HEALTH GLOSSARY

Aboriginal and Torres Strait Islander

Persons who identify themselves as being of Aboriginal and/or Torres Strait Islander origin.

Aboriginal and Torres Strait Islander death

The death of a person who is identified as being of Aboriginal and/or Torres Strait Islander origin on the Death Registration Form (DRF). From 2007, Aboriginal and Torres Strait Islander origin for deaths registered in South Australia, Western Australia, Tasmania, the Northern Territory and the Australian Capital Territory is also derived from the Medical Certificate of Cause of Death (MCCD).

Age-specific death rate

Age-specific death rates (ASDRs) are the number of deaths (occurred or registered) during the calendar year at a specified age per 1,000 of the estimated resident population of the same age at the mid-point of the year (30 June). Pro rata adjustment is made in respect of deaths for which the age of the deceased is not given.

Alcohol consumption risk level

Alcohol consumption risk levels in the long-term were derived from the average daily consumption of alcohol by persons aged 15 years and over for 3 days of the week prior to interview and are grouped into relative risk levels as defined by the National Health and Medical Research Council (NHMRC) in 2001 as follows:

Alcohol risk level(a)
	Consumption per day
Risk level	Males	Females
Low risk	50 mLs or less	25 mLs or less
Risky	More than 50 mLs, up to 75 mLs	More than 25 mLs, up to 50 mLs
High risk	More than 75 mLs	More than 50 mLs
(a) One standard drink contains 12.5 mLs of alcohol.

It should be noted that risk level as defined by the NHMRC is based on regular consumption levels of alcohol whereas estimates of risk from the NHS do not take into account whether consumption in the reference week was more, less or the same as usual.

The level of long-term risk is associated with regular daily patterns of drinking. Drinking status information was also collected for those who did not consume any alcohol in the 7 days prior to interview. Categorised as:

• Last consumed more than one week to less than 12 months ago;
• Last consumed 12 months or more ago; and
• Never consumed.

Body Mass Index (BMI)

Calculated from height and weight information, using the formula weight (kg) divided by the square of height (m). To produce a measure of the prevalence of underweight, normal weight, overweight or obesity in adults, BMI values are grouped according to the table below which allows categories to be reported against both the World Health Organization (WHO) and National Health and Medical Research Council (NHMRC) guidelines.

Body mass index, Adult
Underweight	Less than 18.5
Normal range	18.5 to less than 20.0
	20.0 to less than 25.0
Overweight	25.0 to less than 30.0
Obese	30.0 and greater

Separate BMI classifications were produced for children. BMI scores were created in the same manner described above but also took into account the age and sex of the child. There are different cutoffs for BMI categories (underweight, normal combined, overweight or obese) for male and female children. These cut-offs differ to those used in the adult BMI classification. For a detailed list of the cutoffs used to calculate BMI for children see 2007-08 National Health Survey Users' Guide (cat. no. 4363.0.55.001).

Carer

A person of any age who provides any informal assistance, in terms of help or supervision, to people with disabilities or long-term condition, or older people (i.e. aged 60 years and over). This assistance has to be ongoing, or likely to be ongoing, for at least six months. Assistance to a person in a different household relates to 'everyday types of activities', without specific information on the activities. Where the care recipient lives in the same household, the assistance is for one or more of the following activities:

• cognition or emotion
• communication
• health care
• housework
• meal perpetration
• mobility
• paperwork
• property maintenance
• self-care
• transport.

For further detail, see Disability, Ageing and Carers: Summary of Findings, Australia, 2003 (cat. no. 4430.0).

Conditions

See 'long-term health condition'.

Current daily smoker

A respondent who reported at the time of interview that they regularly smoked one or more cigarettes, cigars or pipes per day.

Current smoker

A respondent who reported at the time of interview that they smoked cigarettes, cigars or pipes, either daily or less frequently.

Death

Death is the permanent disappearance of all evidence of life after birth has taken place. The definition excludes all deaths prior to live birth. For the purposes of the Deaths and Causes of Death collections of the Australian Bureau of Statistics (ABS), a death refers to any death which occurs in, or en route to Australia and is registered with a state or territory Registry of Births, Deaths and Marriages.

