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4102.0 - Australian Social Trends, 1996  
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Contents >> Health >> Risk Factors: Health risk factors and Indigenous people

Risk Factors: Health risk factors and Indigenous people

The lower standard of health of Indigenous people compared to non-Indigenous people may be partly due to their higher exposure to health risk factors.

The overall health of Indigenous Australians is worse than that of the total population (see The health of Indigenous people). Health risk factors such as the use of tobacco, alcohol and other drugs, as well as inadequate diet and nutrition, impact on people's health. Examining the link between risk factors and illness can lead to the development of strategies to improve health.

In the opinion of Indigenous people, the abuse of alcohol and other substances is one of their major health problems. The National Aboriginal Health Strategy includes a series of targets aimed at reducing this and other health risk behaviour1.


Health risk factors

Health risk factors are those factors which increase the chance an individual has of developing an illness or injury. Health risk factors include tobacco and alcohol consumption, lack of exercise, poor diet, low or excess weight and exposure to accidental injury. In this review the population refers to people aged 13 and over.

Care should be taken when considering the link between risk factors and illness conditions. People suffering from an illness may not be currently engaging in any health risk behaviours. However, they may have engaged in health risk behaviours before they developed the illness condition.

This review presents data on the proportion of Indigenous people who reported being current smokers and drinkers. Strictly comparable data are not available for the entire Australian population. However, to give an indication of whether Indigenous rates are high or low in comparison to the general population, Population Survey Monitor (PSM) data can be used. In May 1994, the PSM collected data on the smoking and drinking behaviour of people aged 18 and over. It found that 24% of people were smokers and 58% of people had consumed alcohol in the previous week.

Capital city comprises all state and territory capital city statistical divisions. Other urban comprises all centres with a total population of 1,000 and over, excluding capital cities. Rural comprises rural areas and towns with a total population of less than 1,000 people. Most remote Indigenous communities are included in this category.


Perceived health risks
In 1994, of the health risk factors listed, Indigenous people most commonly identified alcohol as a problem in their local area (59%). This was followed by drugs (30%), and diet/nutrition (20%). A similar proportion of males and females reported drugs as a health problem in their local area. However, males were slightly more likely than females to report alcohol as a problem (60% compared to 58%) while females were slightly more likely than males to report diet/nutrition as a health problem (22% compared to 18%).

People aged 18-44 were more likely than those in other age groups to perceive alcohol (62%) and drugs (32%) as a problem in their local area. Those aged 35-54 were more likely than people in other age groups to report diet and nutrition (25%) as a health problem in their local area. This may be because many people have family responsibilities at this age.

INDIGENOUS PEOPLE'S PERCEIVED HEALTH RISK FACTORS(a), 1994

Alcohol
Drugs
Diet/nutrition
Other substances
Age
%
%
%
%

13-17
49.5
30.0
12.2
4.9
18-24
63.4
32.8
16.3
4.8
25-34
61.5
31.4
21.2
6.0
35-44
62.6
33.0
25.7
6.4
45-54
58.1
28.7
24.7
8.0
55-64
56.9
21.2
22.7
3.7*
65 & over
51.9
16.8
17.0
3.2*
Total
59.1
30.3
19.7
5.6
'000
'000
'000
'000
Total(b)
114.3
58.6
38.0
10.8

(a) Refers to the proportion in each age group who perceived the health risk factors listed to be a problem in their local area. People could identify more than one risk factor. Percentage calculations exclude perceived health risk factors not stated. Data exclude prisoners.
(b) Total people who identified each health risk factor as a problem in their local area.

Source: National Aboriginal and Torres Strait Islander Survey, 1994 (unpublished data)


Alcohol use
Excessive consumption of alcohol is a major risk factor for many illnesses. In the 1994 National Aboriginal and Torres Strait Islander Survey information was not collected on level of alcohol consumption. Indigenous people were asked the period of time since they had last consumed alcohol. 62% of Indigenous people reported that they had consumed alcohol in the previous year. Males were more likely than females to report that they had consumed alcohol (69% compared to 55%).

In 1994, 29% of Indigenous people aged 13-17 reported that they had consumed alcohol in the previous year. This rose to 74% for people aged 18-34, and decreased to 34% for those aged 65 and over. This pattern is similar for the total population (see Australian Social Trends 1995, Alcohol use).

