How quality of life changes over time for Australians with disability

First published online 10 June 2024.

Why this study was done

People with disabilities often face challenges that can affect their quality of life. However, some report a surprisingly high quality of life despite these challenges—a phenomenon known as the “disability paradox.”

This study aimed to explore whether this paradox holds true over time by tracking how the health-related quality of life of Australians with disabilities changes over a decade. The researchers also wanted to understand how different types of disabilities and personal factors (like age, gender, income, and education) influence these changes.

What the study did

Using data from the HILDA Survey (a large, long-term Australian study), the researchers followed over 3,700 people with disabilities from 2011 to 2021. They used a health score called SF-6D, which measures physical and mental well-being, to track changes in quality of life.

They grouped people based on how their health scores changed over time using a method called Group-Based Trajectory Modelling.

What the study found

Four Distinct Quality of Life Trajectories:

1. High health-related quality of life Group (33%)

• Consistently high quality of life over time.

2. Moderate-Improving Group (19%)

• Started with lower scores but improved over time.

3. Moderate-Deteriorating Group (12%)

• Started well but declined over time.

4. Low health-related quality of life Group (36.5%)

• Consistently low quality of life.

What Influences These Trajectories?

1. Type of Disability Matters

• People with psychosocial disabilities (e.g., mental health conditions) had the highest risk of being in the low health-related quality of life group.
• Physical disabilities and work-limiting disabilities also strongly predicted lower quality of life.
• People with multiple disabilities were more likely to stay in poor health over time.

2. Demographics

• Older adults were more likely to be in the deteriorating or low health-related quality of life groups.
• Women were more likely than men to be in the low or improving groups, suggesting both vulnerability and potential for improvement.

3. Socioeconomic Status

• People with higher income and education were more likely to be in the high health-related quality of life group.
• Those with lower income were more likely to be in the low health-related quality of life group.

Does the “Disability Paradox” Hold Up?

Not really. The study found that people with fewer or less severe disabilities and better socioeconomic conditions had better quality of life. So, the idea that people with significant disabilities often report high quality of life (the paradox) didn’t hold up in this long-term data.

What this means

Not all people with disabilities experience the same quality of life over time. By understanding the different paths people take, we can better design policies and supports that meet their specific needs and improve their well-being.

• Targeted support is needed for people with psychosocial and physical disabilities, especially those with work-limiting conditions.
• Programs like the National Disability Insurance Scheme and Disability Support Pension could be more effective if they consider these different life trajectories.
• Resource allocation should be based on the type and severity of disability and the person’s life circumstances.

This study was conducted by:

Dr. Rubayyat Hashmi, Prof. Byron W. Keating, Dr. Mohammad Afshar Ali & Dr. Syed Afroz Keramat

To read the full article, visit the journal.

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Disclaimer: The QDRN has utilised generative AI to refine the wording of this plain language summary. All content has been checked for accuracy, appropriate tone and clarity and approved by the author.