewhat more common in older adults with disability, with 89 percent of adults aged 85 and over using some kind of prescription or non-prescription medication in the previous 12 months, compared with 73 percent of adults aged 15-24.

Adults whose main disability was a mobility disability (86 percent), an agility disability (83 percent) or a psychiatric/psychological disability (84 percent) were more likely to have taken medication than adults whose main disability was a hearing disability (68 percent), a seeing disability (71 percent) or an intellectual disability (77 percent).

Ninety-two percent of adults with severe disability had taken medication in the previous 12 months, compared with 85 percent of adults with moderate disability and 72 percent of adults with mild disability.

Prescribed medication

Looking just at prescribed medication, 60 percent of adults with disability indicated they used prescribed medication on a daily basis and 17 percent indicated they used it as needed.

Older adults with disability were more likely than younger adults with disability to use prescribed medication on a daily basis, with only 37 percent of adults aged 15-24 and 41 percent aged
25-44 using prescribed medication on a daily basis, compared with 79 percent of adults aged
65-74, 78 percent aged 75-84, and 79 percent aged 85 and over.

In general, younger adults with disability were more likely than older adults with disability to use prescribed medication as needed. Twenty-seven percent of adults aged 15-24 and 25-44 with disability using prescribed medication as needed, compared with just 8 percent of adults aged 65-74 and 75-84 with disability.

In terms of disability type, the highest rates of daily prescribed medication use were among adults with mobility (69 percent) and agility disability (69 percent). The lowest was among adults with intellectual disability (59 percent). Sixty-six percent of adults with psychiatric/psychological disability used prescribed medication on a daily basis.

Seventy-five percent of adults whose main disability was caused by disease/illness used prescribed medication daily, as did 67 percent of adults whose main disability was caused by ageing, 49 percent of adults whose main disability was caused by accident/injury and 43 percent of adults whose main disability was caused by a condition present at birth.

Seventy-five percent of adults with severe disability used prescribed medication daily, compared with 66 percent of adults with moderate disability and 49 percent with mild disability.

Non-prescribed medication

Fourteen percent of adults with disability indicated they were taking non-prescribed medication on a daily basis such as aspirin or herbal remedies (but excluding vitamins). Thirty-three percent were taking non-prescribed medication as needed.

In terms of age, rates of daily use of non-prescribed medication were comparatively high among adults aged 75-84 (23 percent), 65-74 (18 percent) and 85 and over (18 percent).

Twenty percent of adults with severe disability used non-prescribed medication on a daily basis, compared with 16 percent of adults with moderate disability and 11 percent of adults with mild disability.

Rates of 'as needed' use of non-prescribed medication were comparatively high in younger adults with disability, with 40 percent of adults aged 15-24 and 42 percent aged 25-44 with disability using non-prescribed medication in this way.

Children

Seventy-six percent of children with disability, an estimated 68,600 children, had taken prescribed or non-prescribed medication in the previous 12 months.

Prescribed medication

Thirty-five percent of all children with disability, an estimated 31,300 children, took prescribed medication on a daily basis. A further 3 percent took prescribed medication as needed; while 2 percent took it once a week or more. Seven percent did not take any prescribed medication.

Children with disability from higher-income households were more likely than children from lower-income households to take prescribed medication on a daily basis. Thirty-eight percent of children from the highest income households ($50,001 and over per year) took prescribed medication daily, compared with 28 percent of children from the lowest income households ($15,000 and under per year).

As might be expected, children with chronic conditions or health problems were the most likely to take prescribed medication daily (54 percent). Children with seeing disability were the least likely to do so (23 percent) (Figure 3.14).

Figure 3.14: Percentage of children with disability who took prescribed medication daily, by disability type, 2001

Source: Statistics New Zealand, 2001 Household Disability Survey

Notes:

- Data in Appendix Table 3.170.

- If individuals reported more than one disability type, they were counted in each applicable disability type group.

Half of all children with severe disability took prescribed medication daily, compared with 31 percent of children with moderate disability and 33 percent of children with mild disability.

Non-prescribed medication

A third of children with disability (34 percent), an estimated 31,000 children, took non-prescribed medication as needed. Four percent took non-prescribed medication daily - an estimated 3600 children. A further 36 percent did not take any non-prescribed medication.

Unmet need for medication

Adults

Seven percent of adults with disability, an estimated 45,000 adults, indicated that in the previous 12 months they had needed medication for disability, but were unable to get it.

In terms of age, adults aged 25-44 reported the highest rate of unmet need for medication (13 percent), followed by adults aged 15-24 and 45-64 (both 7 percent). In the older age groups, from 65 to 85 and over, rates of unmet need for medication were comparatively low, at 3 percent or less.

