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Professor Robert A. Cummins, School of Psychology, Deakin University delivered this presentation at the 2013 National Disability Summit in Australia. The annual conference brings together healthcare industry professionals to discuss the future direction of disability policy reform. For more information, please visit the conference website: www.healthcareconferences.com.au/nationaldisabilitysummit
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Robert A. Cummins Australian Centre on Quality of Life
Deakin University
Informal Carers:
Some of our Most Disadvantaged
Citizens
http://www.deakin.edu.au/research/acqol
Conference Theme
The National Disability Insurance Scheme
and the transition to self-directed funding
and support
Conference Theme
The National Disability Insurance Scheme
and the transition to self-directed funding
and support
How will we know if the scheme is
effective?
An evaluation with many parts
1. To measure the subjective wellbeing of
the recipients before and after the
scheme becomes operational
2. To look especially carefully at our most
disadvantaged citizens
Quality of Life
[wellbeing]
Objective Wellbeing Subjective Wellbeing
[happiness]
Objective Conditions
e.g. Physical health
Subjective Perceptions
e.g. Satisfaction with health
?
www.vermontdairy.com/ice_cream
Feelings of ‘happiness’
come in two varieties
Short-term ‘emotional’ happiness
An emotional response to something nice
Long-term ‘mood’ happiness
A mood with a genetic basis
Subjective wellbeing
[Contentment]
Personal Wellbeing Index
• Standard of living
• Health
• Achieving in life
• Relationships
• Safety
• Community connectedness
• Future security
How satisfied are you with your-----?
∑ = Subjective
Wellbeing
The Australian Unity Wellbeing Index
Surveys
Geographically representative sample
N = 2,000
Telephone interview
#1: April 2001
------------
#28: Sept 2012
76.7
73.7
>S11
>S2, S4, S5
Scores above this line aresignif icantly higher than S1
SurveyDate
Major eventspreceding survey
72
73
74
75
76
77
S1 A
pr 2001
S2 S
ep
t 2001
S3 M
ar
2002
S4 A
ug
2002
S5 N
ov 2
002
S6 M
ar
2003
S7 J
un 2
003
S8 A
ug
2003
S9 N
ov 2
003
S10 F
eb
2004
S11 M
ay 2
004
S12 A
ug
2004
S13 M
ay 2
005
S14 O
ct
2005
S15 M
ay 2
006
S16 O
ct
2006
S17 A
pr
2007
S18 O
ct
2007
S18.1
Feb
2008
S19 A
pr
2008
S20 O
ct
2008
S20.1
Feb
2009
S21 M
ay 2
009
S22 S
ep
t 2009
S23 A
pril 2010
S24 S
ep
t 2010
S25 A
pr
2011
S26 S
ep
t 2011
Strengthof
satisfaction
Maximum = 76.3Current = 75.5Minimum = 73.2
a b c d e f g h i j k l m n
Personal Wellbeing Index
2001 - 2012
76.7
73.7
>S11
>S2, S4, S5
Scores above this line aresignif icantly higher than S1
SurveyDate
Major eventspreceding survey
72
73
74
75
76
77
S1 A
pr 2001
S2 S
ep
t 2001
S3 M
ar
2002
S4 A
ug
2002
S5 N
ov 2
002
S6 M
ar
2003
S7 J
un 2
003
S8 A
ug
2003
S9 N
ov 2
003
S10 F
eb
2004
S11 M
ay 2
004
S12 A
ug
2004
S13 M
ay 2
005
S14 O
ct
2005
S15 M
ay 2
006
S16 O
ct
2006
S17 A
pr
2007
S18 O
ct
2007
S18.1
Feb
2008
S19 A
pr
2008
S20 O
ct
2008
S20.1
Feb
2009
S21 M
ay 2
009
S22 S
ep
t 2009
S23 A
pril 2010
S24 S
ep
t 2010
S25 A
pr
2011
S26 S
ep
t 2011
Strengthof
satisfaction
Maximum = 76.3Current = 75.5Minimum = 73.2
a b c d e f g h i j k l m n
Personal Wellbeing Index
2001 - 2012
This represents a 3.0 percentage point variation
Why is subjective wellbeing
held so steady?
Homeostasis
Just like we hold body temperature steady
Subjective wellbeing homeostasis
Each person has a set-point for their
subjective wellbeing.
