People living with disability are 3.6 times more likely to die from a potentially preventable cause than the general population (AIHW 2020a), partially due to a lack of preventative healthcare measures being taken for people with disability (NDIS Commission 2019).

However, in addition to proactively addressing health risks in people with disability, health issues and potential deaths can also be reduced in these populations by modifying lifestyle risk factors (AIHW 2020b).

It’s been found that people living with disability in Australia display higher rates of certain modifiable lifestyle risk factors than the general population (AIHW 2020b).

This is likely because people living with disability may face specific challenges that make it more difficult to modify these risk factors - for example, a person with a physical disability may require extra assistance to maintain regular physical activity (AIHW 2020b).

In 2019, it was recommended that the NDIS Commission increase providers and workers’ awareness and knowledge of how the serious injury and death of people with disability can be prevented (NDIS Commission 2019).

As part of these recommendations, in July 2021, the Australian Commission on Safety and Quality in Health Care and NDIS Commission released a practice alert explaining the importance of addressing lifestyle risk factors in people with disability.

What are Lifestyle Risk Factors?

Lifestyle risk factors are modifiable attributes, characteristics or exposures that may increase the risk of developing illnesses and health issues, or exacerbate existing health problems (ACSQHC & NDIS Commission 2021; AIHW 2020b).

Changing or modifying these risk factors can improve the overall health of an individual, as well as reduce the risk of illness or death (ACSQHC & NDIS Commission 2021; AIHW 2020b).

There are two types of lifestyle risk factors:

1. Behavioural risk factors are actions that individuals can directly modify
2. Biomedical risk factors are potentially harmful bodily states that can be influenced by behaviours but are also associated with genetic, socioeconomic and psychological factors.

(AIHW 2020b)

Examples of lifestyle risk factors include:

(AIHW 2016; ACSQHC & NDIS Commission 2021)

Consequences of Lifestyle Risk Factors

Lifestyle risk factors are associated with a variety of health issues, including:

• Cardiovascular disease
• Stroke
• Type 2 diabetes
• Osteoporosis
• Cancers (colorectal, breast, lung, cervical)
• Poor oral health
• Chronic kidney disease
• Depression
• Osteoarthritis
• Rheumatoid arthritis
• Chronic obstructive pulmonary disease
• Asthma.

(AIHW 2016)

Lifestyle Risk Factors in People With Disability

People with disability are more likely than the general population to experience certain physical and mental health conditions that could be caused or exacerbated by lifestyle risk factors. These include cardiovascular disease, respiratory disease, cancer, diabetes, oral diseases, depression and anxiety (ACSQHC & NDIS Commission 2021).

They are also more likely to have lifestyle risk factors than the general population. For example, in Australia:

• 72% of people with disability are inactive (compared to 52% of the general population)
• 49% of people with disability do not consume an adequate amount of fruits and vegetables (compared to 41% of the general population)
• 18% of people with disability smoke daily (compared to 12% of the general population)
• 54% of people with disability have hypertension (compared to 27% of the general population).

(AIHW 2020b)

Interestingly, people living with disability have lower rates of excessive alcohol consumption than the general population (AIHW 2020b).

Barriers to Addressing Lifestyle Risk Factors

There are a variety of reasons why people with disability may find it more difficult than the general population to modify certain behavioural lifestyle risk factors:

(Gadsby & Jones 2014; AIHW 2020b; ACSQHC & NDIS Commission 2021)

Supporting Clients to Address Lifestyle Risk Factors

With the above barriers in mind, how can people living with disability be supported to optimise their health and wellbeing and reduce lifestyle risk factors?

• Support clients to set achievable small goals and slowly work their way up (e.g. not having sugar in their coffee)
• Facilitate connection with others by encouraging clients to participate in community and local activities that promote a healthy lifestyle (e.g. cooking classes, walking groups, a community garden)
• Use health promotion to help clients better understand the importance of a healthy lifestyle
• Support clients to make informed decisions about their own lifestyle, including helping them to understand any current health risks and how they can be addressed
• Increase clients’ motivation to maintain a healthy lifestyle by encouraging them and highlighting their achievements
• Suggest a variety of ideas for improving health, e.g. learning to cook or walking instead of driving
• Support clients to make changes to their living environments (e.g. increasing the number of healthy foods in their cupboard)
• Support clients to access health professionals such as dietitians and physiotherapists who can help them achieve their health goals
• Ensure clients undergo an annual comprehensive health assessment.

(ACSQHC & NDIS Commission 2021)