People with disabilities report poor health and mental health status

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The detail in 'Irish Health Survey 2019 - Persons with a Disability' is based on self-reported data from persons aged 15 years and over who experience certain physical and sensory difficulties and outlines their view of their health status, the informal social supports available to them, and the extent to which they encounter (for persons aged 55 years and over) difficulties in performing personal care (for example, eating, dressing themselves, showering) or household activities (for example, performing housework or shopping).  The Physical and sensory difficulties covered in the report are: (i) Difficulty in seeing, even when wearing glasses or contact lenses, (ii) Difficulty in hearing what is said in a conversation with one other person in a quiet room even when using a hearing aid, (iii) Difficulty in hearing what is said in a conversation with one other person in a noisier room even when using a hearing aid, (iv) Difficulty in walking half a km on level ground without the use of any aid, (v) Difficulty in walking up or down 12 steps, (vi) Difficulty in remembering or concentrating.

Main findings

• A quarter of persons with a disability report that their health status is Bad or very bad, which is well in excess of the 4% of persons at State level who also report their health status as Bad or very bad.
• 43% of persons with disabilities report some form of depression, well above the State average of 14%.
• 31% of those with a lot of Difficulty remembering or concentrating, report they have Moderately severe or severe depression.
• Persons with walking difficulties report the poorest non-mental health status of persons with disabilities.
• Around a quarter of persons with disabilities report having unmet health care needs due to waiting times, compared to a State average of 14%.
• Almost 90% of persons with disabilities report that others show some or a lot of interest or concern in what they are doing.
• Three-quarters of persons with disabilities report that they find it Easy or very easy to get practical help from neighbours.

Health Status of people with disability

A quarter of persons with any of the disabilities surveyed reported that their health status is Bad or Very Bad, which is well in excess of the 4% of persons at State level who also report their health status as Bad or Very Bad. Three-quarters of those with a disability report they have a long-standing health condition (compared to a State average of a quarter), and 35% of those with any of the physical or sensory difficulties surveyed reported they are Severely limited in carrying out everyday activities due to a health problem (compared to a State average of 5% of persons aged 15 years and over).

Over 4-in-10 (43%) of persons aged 15 years and over with disabilities report some form of depression, well above the State average of 14%. In particular, 9% of persons with a disability report suffering from Moderately severe or severe depression, over four times the average State level of 2%.

Persons with Difficulties in remembering or concentrating report the highest levels of depression of those with disabilities, with only 20% of them reporting None to minimal levels of depression, with the other disability categories reporting that at least half of them had None to minimal levels of depression. The differences in depression levels between the different disability types is more pronounced for the more severe levels of depression – 31% of those who indicated they had a lot of Difficulty with remembering or concentrating or cannot do it all, report they have Moderately severe or severe depression, well in excess of the next highest grouping (10% of persons with Difficulty hearing what is said in a quiet room or Difficulty in walking half a km).

Just one fifth (20%) of persons with disabilities who indicated a physical difficulty with walking (either Difficulty walking half a km or Difficulty walking up or down 12 steps) indicate that their health status is Very good or good. This level is far below the health status reports for other disability types – around half of persons with hearing difficulties report their health status as being Very good or good, while 39% of those with sight difficulties so report.  Persons with walking difficulties also report relatively high levels of having a long-standing health condition (85% of those who report having a lot of difficulty with walking or cannot do it all). Only persons with Difficulties remembering or concentrating report higher levels of having a long-standing health condition (at 89% of this group).

Around a quarter (26%) of persons with disabilities report having unmet health care needs in the 12 months prior due to waiting times, compared to a State average of 14% of persons aged 15 years and over.  

Over a third (37%) of persons with disabilities aged 55 years and over report they have at least one difficulty with a personal care activity (Feeding, Getting in and out of a bed or chair, Dressing or undressing, Using toilets and Bathing or showering). This is four times higher than the State average (9%) for persons aged 55 years and over.

Almost 8-in-10 (77%) of persons with disabilities aged 55 years and over report having difficulties with household activities, like housework, shopping and preparing meals. Persons who report a lot of difficulty with walking activities and with Difficulty remembering or concentrating report the highest levels for difficulties with household activities – at over 90% of persons in these disability groups.

Policy Recommendations

People with disabilities have been cumulatively affected by a range of decisions made as part of successive austerity Budgets. These included cuts to social welfare payments, changes in medical card eligibility, increased prescription charges, and cuts to supports such as respite, home support hours, and housing adaptation grants. The cumulative effect of changes makes it difficult for some people to continue to live in their communities. People with a disability have also been disproportionately impacted by Covid-19 which has had a hugely negative impact on ther services and supports available to them.  Despite Government commissioning work on the issue of a cost of disability payment no steps as yet have been taken towards its introduction. If people with a disability are to be equal participants in society, the extra costs generated by disability should not be borne by them alone. The cross-sectional needs of people with disabilities must also be recognised. People with a disability need to be supported, not only by the health service, but through Local Authorities with regard to housing need, through the Department of Social Protection in terms of income supports, as well as by the Department of Education through education and training.