Fifteen percent of adults with severe disability reported an unmet need for medication, compared with 8 percent of adults with moderate disability and 5 percent with mild disability.

By far the most common reason for having an unmet need for medication was affordability, mentioned by 5 percent of all adults with disability (an estimated 32,900 adults). The next most common reason was that adults did not know they could apply for financial help or where to apply for it (an estimated 5100 adults, or 1 percent of all adults with disability). An estimated 3900 adults (1 percent) reported they had applied for financial help, but had found they were ineligible.

Children

Based on the reports of their parents or caregivers, 10 percent of children with disability had needed medication in the previous 12 months, but had been unable to get it. This was an estimated 8800 children.

Seventeen percent of Mäori children with disability had experienced an unmet need for medication, compared with 13 percent of Pacific and 6 percent of European children. [The number of Asian/Other children with an unmet need for medication was too small to report.]

Children with disability from the lowest annual income households ($15,000 and under) were more likely than children with disability from the highest annual income households ($50,001 and over) to have an unmet need for medication. Twenty percent of children from the lowest annual income households had an unmet need for medication, compared with just 6 percent of children from the highest annual income households.

Similarly, children with disability from the most socioeconomically deprived areas were more likely than children with disability from the least socioeconomically deprived areas to have an unmet need for medication. Seventeen percent of children living in NZDep2001 areas 9-10 (the most deprived) had an unmet need for medication, compared with 5 percent of children living in NZDep2001 areas 1-2 (the least deprived).

A larger proportion of children with severe disability (17 percent) had an unmet need for medication than children with moderate (10 percent) or mild disability (7 percent).

Affordability was the reason most commonly given for why children with disability were not able to get the medication they needed. This reason applied to an estimated 7400 children or 84 percent of children who said they had an unmet need for medication.

Other, less common, reasons were: parents or caregivers did not know they could apply for financial help for medication for their child, or did not know where to apply for help (1100 children); or parents or caregivers had applied for financial help for getting medication, but were ineligible (900).

Payment and subsidies for medication

Adults

Government grants and allowances to pay for medication

Seventeen percent of adults with disability, an estimated 105,600 adults, indicated they had received the Disability Allowance or a Special Needs Grant to pay for medication in the previous 12 months.

Older adults were more likely than younger adults to receive these kinds of financial assistance to pay for medication. For example, 25 percent of adults with disability aged 85 and over got a Disability Allowance or Special Needs Grant to pay for medication, compared with just 12 percent of adults aged 15-24 and 25-44 with disability. [Note that the Disability Allowance and Special Needs Grants are means tested, so receipt of these depends on financial eligibility as well as the degree of health-related need. In general, older adults are more likely than younger adults to receive a Disability Allowance, but less likely to receive a Special Needs Grant (also see chapter 5).]

Paid for medication

In the previous 12 months, 54 percent of adults with disability, an estimated 336,500 adults, paid for medication they needed for disability without getting all the money they paid refunded by a government agency or medical insurer.

Older adults with disability were generally more likely than younger adults with disability to pay for medication themselves, with 64 percent of adults aged 85 and over paying for medication, compared with 49 percent of adults aged 15-24 and 53 percent of adults aged 25-44.

Children

In the previous 12 months, parents or caregivers of 15 percent of children, an estimated 13,900 children, with disability received a Special Needs Grant or Disability Allowance to help pay for their child's medication.

Twenty-three percent of children with disability living in the Southern region received these subsidies for medication, compared with 10 percent of children in the Northern region, 14 percent of children in the Central region and 16 percent of children in the Midland region.

As might be expected given the eligibility criteria, children from the lowest income households were most likely to have received a Special Needs Grant or Disability Allowance for medication. Twenty-four percent of children with household incomes of $15,000 and under per year received this type of assistance, compared with 10 percent of children with household incomes of $50,001 and over per year.

Children using technical aids (42 percent) and children with intellectual disability (35 percent) were the most likely to receive these types of assistance. Children with hearing disability (10 percent) and children with seeing disability (12 percent) were the least likely to receive them.

Children with multiple disabilities were three times as likely as children with a single disability to receive a Disability Allowance or Special Needs Grant in the previous 12 months for medication (24 percent compared with 8 percent).

Children with severe disability (39 percent) were markedly more likely than children with moderate (16 percent) or mild disability (6 percent) to receive these types of assistance.

One percent of families had paid for medication their child needed without getting all the money refunded from a government agency or medical insurer. This was an estimated 1100 children with disability.

Comparing 2001 and 1996

The percentages of people receiving or needing most types of disability-related services and equipment did not change substantially between 1996 and 2001.

