Summary

Health outcomes among people with chronic conditions can vary depending on socioeconomic position. There is limited information on how chronic condition health outcomes vary with individual socioeconomic position measures, such as employment status and income level. Therefore, this report aims to increase the knowledge of the association between individual-based measures of socioeconomic position and health status among people with chronic conditions.

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Profile of working-age Australians with chronic conditions

Working-age Australians (15–64 years) living with chronic conditions when compared to those without chronic conditions, in 2017–18 were:

  • older, with 47% in the 45–64 age group compared with 29%
  • more likely to be living alone, 13% compared with 8%
  • more likely to live outside major cities, 29% compared with 23%
  • less likely to be employed either full-time or part-time, 71% compared with 80%
  • more likely to receive a government pension or allowance, 18% compared with 7%
  • more likely to self-assess their health as poor, 21% compared with 5%.

Around 2 in 3 working-age Australians had tertiary qualifications, 67% among those with chronic conditions and 68% among those without chronic conditions.

Factors associated with poor self-assessed health among mature working-age Australians with chronic conditions

Among people living with chronic conditions, poor self-assessed health is more common with increasing age—26% of those aged 45–64 years had poor self-assessed health, compared with 16% among those aged 15–44 years.

To identify the factors associated with poor self-assessed health among mature working-age (45–64) Australians with chronic conditions, a cross-sectional analysis using multiple logistic regression was conducted.

In summary, the analysis found that after keeping all the other factors equal, mature working-age Australians with chronic conditions were more likely to report poor self-assessed health if they had any of the following characteristics:

  • had 3 or more types of chronic conditions—adjusted odds ratio (OR) (95% confidence interval, CI): 3.17 (2.42–4.16) when compared with those who had 1 type of chronic condition
  • had any activity limitations or a disability—adjusted OR (95%CI): 3.48 (2.64–4.58) when compared with those who had no activity limitations or a disability
  • were male—adjusted OR (95%CI): 1.65 (1.25–2.17) when compared with females
  • were renters—adjusted OR (95%CI): 1.61 (1.13–2.30) when compared with those who were home owners without a mortgage
  • were living alone—adjusted OR (95%CI): 1.39 (1.07–1.81) when compared with those who lived in a couple-only household
  • had no tertiary qualifications—adjusted OR (95%CI): 1.37 (1.03–1.83) when compared with those who had tertiary qualifications.

How COVID-19 could affect the life and work of Australians with chronic conditions

In 2020 and 2021, the lives of all Australians have been affected by the COVID-19 pandemic to varying degrees. The following are examples of socioeconomic changes due to the COVID-19 pandemic that may have affected working-age Australians with chronic conditions:
 

  • Risk of social isolation and loneliness

    During an outbreak, social interaction was significantly limited by government restrictions that were put in place to lower the risk of COVID-19 transmission in the community, increasing the risk of social isolation and loneliness.

    People who are living on their own may have a greater risk of experiencing social isolation and loneliness (Relationships Australia 2018). Living alone has also been associated with a 30% increased risk of early death, which is similar to the risk associated with well-known risk factors such as obesity (Holt-Lunstad et al. 2015).

    In 2017–18, more working-age Australians with chronic conditions were living alone compared to those without chronic conditions (13% compared with 8%).

  • Labour force changes among more mature working age Australians

    At the time of writing, there is no information on how the pandemic affected labour force participation among Australians with chronic conditions, particularly, among those of mature working age. This is particularly important as mature-age workers can find it hard to change jobs or find a new job if they are made redundant (COTA 2018).

    In 2017–18, mature working age Australians (45–64) with chronic conditions were:

    • twice as likely to be out of the labour force—30% were not in the labour force compared with 16% of those without chronic conditions. Whereas, of those 15–44, the proportions were 20% compared with 16%, respectively.
    • less likely to be employed—67% compared with 82% of those without chronic conditions. ​

    The Australian Government recognises the barriers to labour force participation among the mature working-age population; more information on the support available can be found here: Mature Age Hub - Department of Education, Skills and Employment, Australian Government (dese.gov.au)
     

  • ​Risk of financial stress

    The COVID-19 pandemic may have had significant impact on the employment and financial circumstances of many people, particularly for those living with chronic conditions. The effects of losing employment or increasing rent in combination with their ongoing chronic conditions management cost may put them at even greater risk of financial stress.

    In 2017–18, an estimated 1 in 5 working-age Australians with chronic conditions were recipients of a government pension or allowance as their main source of income—more than the proportion of those without chronic conditions (18% compared with 7%).

    More information on Australian Government COVID-19-related support can be found at Coronavirus (COVID-19)—Department of Education, Skills and Employment, Australian Government (dese.gov.au)