Disability Adjusted Life Year (DALY)

The DALY is a measure that combines information about the years of healthy life lost due to either premature mortality (relative to a standard life expectancy) or to years lived with a disability (here disability means any departure from full health, and includes conditions that range from the common cold to quadriplegia). It is an incidence based measure.

The burden of disease can be quantified by Disability Adjusted Life Years (DALY), for example, one DALY represents one lost year of healthy life due to disability or premature death. The more DALYs, the greater the burden.

Disability status

A disability or restrictive long-term health condition exists if a limitation, restriction, impairment, disease or disorder, has lasted, or is expected to last, for six months or more, and which restricts everyday activities.

It is classified by whether or not a person has a specific limitation or restriction. Specific limitation or restriction is further classified by whether the limitation or restriction is a limitation in core activities or a schooling/employment restriction only.

There are four levels of core activity limitation (profound, severe, moderate and mild) which are based on whether a person needs help, has difficulty, or uses aids or equipment with any of the core activities (self care, mobility or communication). A person's overall level of core activity limitation is determined by their highest level of limitation in these activities.

Employed

Persons aged 15 years or over who had a job or business, or who undertook work without pay in a family business, for a minimum of one hour, in the previous week. Includes persons who were absent from a job or business.

Exercise level

Based on frequency, intensity (i.e. walking, moderate exercise and vigorous exercise) and duration of exercise (for fitness, recreation or sport) in the two weeks prior to the interview. From these components, an exercise score was derived using factors to represent the intensity of the exercise:

• 3.5 for walking
• 5.0 for moderate exercise
• 7.5 for vigorous exercise

Scores were grouped into the following four categories:

Level of exercise
Category
Very low(a)	Score less than 100
Low	Score of 100 to less than 1,600
Moderate	Score of 1,600 to 3,200, or score of more than 3,200 but with less than 2 hours of vigorous exercise.
High	Score of more than 3,200 plus 2 hours or more of vigorous exercise
(a) Includes no exercise.

Inadequate exercise levels are sedentary and low exercise levels. Sedentary refers to sitting in one place for extended periods of time.

External causes of death

Deaths due to causes external to the body (for example Suicide, transport accidents, falls, poisoning etc). ICD-10 codes V01-Y98.

Heart, stroke and vascular conditions

A subset of reported long-term conditions comprising the following:

• Angina and other ischaemic heart disease;
• Cerebrovascular disease;
• Heart failure,
• Oedema; and
• Diseases of arteries, arterioles and capillaries.

Health risk factors

Specific lifestyle and related factors impacting on health, including:

• Tobacco smoking;
• Alcohol consumption;
• Exercise;
• Body mass; and
• Dietary behaviours - fruit, vegetable and milk consumption.

Incidence

The number of new cases (of an illness or event, and so on) occurring during a given period.

Infant death

An infant death is the death of a live-born child who dies before reaching his/her first birthday.

Infant mortality rate

The number of deaths of children under one year of age in a calendar year per 1,000 live births in the same calendar year.

Ischaemic heart disease

A disease of the blood vessels supplying the heart muscle.

Leading causes of death

Leading causes of death are based on the total number of deaths attributed to specific causes. For further information on leading causes of death, see Causes of Death, Australia, 2008 (cat. no. 3303.0) Explanatory Notes 40-42, and Glossary.

Life expectancy

Life expectancy refers to the average number of additional years a person of a given age and sex might expect to live if the age-specific death rates of the given period continued throughout his/her lifetime.

Live birth

A live birth is the birth of a child who, after delivery, breathes or shows any other evidence of life such as a heartbeat.

Long-term health condition

A medical condition (illness, injury or disability) which has lasted at least six months, or which the respondent expects to last for six months or more. Some reported conditions were assumed to be long-term, including arthritis, cancer, osteoporosis, diabetes, rheumatic heart disease, heart attack, angina, heart failure and stroke. Rheumatic heart disease, heart attack, angina, heart failure and stroke are also assumed to be current.

