This section provides an overview of Indigenous people's experience of various illnesses and health conditions using prevalence data, visits to general practitioners (GPs) and admissions to hospitals. Specific causes of ill-health are then discussed in more detail in the following section. Information on prevalence of disability is presented in Chapter 5.
Prevalence
Information about the self-reported prevalence of various conditions is available from the 2001NHS. In 2001, eye/sight problems, musculoskeletal problems, diseases of the respiratory and circulatory systems, and ear/hearing problems were the most commonly reported conditions among Indigenous people. After adjusting for age, Indigenous people had a higher prevalence of most types of health conditions than non-Indigenous people (table 7.7).
7.7 Age-standardised prevalence of selected conditions(a)(b)(c) - 2001 |
|  |
| | Indigenous | Non-Indigenous | |
| Condition | % | % | |
| |
| Eye/sight problems | 46 | 51 | |
| Musculoskeletal diseases | 35 | 32 | |
| Arthritis | 16 | 7 | |
| Diseases of the respiratory system | 33 | 30 | |
| Asthma | 17 | 12 | |
| Circulatory problems/diseases | 19 | 17 | |
| Ear/hearing problems | 18 | 14 | |
| Endocrine, nutritional and metabolic diseases | 15 | 9 | |
| Diabetes mellitus | 11 | 3 | |
| Diseases of the nervous system | 10 | 8 | |
| Digestive diseases | 7 | 7 | |
| |
| (a) Proportions have been age standardised using the 2001 estimated resident population of Australia. |
| (b) Total numbers have been weighted using ABS population estimates. |
| (c) Sum of components may exceed 100% as persons may have reported more than one type of condition. |
| ABS, 2001 National Health Survey |
Consultations with General Practitioners
Information about GP consultations is available from the ‘Bettering the Evaluation and Care of Health’ (BEACH) survey. Information is collected from a random sample of approximately 1,000 GPs from across Australia each year. A sample of 100 consecutive consultations is collected from each GP. Over the period 1998-99 to 2002-03, there were 5,476 GP consultations with Aboriginal and Torres Strait Islander patients recorded in the survey, representing 1.1% of total GP consultations. Respiratory conditions (mainly upper respiratory tract infections and asthma) were the problems most commonly managed at consultations with Indigenous patients (23 per 100 consultations), followed by skin problems (16 per 100), musculoskeletal conditions (14 per 100), psychological problems (13 per 100), circulatory problems (mainly hypertension) and endocrine and metabolic diseases (mainly diabetes) (both at a rate of 13 per 100) (table 7.8).
The number of Indigenous patients in the BEACH survey is likely to be underestimated. This is because some GPs do not ask about Indigenous status, or the patient may choose not to identify (AIHW 2002b). Therefore, the rate of GP consultations for Indigenous Australians presented in table 7.8. is likely to be an underestimate of the true level of consultation with GPs. It should also be noted that the estimates are derived from a relatively small sample of GP consultations involving Indigenous Australians.
7.8 General practitioner consultations, selected problems managed - 1998-99 to 2002-03 |
| |
| | Number | Rate per 100 consultations | |
| Type of problem | Indigenous | Total | Indigenous | Total | |
| |
| Respiratory | 1 235 | 108 865 | 22.5 | 21.7 | |
| Skin | 891 | 83 469 | 16.3 | 16.6 | |
| Musculoskeletal | 747 | 87 092 | 13.6 | 17.4 | |
| Psychological | 734 | 56 950 | 13.4 | 11.3 | |
| Circulatory | 712 | 83 461 | 13.0 | 16.6 | |
| Endocrine and metabolic | 712 | 49 906 | 13.0 | 9.9 | |
| Diabetes | 389 | 14 019 | 7.1 | 2.8 | |
| Digestive | 571 | 50 412 | 10.4 | 10.0 | |
| Pregnancy, family planning | 359 | 21 757 | 6.6 | 4.3 | |
| Ear | 325 | 21 611 | 5.9 | 4.3 | |
| Other | 1 411 | 166 083 | 25.9 | 33.2 | |
| Total problems(a) | 8 086 | 743 625 | 147.7 | 148.1 | |
| |
| (a) Components may not add to total as more than one problem can be managed at each consultation. |
| Britt et al. 2003 |
Hospitalisations
Hospitalisation statistics are not a measure of prevalence or incidence of a disease, but can provide insights into the health of the population who use hospitals. A number of qualifications need to be made about hospitalisations data with regard to Indigenous identification (box 7.9). The identification of Aboriginal and Torres Strait Islander patients in hospital records is incomplete and is considered to be in need of improvement in some jurisdictions (New South Wales, Victoria, Queensland, Tasmania and the Australian Capital Territory) (AIHW 2005b). Therefore, true hospitalisation rates for Aboriginal and Torres Strait Islander people are likely to be higher than those reported in this chapter.