In 1994, 39% of Indigenous people reported that they had consumed alcohol in the previous week. This represented almost two-thirds (64%) of all Indigenous people who had consumed alcohol in the previous year suggesting that most people who consumed alcohol did so regularly. Almost half of all Indigenous people aged 18-44 had consumed alcohol in the previous week (49%).

PERIOD SINCE INDIGENOUS PEOPLE LAST CONSUMED ALCOHOL, 1994

Aged 13-17
Aged 18-24
Aged 25-34
Aged 35-44
Aged 45-54
Aged 55-64
Aged 65 & over
Total
Period since last consumed alcohol
%
%
%
%
%
%
%
%

Total who consumed alcohol(a)
28.5
74.5
73.7
72.2
60.4
47.2
34.1
61.7
    One week or less ago
9.2
48.8
48.4
49.6
40.6
31.1
25.9
39.4
    Over 1 week to under 1 month ago
8.2
12.8
12.7
9.7
11.1
7.9
4.2*
10.7
    1 month to under 3 months ago
4.2
5.6
4.8
5.2
4.1
3.5*
3.1*
4.7
    3 months to under 12 months ago
7.0
7.3
8.0
7.7
4.5
4.7
* *
6.8
Total who did not consume alcohol
71.5
25.5
26.3
27.8
39.6
52.8
65.9
38.3
Total
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
'000
'000
'000
'000
'000
'000
'000
'000
Total people
33.7
41.7
51.5
33.6
18.6
10.8
7.6
197.5

(a) Refers to people who drank in the previous 12 months.

Source: National Aboriginal and Torres Strait Islander Survey, 1994 (unpublished data)


Tobacco use
Tobacco use is recognised as a major preventable cause of disease, disability and death. In 1994, 50% of Indigenous people aged 13 and over said they were smokers. Males were more likely than females to smoke (54% compared to 46%).

Tobacco consumption among Indigenous people varies by age. In 1994, 22% of Indigenous people aged 13-17 reported being smokers. This rose to 63% for those aged 25-34, then decreased to 25% for those aged 65 and over.

In 1994, smokers and non-smokers were about equally likely to report experiencing a long-term illness. This may be due to people giving up smoking when they develop an illness. It is also associated with long-term illnesses occurring at older ages, when people are less likely to be smokers.

PROPORTION OF INDIGENOUS PEOPLE WHO SMOKE(a), 1994

Males
Females
Persons
Age
%
%
%

13-17
22.6
21.8
22.2
18-24
61.4
53.4
57.5
25-34
66.7
59.7
63.3
35-44
61.7
53.1
57.3
45-54
53.6
45.1
49.3
55-64
46.5
29.9
38.0
65 & over
38.0
16.1
25.1
Total
53.8
46.0
49.9
'000
'000
'000
Total smokers
52.6
45.6
98.2

(a) Smokers refer to all people who reported smoking cigarettes. Percentage calculations exclude smoker status not stated.

Source: National Aboriginal and Torres Strait Islander Survey, 1994 (unpublished data)

SMOKING STATUS OF INDIGENOUS PEOPLE WHO HAD A LONG-TERM ILLNESS, 1994

Smoker(a)
Non-smoker
Total(b)
Type of illness experienced
%
%
%

Asthma
12.3
13.2
12.8
High blood pressure
9.0
10.6
9.8
Diabetes
5.5
7.0
6.2
Chest problems
7.4
4.5
6.0
Heart problems
4.7
6.3
5.5
Kidney problems
4.7
3.5
4.1
Total who had a long-term illness(c)
38.4
39.0
38.7
'000
'000
'000
Total who had a long-term illness
37.7
38.5
76.4

(a) Refers to all people who reported smoking cigarettes.
(b) Includes smoker status not stated.
(c) Includes other long-term illnesses. Components do not add to totals because a person may experience more than one type of illness.

Source: National Aboriginal and Torres Strait Islander Survey, 1994 (unpublished data)


Diet
People's diets are a major determinant of their health status. Many Indigenous people suffer from a range of health problems which may be linked to inadequate diet. They may also lack a secure, affordable, quality food supply, especially people in remote communities2. In 1994, 5% of Indigenous people aged 13 and over reported that they had gone without food for one day or more during the previous four weeks.

Of those people who went without food, 39% did so for 1-3 days and 34% for 4-6 days. 16% did not state the length of time they went without food. Indigenous people living in rural areas were more likely than those in capital cities or other urban areas to go without food. In 1994, over half (52%) of all people who went without food were living in rural areas.