60
90
Range for
individual
set-points
These set-points
lie between
60 and 90
Set-points are always POSITIVE
ie above 50
Subjective wellbeing constantly under
challenge, but is well protected
Challenges Subjective
Wellbeing
[normal] X
External resources
(eg. relationships,
money)
The most protective External Resources
A close relationship
http://images.google.com.au/imgres?imgurl=http://i1.trekearth.com/photos/12651/small_-_old_couple.jpg&imgrefurl=http://www.trekearth.com/gallery/Asia/China/photo114529.htm
&h=267&w=400&sz=97&hl=en&start=13&sig2=g6PUgVjsMT8vqd1hp3DFsQ&um=1&tbnid=2jGBr7dyST6m0M:&tbnh=95&tbnw=143&ei=3rOhRt6XEJ2mggOIhqXlDQ&prev=/images%3
Fq%3Dold%2Bcouple%26svnum%3D10%26um%3D1%26hl%3Den%26safe%3Doff%26sa%3DG
Money
How does money link to happiness?
Money is a flexible resource that allows
people to defend themselves against life’s
challenges
Income is an external resource that enhances
resilience
Median
Total N ≈ 30,000
76.3
Normal Range
73.0
* 78.0
* 76.5
* 73.9
71.7
74.9
78.3 78.4
71
72
73
74
75
76
77
78
79
80
81
<$15 $15-30 $31-60 $61-90 $91-120 $121-150 $150+
Gross household income ($'000)
Subjective
wellbeing *
Australian Unity Wellbeing Index
[cumulative data]
763
Normative Range
73.0
79.1 79.1
77.4 77.4 77.3
76.5
75.4
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
<$15 $15-$30 $31-$60 $61-$90 $91-$120 $121-$150 $150+
Household Income ($'000)
Partner only
Subjective
Wellbeing
median
Australian Unity Wellbeing Index
[cumulative data]
76.3
73.0
Normative Range
79.1
80.7
75.4
76.5 77.3 77.4
77.4
79.1
77.3
78.9
70.3
72.6
75.9
78.2
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
<$15 $15-$30 $31-$60 $61-$90 $91-$120 $121-$150 $150+
Household Income ($'000)
Partner only
Partner & children
Subjective
Wellbeing
Australian Unity Wellbeing Index
[cumulative data]
76.3
Normative Range
73.0
79.1
80.7
64.1
70.1
76.3
79.1
77.4 77.4 77.3
76.5
75.4
78.2
75.9
72.6
70.3
78.9
77.3 76.5
69.6
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
<$15 $15-$30 $31-$60 $61-$90 $91-$120 $121-$150 $150+
Household Income ($'000)
Partner only
Partner & children
Sole parent
Subjective
Wellbeing
Australian Unity Wellbeing Index
[cumulative data]
76.3
Normative Range
73.0
79.1
80.7
64.1
70.1
76.3
79.1
77.4 77.4 77.3
76.5
75.4
78.2
75.9
72.6
70.3
78.9
77.3 76.5
69.6
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
<$15 $15-$30 $31-$60 $61-$90 $91-$120 $121-$150 $150+
Household Income ($'000)
Partner only
Partner & children
Sole parent
Subjective
Wellbeing
SWB at low levels is
exquisitely responsive
to additional resources
Homeostasis can fail
Overwhelming
negative
challenges
Subjective
wellbeing
Homeostasis can fail
Overwhelming
negative
challenges
Subjective
wellbeing
The result of subjective wellbeing loss is
depression
March 2007
Special Report 16.1
“The Wellbeing of Australians – Groups with the highest and lowest
wellbeing in Australia”
http://www.deakin.edu.au/research/acqol/index_wellbeing/index.htm
So who are our most disadvantaged citizens?
Normal range76.4
(N)
73.4
66.6
71.4 71.970.5
61.360.0
58.5
55
60
65
70
75
80
(548)
Unemployed
(2,146)
<$15K
(2,774)
Live
alone
(752)
<$15K
and
Alone
(144)
<$15K
and
Unemployed
(134)
Alone
and
Unemployed
(3,766)
Carers
PWI
Low Wellbeing in Australia
.
Normal range76.4
(N)
73.4
66.6
71.4 71.970.5
61.360.0
58.5
55
60
65
70
75
80
(548)
Unemployed
(2,146)
<$15K
(2,774)
Live
alone
(752)
<$15K
and
Alone
(144)
<$15K
and
Unemployed
(134)
Alone
and
Unemployed
(3,766)
Carers
PWI
Low Wellbeing in Australia
.