Mental disorder

A mental disorder (or mental illness) is a clinically recognisable set of symptoms or behaviours associated with distress and with interference with personal functions. The selected disorders explored by the 2007 National Survey of Mental Health and Wellbeing can be separated into three groups: anxiety, affective (mood) and substance use disorders.

Mortality

Death.

OECD

Organisation for Economic Co-operation and Development.

Potentially avoidable deaths

Potentially avoidable deaths are defined as mortality before the age of 75 years, from conditions which are potentially avoidable within the present health system. Avoidable deaths can be categorised into:

• preventable (amenable to screening and primary prevention), for example lung cancer which may be avoided through reduction of risk factors such as smoking or lack of exercise; and
• treatable (amenable to therapeutic interventions), for example bowel cancer for which mortality may potentially be avoided through effective surgery, chemotherapy and radiotherapy.

Some underlying causes of death are considered both treatable and preventable, such as ischaemic heart disease which may be preventable through diet and exercise and treatable through effective surgery. Conversely, an example of a death which is unavoidable is one from Dementia, where no substantial gains are available through either primary, secondary or tertiary prevention with current medical technology.

Only deaths of individuals under 75 years are considered potentially avoidable as beyond this age people may have several different health problems and determining a single underlying cause is difficult.

Profound or severe core-activity limitation

See 'Disability status' above.

Psychological distress

Derived from the Kessler Psychological Distress Scale -10 items (K10). This is a scale of non-specific psychological distress based on 10 questions about negative emotional states in the four weeks prior to interview. The K10 is scored from 10 to 50, with higher scores indicating a higher level of distress; low scores indicate a low level of distress. In this publication, scores are grouped as follows:

• Low 10-15;
• Moderate 16-21;
• High 22-29; and
• Very high 30-50.

Socio-Economic Index for Areas (SEIFA)

The ABS has developed four indexes to rank the level of social and economic wellbeing of a region. The analysis in this publication uses the Socio-Economic Indexes for Areas (SEIFA) Index of Disadvantage based upon the 2006 Census of Population and Housing. The SEIFA Index of Disadvantage is compiled from various characteristics of persons resident in particular areas and summarises attributes such as low income, low educational attainment, high unemployment, and jobs in relatively unskilled occupations. These areas are then ranked on a scale of relative disadvantage. In this publication the scale is divided into quintiles - with the first quintile representing the areas of greatest relative disadvantage and the fifth quintile representing the areas of least relative disadvantage. The quintiles are derived from area-based Collection District level. For further information about SEIFAs see Chapter 6 of the 2007-08 National Health Survey: Users' Guide (cat. no. 4363.0.55.001).

Self-assessed health status

A person's general assessment of their own health against a five point scale from excellent through to poor.

Standardised death rate (SDR)

Standardised death rates (SDRs) enable the comparison of death rates between populations with different age structures by relating them to a standard population. The ABS standard populations relate to the years ending in 1 (e.g. 2001). The current standard population is all persons in the Australian population at 30 June 2001. SDRs are expressed per 1,000 or 100,000 persons. There are two methods of calculating standardised death rates:

• The direct method - this is used when the populations under study are large and the age-specific death rates are reliable. It is the overall death rate that would have prevailed in the standard population if it had experienced at each age the death rates of the population under study.
• The indirect method - this is used when the populations under study are small and the age-specific death rates are unreliable or not known. It is an adjustment to the crude death rate of the standard population to account for the variation between the actual number of deaths in the population under study and the number of deaths which would have occurred if the population under study had experienced the age-specific death rates of the standard population.

Wherever used, the definition adopted is indicated.

Type of conditions

All reported long-term medical conditions were coded to a classification developed by the ABS for use in the 2001 National Health Survey, which is based on the tenth revision of the International Classification of Diseases and Health Related Problems (ICD-10). Further information can be found in the 2007-08 National Health Survey: Users' Guide (cat. no. 4363.0.55.001).

Unemployed

People aged 15 years and over who were not employed but were actively looking for work in the previous four weeks, and were available to start work in the previous week.