Excessive alcohol consumption is a major risk factor for morbidity and mortality in all populations (AIHW 2006b). People who regularly drink at harmful levels place themselves at substantially increased risk of chronic ill-health and premature death, while an episode of heavy drinking places the drinker and others at increased risk of injury and morbidity (NHMRC 2001). In 2003, alcohol was associated with 7% of all deaths and 6% of the total burden of disease for Indigenous Australians (Vos et al 2007). Excessive alcohol consumption also accounted for the greatest proportion of the burden of disease and injury for young Indigenous males (aged 15-34 years) and the second highest (after intimate partner violence) for young Indigenous females.
Two measures of alcohol consumption risk level were derived from the 2004-05 NATSIHS. The first measure was designed to capture long-term risk and was based on a person's reported average daily consumption of alcohol in the previous week. The second measure was designed to capture short-term risk, or binge drinking, and was based on the frequency of consuming five or more (for females) or seven or more (for males) standard drinks on any one occasion in the last 12 months. See box 8.4 for further details.
Chronic alcohol consumption
|8.4 MEASURES OF ALCOHOL CONSUMPTION IN ABS INDIGENOUS HOUSEHOLD SURVEYS|
Two measures of alcohol consumption are collected in ABS Indigenous household surveys: risk level associated with long-term (or chronic) patterns of alcohol consumption; and risk level associated with episodes of short-term (or binge) drinking. Risk levels in both the 2004-05 NATSIHS and 2002 NATSISS were based on the 2001 National Health and Medical Research Council (NHMRC) risk levels for harm in the long-term and short-term. Both surveys assume the level of long-term alcohol consumption in the reference period was typical.
In the 2004-05 NATSIHS, information on long-term risky/high risk alcohol consumption was collected for Indigenous persons aged 18 years and over, based on the average self-reported daily amount (mls) of alcohol consumed in the week prior to interview. This methodology was essentially the same as that used in the 2001 NHS(I), therefore the results for the two surveys are considered directly comparable.
Information on short-term (or binge) risky/high risk alcohol consumption was collected in the NHS for the first time in 2004-05. This measure was based on the self-reported frequency of consuming five or more (for females) or seven or more (for males) standard drinks on any one occasion in the 12 months prior to interview. The output for this item comprised two parts: short-term risky/high risk alcohol consumption at least once a week in the last 12 months; and short-term risky/high risk alcohol consumption on at least one occasion in the last 12 months.
The 2002 NATSISS also collected both long-term and short-term measures of alcohol consumption, but these measures were different from those used in the 2004-05 NATSIHS. The long-term risky/high risk measure was collected for Indigenous persons aged 15 years and over and was based on the self-reported amount of alcohol (mls) consumed on a usual drinking day, as well as the frequency of consumption, in the 12 months prior to interview. The short-term measure was based on the self-reported largest quantity of alcohol consumed on a single day during the fortnight prior to interview.
Given the different conceptual elements and collection methodologies between the two surveys (particularly for short-term alcohol risk) the results cannot be directly compared. However, both the NATSIHS and NATSISS produced very similar estimates of the proportion of Indigenous adults who drink at chronic risky/high risk levels.
In 2004-05, Indigenous people aged 18 years and over were more likely than non-Indigenous people to abstain from drinking alcohol (table 8.6). Of those who did consume alcohol in the week prior to the survey, one in six Indigenous adults (16%) reported long-term (or chronic) risky/high risk alcohol consumption, up from 13% in 2001. In non-remote areas, the proportion of Indigenous adults who drank at chronic risky/high risk levels increased from 12% in 2001 to 17% in 2004-05.
Indigenous men were more likely than Indigenous women to drink at long-term risky/high risk levels (19% compared with 14%). This was evident in all broad age groups under 55 years (graph 8.5). While rates of risky/high risk drinking were similar for Indigenous people in remote and non-remote areas, people in remote areas were nearly three times as likely as those in non-remote areas to report never having consumed alcohol (18% compared with 6%).
8.5 CHRONIC RISKY/HIGH RISK ALCOHOL CONSUMPTION(a),
Indigenous persons aged 18 years and over -
Indigenous people who drank at long-term risky/high risk levels were more likely than those who drank at low risk levels to report fair/poor health (25% compared with 18%) and were less likely to report excellent or very good health (35% compared with 45%). Chronic risky/high risk alcohol consumption was also associated with higher rates of tobacco smoking (69% compared with 48% of low risk drinkers), high/very high levels of psychological distress (32% compared with 24%) and hypertensive disease (23% compared with 16% for those aged 35 years and over).
After adjusting for age differences between the two populations, the rates of chronic risky/high risk drinking were similar for both Indigenous and non-Indigenous Australians in 2004-05 (table 8.6).
8.6 CHRONIC ALCOHOL CONSUMPTION, Persons aged 18 years and over - 2004-05
Age standardised rate ratio(a)
|Chronic alcohol risk level |
|Low risk |
|Risky/high risk |
|Total drinkers in the last week(b) |
|Did not consume alcohol in the last week(c) |
|. . not applicable |
|(a) Rate ratios are calculated by dividing the Indigenous age standardised proportion for a particular characteristic by the non-Indigenous age standardised proportion for the same characteristic. |
|(b) Includes persons for whom risk level was unknown. |
|(c) Includes persons who had never consumed alcohol. |
|(d) Includes persons for whom time since last consumed alcohol was not known. |
|Source: ABS 2004-05 NATSIHS, 2004-05 NHS |
In 2004-05, more than half (55%) of Indigenous people aged 18 years and over reported drinking at short-term risky/high risk levels on at least one occasion in the last 12 months. One in five (19%) reported drinking at these levels at least once a week. Rates of weekly binge drinking were lower among older age groups, ranging from 23% of those aged 18-24 years to 9% of those aged 55 years and over. In all age groups, regular binge drinking was more common among Indigenous males than Indigenous females. Overall, 24% of males drank at short-term risky/high risk levels on a weekly basis compared with 15% of females.
Regular binge drinking was associated with poorer health and wellbeing among Indigenous young people in 2004-05. Indigenous people aged 18-34 years who reported binge drinking at least once a week were less likely to say their health was excellent/very good compared with those who had not consumed alcohol in the last 12 months (43% compared with 58%). They were also more likely to report high/very high levels of psychological distress in the four weeks prior to interview (35% compared with 21%). Weekly binge drinkers were also more likely than those who had not consumed alcohol in the last year to regularly smoke (67% compared with 37%) and, in non-remote areas, to have recently used illicit substances (43% compared with 11%).
In 2004-05, rates of binge drinking were higher for Indigenous than non-Indigenous people in every age group (graph 8.7). After adjusting for age differences between the two populations, Indigenous Australians were twice as likely as non-Indigenous Australians to drink at short-term risky/high risk levels at least once a week.
8.7 ACUTE RISKY/HIGH RISK ALCOHOL CONSUMPTION(a),
Persons aged 18 years and over -