In Australia, approximately 4.4 million people or 18% of the population have disability.1 Disability is a broad term that refers to impairments, activity limitations and restrictions that impact an individual’s ability to participate in society on an equal basis with others.1 Twenty-three per cent have a mental or behavioural disorder as their primary disability.1 Studies show that the prevalence of disability in Aboriginal and Torres Strait Islander peoples is twice that of the non-Indigenous population, although there are some data collection gaps in terms of methodology.2,3 The participation rates of Aboriginal and Torres Strait Islander peoples in disability services remains lower than the reported prevalence.4 Almost 43% of people aged 15–64 years with disability rely on a government payment as their main source of income and 53% are participating in the labour force.1
People with disability have a higher burden of poor health outcomes and risk factors. In a national survey of self-reported outcomes, 32% of participants with disability reported high levels of psychological distress compared to 8% of the participants without disability.1 People with disability have much higher rates of obesity, hypertension and smoking and lower rates of sufficient physical activity when compared to people without disability.1,5
People with disability experience higher rates of health inequity, abuse and discrimination, as evidenced by the Royal Commission into Violence, Abuse, Neglect, and Exploitation of People with Disability, established in 2019. Across their lifespan, twice as many people with disability reported experiencing physical violence, sexual violence, intimate partner violence, emotional abuse and/or stalking compared to their counterparts without disability.6 People with intellectual disability are markedly over-represented in preventable hospitalisations for epilepsy and convulsions as well as for vaccine preventable conditions such as influenza and pneumococcal disease.7 Patients with disability in regional and remote areas likely face greater hardships with regards to access to appropriate health services.
General practitioners (GPs) play an essential role in disability care, both in terms of looking after the health of patients with disability, but also in terms of being their advocates while navigating an increasingly fragmented and complex health system. Screening children early for signs of developmental delay in primary care is crucial to linking paediatric patients with allied health interventions that can change the trajectory of their development and potential disability. Screening for and managing metabolic risk factors for patients with disability becomes even more important considering the higher burden of chronic disease they experience.
GPs are the primary physicians for patients with disability living in residential care, playing a key role in screening for issues including cognitive decline, frailty and signs of abuse, while also advocating for appropriate strategies including falls prevention, management plans for chronic diseases and appropriate behaviour management strategies for patients.