Australian Bureau of Statistics
Celebrating the International Year of Statistics 2013

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SELF-ASSESSED HEALTH

Self-assessed health status provides an overall measure of a population's health based on individuals' personal perceptions of their own health. Health is recognised as having physical, mental, social, and spiritual components and measures of health must therefore go beyond more objective measures such as morbidity and mortality. Self-assessed health provides a suitable broad measure of health status. It is dependent on an individual's awareness of their health as well as the social constructs and definitions of health that surround them. There may therefore be inconsistencies between a person's own self-assessed health status and their health status as measured by objective health assessment techniques (AHMAC 2006). Despite self-assessed health status being a subjective measure of health status, international studies have found it has strong predictive power for subsequent mortality (Quesnel-Vallee 2007).

In the 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), around 43% of the Indigenous population aged 15 years and over reported their health as very good or excellent, 35% reported their health as being good and 22% reported their health as fair or poor. After adjusting for differences in the age structures of the Indigenous and non-Indigenous populations, Indigenous Australians were twice as likely as non-Indigenous Australians to report their health as fair or poor in 2004-05 (ABS 2006c).

The proportion of both Indigenous and non-Indigenous Australians reporting fair or poor health was higher in older age groups (graph 7.1). Around one in ten Indigenous Australians aged 15-24 years ( 9%) reported fair or poor health compared with 50% of those aged 55 years and over (ABS 2006c).

Indigenous females were more likely to report their health as fair or poor than Indigenous males (24% compared with 19% respectively). Indigenous Australians aged 15 years and over in non-remote areas were more likely than those in remote areas to report fair or poor health (23% compared with 19%) (AIHW 2007a).

7.1 PERSONS REPORTING FAIR OR POOR HEALTH, by Indigenous status and age - 2004-05

7.2 SELF-ASSESSED HEALTH STATUS, Indigenous persons aged 15 years and over, by sex - 1994 and 2004-05
		1994 NATSIS			2004-05 NATSIHS
		Males	Females	Persons	Males	Females	Persons
Excellent/very good	%	48.8	42.1	45.3	44.9	41.7	43.2
Good	%	32.8	40.9	37.1	35.7	34.1	34.9
Fair/poor	%	18.1	16.8	17.5	19.4	24.1	21.9
Total	no.	102 200	112 400	214 600	139 600	154 000	293 600
Source: ABS 1994 NATSIS, 2004-05 NATSIHS

Self-assessed health and socioeconomic factors

Health status is related to socioeconomic status - people with higher socioeconomic status generally enjoy better health than those with lower socioeconomic status. In 2004-05, Indigenous adults with relatively high equivalised household incomes (as measured by the fourth and fifth quintiles) were more likely to report very good or excellent health than those with lower equivalised household incomes (49% compared with 33%) (table 7.3). For more information on equivalised income and income quintiles, see Glossary.

Indigenous males and females who had completed Year 12 or equivalent were also much more likely to report very good or excellent health (54% of males and 50% of females) compared with those whose highest level of schooling was Year 9 or below (28% of males and 29% of females). Similarly, employed Aboriginal and Torres Strait Islander people were more likely than those who were unemployed to report very good or excellent health (48% compared with 41%) (table 7.3). Those who were not in the labour force were even less likely than the unemployed to report very good or excellent health (29%), however, this is probably also age-related (i.e. older people comprise a greater share of those who are not in the labour force, and a smaller share of those with very good or excellent health).

After adjusting for age differences between the Indigenous and non-Indigenous populations, Indigenous adults were less likely than non-Indigenous adults with the same socioeconomic characteristics to report very good or excellent health. Apart from unemployed Indigenous and non-Indigenous females who were equally likely to report very good or excellent health, Indigenous to non-Indigenous sex-specific rate ratios were between 0.6 and 0.8 for the selected socioeconomic characteristics (table 7.3).

7.3 SELECTED SOCIOECONOMIC CHARACTERISTICS, Proportion of Indigenous persons aged 18 years and over with excellent/very good health - 2004-05
		Proportion with excellent/very good health			Indigenous to Non-Indigenous rate ratio(a)
		Males	Females	Persons	Males	Females	Persons
		%	%	%	rate	rate	rate
Equivalised gross household income(b)
	Lowest quintile	31.3	34.2	33.0	0.8	0.7	0.7
	Second quintile	42.0	37.1	39.3	0.7	0.6	0.7
	Third quintile	51.9	43.6	48.1	0.8	0.7	0.7
	Fourth and fifth quintile	46.8	51.6	49.2	0.7	0.7	0.7
Highest year of school completed(c)
	Year 9 or below(d)	28.3	28.5	28.4	0.8	0.7	0.7
	Year 10 or 11	45.5	39.8	42.4	0.6	0.6	0.7
	Year 12 or equivalent	54.0	50.2	51.9	0.7	0.6	0.7
Labour force person
	Employed	48.7	46.0	47.5	0.7	0.6	0.7
	Unemployed	43.2	37.8	40.8	0.6	1.0	0.8
	Not in the labour force	23.5	32.1	29.3	0.7	0.6	0.6
(a) Rate ratios are the age standardised rates for Indigenous persons divided by the rates for other persons. Rates are directly age standardised to the 2001 Australian population.
(b) The annual household income quintile boundaries are based on the equivalised gross household income per week for the total population of Australia. Boundaries are as follows: lowest quintile $0-264 per week; second quintile $265-426 per week; third quintile $427-611 per week; fourth quintile $612-869 per week; and fifth quintile $870 or more per week.
(c) Excludes persons still at school.
(d) Includes persons who never attended school.
Source: AIHW analysis of the ABS 2004-05 NATSIHS

Self-assessed health status and other selected indicators

According to the 2004-05 NATSIHS, Indigenous adults who reported having been removed from their natural families as children were more likely to report fair or poor health (35% of men and 41% of women) than those who had not (20% of men and 25% of women). Indigenous adults who spoke English as their main language at home were more likely to report fair or poor health (22% of men and 27% of women) than those who spoke an Aboriginal or Torres Strait Islander language at home (19% of both men and women).

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