Adults

However, between 1996 and 2001 there was a slight decrease in the percentage of adults with disability receiving help with heavy household work (from 35 percent to 30 percent).

As well, the percentage of adults with disability consulting medical specialists in the previous 12 months decreased from 48 percent to 40 percent.

The percentage of adults with disability consulting a pharmacist or chemist for health advice or medication in the previous 12 months increased from 68 percent to 76 percent (Table 3.10).

Table 3.10: Comparison of selected 1996 and 2001 Household Disability Survey results for adults

	Estimated number of adults with disability living in households		Percentage of adults with disability living in households (%)
	1996 survey	2001 survey	1996 survey	2001 survey
Help received from others with everyday activities because of disability
Preparing meals	75,100	67,400	13	11
Shopping for groceries and other necessities	102,500	99,700	18	16
Everyday housework	128,300	128,500	22	21
Heavy household work	201,300	186,700	35	30
Personal finances	45,900	51,300	8	8
Personal care	29,300	34,900	5	6
Communicating with others	23,600	39,100	4	6
Unmet need for help with everyday tasks in the previous 12 months
Unmet need for help with personal care from providers other than family or friends	11,300	13,100	2	2
Unmet need for help with tasks such as housework or shopping from providers other than family or friends	24,500	23,300	4	4
Unmet need for help with home repairs or maintenance	24,900	26,400	4	4
Total with reported unmet needs for help with everyday tasks	48,200	47,800	8	8
Respite care
Unmet need for respite care in previous 12 months	9,800	10,300	2	2
Equipment and technology
Uses equipment or technology	209,000	207,200	36	33
Unmet need for equipment or technology in previous 12 months	72,200	77,100	12	12
Use of health professionals in previous 12 months
One or more consultations with GP or family doctor	523,200	541,000	87	86
One or more consultations with a nurse (without seeing a doctor)	160,000	198,400	28	32
One or more consultations with a pharmacist or chemist for health advice or medication	421,100	473,700	68	76
One or more consultations with a medical specialist	235,600	252,600	48	40
Unmet need for consultation with any health service in previous 12 months	62,300	94,900	11	15
Needs assessment
Had one or more needs assessments	81,100	95,400	14	15

Source: Statistics New Zealand, 2001 Household Disability Survey, 1996 Household Disability Survey

- Numbers too small to report (estimated frequencies outside the 70 percent relative sampling error cut-off point).

Children

There were some changes between 1996 and 2001 related to the use of health services by children with disability. The percentage of children consulting a nurse (without seeing a doctor at the same time) in the previous 12 months increased from 23 percent to 30 percent.

The percentage of parents or caregivers of children with disability reporting their child had an unmet need to consult a GP or family doctor (decreased from 16 percent to 5 percent) (Table 3.11). [In 1997, subsidies were introduced for GP visits by children under six (Ministry of Health 2004).]

Table 3.11: Comparison of selected 1996 and 2001 Household Disability Survey results for children

	Estimated number of children with disability living in households		Percentage of children with disability living in households (%)
	1996 survey	2001 survey	1996 survey	2001 survey
Unmet need for help in the previous 12 months
Unmet need for parents or caregivers to get help with personal care of child with disability	4,900	4,100	5	5
Unmet need for parents or caregivers to get help with tasks such as housework or shopping related to care of child with disability	3,600	3,600	4	4
Unmet need for parents or caregivers to get help with home repairs or maintenance related to care of child with disability	3,500	4,300	4	5
Respite care
Parents or caregivers needed respite care in previous 12 months	16,700	16,600	18	18
Unmet need for respite care in previous 12 months	7,100	8,000	8	9
Equipment and technology
Uses equipment or technology	N/A	7,700	N/A	9
Unmet need for equipment or technology in previous 12 months	2,800	2,700	3	3
Use of health professionals in previous 12 months
One or more consultations with GP or family doctor	82,000	78,800	87	88
One or more consultations with a nurse (without seeing a doctor)	25,400	27,200	23	30
One or more consultations with a pharmacist or chemist for health advice or medication	56,400	54,900	57	61
One or more consultations with a medical specialist	42,100	37,800	39	42
Unmet need for consultation with a GP or family doctor in previous 12 months	15,100	4,400	16	5
Unmet need for consultation with a medical specialist in previous 12 months	8,400	6,500	9	7
Unmet need for consultation with any health service in previous 12 months	16,200	15,500	17	17
Needs assessment
Had one or more needs assessments	11,700	13,200	12	15

Source: Statistics New Zealand, 2001 Household Disability Survey, 1996 Household Disability Survey

- Numbers too small to report (estimated frequencies outside the 70 percent relative sampling error cut-off point).

N/A Not applicable.