Ratios have been used in this chapter as a measure of hospitalisation in the Indigenous population relative to other Australians. Ratios of this type illustrate differences between the rates of hospital admissions among Indigenous people and those of other Australians, taking into account differences in age distributions. They reflect differences between observed hospitalisations of Aboriginal and Torres Strait Islander people and those expected if they had the same hospitalisation rate as other Australians.
7.9 Identification of Indigenous people in hospital records
In 2003-04, the most common diagnosis for Indigenous Australians was 'care involving dialysis' which is used in the treatment of kidney failure. Indigenous Australians were also commonly hospitalised for injury (e.g. assault and suicide), pregnancy and childbirth (e.g. complications associated with labour and delivery), respiratory diseases (e.g. influenza and pneumonia), digestive diseases (e.g. diseases of the liver, intestines and oral cavity), and mental and behavioural disorders (e.g. schizophrenia and psychoactive substance use). ‘Symptoms, signs and abnormal clinical and laboratory findings' was also a common diagnosis for Indigenous Australians and includes conditions such as convulsions, fever of unknown origin, pain in throat and chest and abdominal and pelvic pain.
Hospitalisation rates for Indigenous Australians were higher than for other Australians for many diagnoses (table 7.10). Indigenous Australians were hospitalised for care involving dialysis at 12 times the rate, and for endocrine, nutritional and metabolic diseases (including diabetes), at three times the rate for other Australians.
7.10 Hospitalisations of Indigenous persons, by principal diagnosis - 2003-04 |
| |
| Principal diagnosis (ICD-10-AM chapter) | Observed hospitalisations | Expected hospitalisations | Ratio(a) | |
| |
| Factors influencing health status and contact with health services | 89 710 | 17 828 | 5.0 | |
| Care involving dialysis (Z49) | 81 983 | 6 816 | 12.0 | |
| Other (Z00-Z99)(b) | 7 727 | 11 012 | 0.7 | |
| Injury, poisoning and certain other consequences of external causes (S00-T98) | 17 318 | 9 234 | 1.9 | |
| Complications of pregnancy, childbirth and the puerperium (O00-O99) | 16 783 | 11 535 | 1.5 | |
| Diseases of the respiratory system (J00-J99) | 16 041 | 7 218 | 2.2 | |
| Diseases of the digestive system (K00-K93) | 11 604 | 13 236 | 0.9 | |
| Mental and behavioural disorders (F00-F99) | 9 558 | 5 475 | 1.7 | |
| Symptoms, signs and abnormal clinical and laboratory findings, n.e.c. (R00-R99) | 9 317 | 6 380 | 1.5 | |
| Diseases of the circulatory system (I00-I99) | 7 260 | 3 864 | 1.9 | |
| Diseases of the genitourinary system (N00-N99) | 5 949 | 5 724 | 1.0 | |
| Diseases of the skin and subcutaneous tissue (L00-L99) | 5 230 | 2 103 | 2.5 | |
| Certain infectious and parasitic diseases (A00-B99) | 5 069 | 2 633 | 1.9 | |
| Endocrine, nutritional and metabolic diseases (E00-E90) | 4 291 | 1 455 | 2.9 | |
| Other | 27 129 | 27 839 | 0.8 | |
| Total | 216 142 | 108 206 | 2.0 | |
| |
| (a) Ratio is observed hospitalisations divided by expected hospitalisations. Expected hospitalisations are based on the age, sex and cause-specific rates for 'Other' Australians. |
| (b) Excludes care involving dialysis. |
| AIHW, National Hospital Morbidity Database. |
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