According to the national Disability, Ageing and Carers survey, the prevalence of disability, impairment and chronic conditions is approximately 1.9 times higher for First Nations Australians when compared to disability prevalence rates for non-indigenous Australians. Where one lives has significant implications for the overall health and wellbeing of First Nations people living with disabilities, their families and communities. 

First Nations Australians with disabilities face a range of barriers to service access and supports across all areas of life, particularly in rural and remote areas. Long-standing issues of racism and disablism in mainstream service design remain. Rural and remote disability provision also lacks a rich diversity of services and supports that are culturally responsive and adaptable to meet specific disability support needs. 

This is compounded by the lack of availability of safe, accessible and adaptable employment opportunities, which only heightened during the ongoing Covid-19 pandemic. In particular, the onset of the Delta variant in 2021 created a new set of risks for First Nations persons with disabilities and their households. Its level of severity intensified the need for a well-developed response from governments, but once again it was the First Nations organizations and services that stepped in to keep communities safe throughout this extremely difficult period. 

Employment rates for First Nations Australians with disabilities are, aside from the impacts of the pandemic, the lowest in Australia when compared to all population groups, including the non-indigenous population with disabilities. Prior to the pandemic, only 33 per cent of working-age First Nations Australians with disabilities were employed, compared to 53 per cent of the disability population overall and 84 per cent of the population living without disabilities. While there is no direct data available on the percentage of the loss of employment for First Nations persons with disabilities as a result of the renewed lockdowns, the experience of the First Peoples Disability Network (FPDN) of working with communities nationwide strongly suggests that households with disabilities were directly affected. 

FPDN’s work on the ground suggests that the impact was two-fold. First, community members living with disabilities and/or chronic health conditions were compelled to withdraw from their workplaces with the switch to remote work from home. Second, for many households, family members were also often forced to withdraw from the workforce to ensure that household members with disabilities and chronic conditions remained safe and protected. Further, First Nations households with family members with disabilities and/or chronic conditions consciously placed in-home support staff ‘on hold’ due to the high risk of contracting Covid-19 from care staff. Family members were then having to step in and fill this gap, impacting upon their capacity to work their previous hours at the same intensity, and in some instances having to leave their jobs completely due to the level of care support required in the home. 

It is often assumed that Australia, a G-20 economy, has well-established digital networks and connectivity across the country. However, enduring issues of infrastructure, reliability and affordability directly impacted on the capacity of many First Nations households to undertake remote work during renewed or extended lockdowns. It is estimated that only 63 per cent of First Nations households have access to home internet. This is not surprising, given its costs and household budget constraints: prior to the pandemic, 32.6 per cent of Aboriginal and Torres Strait Islander people with disabilities were living in households with an equivalized weekly gross income in the lowest quintile. First Nations household budgets prioritize food, energy expenditure and costs associated with private transport to ensure ongoing access to health care and services, particularly in peri-urban, rural and remote areas that rarely offer readily available, accessible and frequent public transport. Therefore, the capacity to ‘work from home’ – requiring not only the upfront costs to purchase IT hardware such as computers, laptops, smartphones and tablets, but also the ongoing costs of maintaining expensive telecommunications plans to access data – is for many simply not an option. 

The impacts of these employment barriers were especially severe in the broader context of increasing public health risks and economic precarity. Despite the lessons learnt in personal protective equipment (PPE) distribution in 2020, there was a continued failure by national, state and territory governments to effectively implement a satisfactory PPE plan for vulnerable First Nations persons with disabilities and their households alongside the disability service sector working in First Nations communities. As at the beginning of the pandemic, the Aboriginal Health and Medical Services continued to be critical to filling this gap for communities. However, the opening of internal and international borders resulted in the rapid spread of the virus in late 2021 and early 2022, leading to widespread infections in areas that until then had managed to prevent the spread to vulnerable community members with disabilities and/or chronic health conditions. Supplies subsequently became extremely thin on the ground and, when available, proved very expensive for low-income households to purchase. At the same time, state and territory governments – which are largely responsible for public health policy – moved to a model of individual responsibility for PPE and rapid test purchasing, again placing a significant financial burden to stay ‘safe and well’ on already strained and vulnerable households. 

Unfortunately, the experience of poor servicing and distribution of PPE, supports and other essential items also generated further distrust of government responses across many First Nations communities regarding vaccine take-up. By October 2021, First Nations leaders such as Professor Peter Yu were calling on the prime minister to respond to the low vaccination rates within First Nations communities nationwide – at the time, only 46 per cent among those aged 16 or older, compared to 75 per cent across the country as a whole – involving open public letters, media advocacy and lobbying. 

Food insecurity also remained at the forefront of challenges for First Nations people with disabilities and their households. Throughout 2021, the strain on food distribution systems was particularly difficult. The rural farm-based contingent workforce has historically been reliant on short-term migrant labour programmes, which were put on hold with the closure of international borders. The food distribution production chain – from farm to supermarket warehouses to homes – faced radical disruption as delivery transport systems were strained with the rapid rise of Covid-19 cases among transport workers, many of whom lived in hard lockdown suburbs and therefore faced severe restrictions on movement with renewed public health orders. Moreover, the broader Australian population made a general switch to home delivery services to minimize the possibilities of contagion. 

All of these constraints, therefore, adversely affected the timely distribution of food and drove up the cost of groceries – particularly healthier options – significantly during the year. For First Nations persons with disabilities, whose households are some of the poorest in Australia, the combined effects of these price increases radically undermined their food security. And unlike 2020, when social security payments doubled to cover the devastating effects of the pandemic on the newly unemployed workforce and precarious workers, payment rates were wound back to almost pre-pandemic levels, outside an AU$25 per week increase, pushing poor, social security dependent households into further food insecurity and economic precarity. While community organizations have done their best to alleviate the plight of the most marginalized families – for instance, FPDN’s innovative partnerships with the Muslim charity Al-Ihsan Foundation Australia was further expanded to ensure community members with disabilities were provided with basic food parcels to address the immediate gaps – it is difficult to keep pace with the scale of need. For First Nations persons with disabilities, this means inclusive health care, added financial assistance to weather the challenges of the pandemic, and a meaningful route to access employment safely and equitably.

Photo: Vale – Elder Aunty Gayle Rankine, ‘Ngarrindjeri woman’ by Belinda Mason, Unfinished Business series. Aunty Gayle Rankine was Chairperson of the First Peoples Disability Network (Australia) and had lived experience of physical disability and as a carer of relatives with physical and neurological disability.