Indigenous people may go without food for many reasons. In 1994, the most common reason reported was not having enough money, reported by 92% of people who went without food.

Breastfeeding is an important health issue for children. Often the growth of Indigenous children is impeded by infection and by poor nutritional intake. Promotion of breastfeeding is the primary strategy to ensure adequate growth in the first six months of life1.

In 1994, 71% of all Indigenous children aged 0-12 either were being or had been breastfed. The proportion of children who either were being or had been breastfed was highest among those aged under 2 years (76%). It was lowest among those aged 12 (63%). This indicates increased participation in breastfeeding among Indigenous people over time.

INDIGENOUS PEOPLE WHO WENT WITHOUT FOOD, 1994

Length of time people went without food(a)

1-3 days
4-6 days
Over 6 days
Total(b)
Geographic location
%
%
%
%

Capital city
23.6
6.0*
30.1*
23.6
Other urban
33.2
18.1
13.1*
24.3
Rural
43.1
75.8
56.8
52.1
Total(c)
100.0
100.0
100.0
100.0
'000
'000
'000
'000
Total people who went without food
4.2
3.7
1.2
10.8

(a) Refers to length of time people went without food in the previous four weeks. This question was asked on the household form, and the answers were applied to all individuals in the household.
(b) Includes period without food not stated.

Source: National Aboriginal and Torres Strait Islander Survey, 1994 (unpublished data)


Relative weight
Being overweight or obese is associated with increased morbidity and mortality from non-insulin dependent diabetes mellitus, coronary heart disease, hypertension, gall bladder disease, and some types of cancers2.

In 1994, of Indigenous people who were measured, 34% were of acceptable weight, 15% were underweight, 29% were overweight and the remaining 23% were obese. Males were more likely than females to be of acceptable weight (35% compared to 32%). Indigenous people were less likely than all Australians to be of acceptable weight. In 1989-90 the National Health Survey found that 50% of people aged 18 and over were of acceptable weight, 12% were underweight, 29% were overweight and the remaining 9% were obese.

In 1994, Indigenous people who were obese were more likely than others to report a long-term illness. 48% of obese people and 42% of overweight people said they suffered a long-term illness, compared to 36% of people of acceptable weight and 37% of people who were underweight. People who were overweight or obese were more likely to report suffering from diabetes, heart problems and high blood pressure than those who were of acceptable weight or underweight.

RELATIVE WEIGHT(a) OF INDIGENOUS PEOPLE, BY LONG-TERM ILLNESS EXPERIENCED, 1994

Underweight
Acceptable weight
Overweight
Obese
Total(b)
Type of illness experienced
%
%
%
%
%

Total who had a long-term illness(c)
37.0
36.1
41.6
47.8
38.7
    Asthma
13.0
11.7
12.8
15.6
12.8
    Ear or hearing problems
9.8
8.8
12.5
12.4
10.0
    High blood pressure
2.4
5.7
12.1
17.8
9.8
    Diabetes
0.8*
3.7
7.0
10.9
6.2
    Chest problems
5.5
6.2
7.0
5.6
6.0
    Skin problems
6.1
6.0
5.9
7.6
5.9
    Heart problems
4.5
3.9
6.7
7.6
5.5
    Kidney problems
4.0
3.3
4.6
4.6
4.1
    Eye problems(d)
2.4
2.8
3.8
3.4
3.0
Total who did not have a long-term illness
63.0
63.9
58.4
52.2
61.3
Total
100.0
100.0
100.0
100.0
100.0
'000
'000
'000
'000
'000
Total people
22.2
49.3
42.3
33.2
197.5

(a) Relative weight is calculated using a body mass index (BMI) score, which is a person's weight in kilograms divided by the square of their height in metres. Underweight refers to a BMI of less than 20; acceptable weight refers to a BMI of 20 to 25; overweight refers to a BMI of over 25 to 30; and obese refers to a BMI greater than 30.
(b) Includes weight not stated.
(c) Includes other long-term illnesses. Components do not add to total because people may report more than one type of illness.
(d) Excludes eye problems which can be corrected by glasses.

Source: National Aboriginal and Torres Strait Islander Survey, 1994 (unpublished data)


Endnotes
1 National Aboriginal Health Strategy Working Party (1989) A national Aboriginal health strategy.

2 Department of Health, Housing and Community Services (1993) Goals and targets for Australia's health in the year 2000 and beyond, University of Sydney.

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