Major risk factors
Special purpose samples
Members of Carers Australia
Mailed questionnaires
July 2007
N ≈ 4,000 returns
Normal range76.4
(N)
73.4
66.6
71.4 71.970.5
61.360.0
58.5
55
60
65
70
75
80
(548)
Unemployed
(2,146)
<$15K
(2,774)
Live
alone
(752)
<$15K
and
Alone
(144)
<$15K
and
Unemployed
(134)
Alone
and
Unemployed
(3,766)
Carers
PWI
The wellbeing of carers
What does low wellbeing mean?
Abnormally
low subjective
wellbeing
= High risk of
depression
Are you the person who provides most
of the care?
76.4Normal range
73.4
*
61.3
58.2
55
60
65
70
75
80
Yes
(N=3,447)
No
(N=295)
Primary care responsibilitiy
PWI
Can we change the subjective
wellbeing of carers by providing
them with more resources?
2011-2012
Evaluation of Carer counselling effectiveness
National Carer Counselling Program
Prior to
counselling
Shortly after
the last
session
3-month
follow-up
Counselling
1 hour/week
6 weeks
Collaboration with Carers Australia
76.7
80.0
76.0 75.4
81.5 82.1
72.8 73.7
79.3
73.7
75.4
73.6 71.9
77.4 75.4
68.8 68.3
76.0
45
50
55
60
65
70
75
80
85
PWI Standard of
Living
Health Achieving Relationships Safety Community Future
Security
General Life
Satisfaction
Strength
of
satisfaction
Generic population domain-specific normative range
76.7
80.0
76.0 75.4
81.5 82.1
72.8 73.7
79.3
73.7
75.4
73.6 71.9
77.4 75.4
68.8 68.3
76.0
45
50
55
60
65
70
75
80
85
PWI Standard of
Living
Health Achieving Relationships Safety Community Future
Security
General Life
Satisfaction
Strength
of
satisfaction
Generic population domain-specific normative range
85 respondents
76.7
80.0
76.0 75.4
81.5 82.1
72.8 73.7
79.3
73.7
75.4
73.6 71.9
77.4 75.4
68.8 68.3
76.0
58.1
68.5
55.2
48.7
55.5
68.8
53.3 54.1
49.5
45
50
55
60
65
70
75
80
85
45
50
55
60
65
70
75
80
85
PWI Standard of
Living
Health Achieving Relationships Safety Community Future
Security
General Life
Satisfaction
Strength
of
satisfaction
Generic population domain-specific normative range
Carers before Time 1
76.7
80.0
76.0 75.4
81.5 82.1
72.8 73.7
79.3
73.7
75.4
73.6 71.9
77.4 75.4
68.8 68.3
76.0
58.1
68.5
55.2
48.7
55.5
68.8
53.3 54.1
49.5
62.8
68.4
59.3
56.9
62.2
72.2
59.7 61.8
58.0
45
50
55
60
65
70
75
80
85
45
50
55
60
65
70
75
80
85
PWI Standard of
Living
Health Achieving Relationships Safety Community Future
Security
General Life
Satisfaction
Strength
of
satisfaction
Generic population domain-specific normative range
Carers before Time 1
Carers after Time 2
76.7
80.0
76.0 75.4
81.5 82.1
72.8 73.7
79.3
73.7
75.4
73.6 71.9
77.4 75.4
68.8 68.3
76.0
58.1
68.5
55.2
48.7
55.5
68.8
53.3 54.1
49.5
62.8
68.4
59.3
56.9
62.2
72.2
59.7 61.8
58.0
65.6
72.3
60.5
59.3
64.9
74.9
63.1 62.4 62.6
45
50
55
60
65
70
75
80
85
45
50
55
60
65
70
75
80
85
PWI Standard of
Living
Health Achieving Relationships Safety Community Future
Security
General Life
Satisfaction
Strength
of
satisfaction
Generic population domain-specific normative range
Carers before Time 1
Carers after Time 2
Carers after Time 3
Will this be significantly changed by
the NDIS?
Conclusion:
The low wellbeing of Carers in Australia
is a national disgrace.
Will this be significantly changed by
the NDIS?
An excellent evaluation will give us the
answer
Conclusion:
The low wellbeing of Carers in Australia
is a national disgrace.