Health risk factors affect the onset and prognosis of a variety of chronic diseases. A wide body of research has demonstrated complex yet robust connections between a number of biomedical and behavioural factors and major chronic diseases and conditions (AIHW 2002d), including the fact that the major chronic diseases share common risk factors (AIHW 2004b). Environmental factors from cultural, socioeconomic and physical domains have also been shown to have a strong association with both disease and ill-health.
Socioeconomic status is a significant determinant of the likelihood that individuals and populations are exposed to health risk factors (Blakely, Hales & Woodward 2004). As outlined in other chapters in this report, Aboriginal and Torres Strait Islander people experience widespread disadvantage across a range of socioeconomic indicators including income, education, employment and housing conditions. These factors may all contribute to the high rates of environmental and behavioural risk factors reported by Indigenous Australians in 2002.
Understanding risk factors facilitates early intervention and management strategies to prevent or ameliorate disease and so achieve health gains for individuals and populations (NPHP 2001). The World Health Organization (2000) states that:
'Much is known about the prevention of non communicable diseases. Experience clearly shows that they are to a great extent preventable through
interventions against the major risk factors and their environmental, economic, social and behavioural determinants in the population'.
The health risk factors presented in this chapter focus on behavioural risk factors, including smoking, alcohol, illicit substance use and physical inactivity, as well as selected environmental risk factors, such as stress, exposure to violence and removal from natural family. Associations between risk factors and other health indicators are also presented. However, in some cases it is not known whether the risk factor leads to poor health or whether poor health leads to increased exposure to that risk factor. A brief section on nutrition and body weight is included at the end of the chapter.
The 2002 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) provides the most recent data for the majority of risk factors presented in this Chapter. Where possible, information from the 2002 General Social Survey (GSS) has also been included in order to provide comparisons between the Indigenous and non-Indigenous populations. Data from various other sources, such as the 2001 National Health Survey (NHS), the 2001 National Drug Strategy Household Survey (NDSHS) and the National Hospital Morbidity Database (NHMD) are also included (see the Data Sources for further details).