4363.0.55.001 - National Health Survey: Users' Guide, 2001  
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Contents >> Chapter 1 - Introduction

CONTENTS

Overview of the survey

Background to the survey


OVERVIEW OF THE SURVEY

This publication presents information about the National Health Survey (NHS) conducted by the Australian Bureau of Statistics (ABS) in 2001. The survey had two components:

  • a survey conducted on a sample from the general population of Australia (referred to as the NHS(G) in this publication), and
  • a survey conducted on a supplementary sample of Indigenous Australians (referred to as the NHS(I) in this publication).

A total of approximately 30,000 people from all States and Territories and across all age groups were included in the survey.

This publication includes information about the survey objectives, how the survey was developed, the survey concepts and methods, procedures used in the collection of data and the derivation of estimates, and information about the quality, interpretation and availability of survey results. Definition of survey terms and copies of key classifications are provided as Appendixes.

The aim of this publication is to provide information to assist users of the data in better understanding the nature of the survey, and its potential, and shortcomings, in meeting their data needs. Further information about the survey is available from the ABS web site, through links provided in the Health and Indigenous theme pages. This information includes:
  • the questionnaires (and associated prompt cards) used to collect the data,
  • lists of output data items available from the NHS(G) and NHS(I),
  • sets of tables from the NHS(G) compiled for States and Territories and for other geographic areas,
  • publication tables for the NHS(I) presenting more accurate RSEs calculated using the replicate weights method,
  • additional tables from client requests for NHS(I) data as they become available,
  • an Information Paper detailing the availability of microdata from the NHS(G) on CDROM and through a Remote Access Data Laboratory.

Other useful information will also be added to the web site over time as it becomes available.


The main findings from the 2001 NHS are presented in the following publications:
  • National Health Survey: Summary of Results, Australia 2001 (cat. no. 4364.0) which contains summary level statistics for most topics covered in the 2001 NHS(G).
  • National Health Survey: Aboriginal and Torres Strait Islander Results, Australia 2001 (cat. no. 4715.0) which presents selected data about the health of Indigenous Australians from information collected in the 2001 NHS total Indigenous sample - topics include measures of health status, health actions taken, and lifestyle factors which may influence health


2001 NHS(G)

The 2001 NHS(G) was conducted during the 10 month period February to November 2001. It is the third in a series of regular population surveys designed to obtain national benchmark information on a range of health-related issues and to enable the monitoring of trends in health over time.

The 2001 NHS collected information about the health status of Australians, their use of health services and facilities and health-related aspects of their lifestyle. Previous surveys in the series were conducted in 1989-90 and 1995. Surveys conducted by the ABS in 1977-78 and 1983, while not part of the NHS(G) series, also collected information similar to that obtained in the 2001 NHS(G). In addition, a range of other ABS surveys on health and related issues have been conducted at the national level and for individual States and Territories. Information about previous ABS surveys of health and related issues is contained in Chapter 8: 'Health and Related Publications' of this Users' Guide.


The 2001 NHS(G) was conducted in 17,918 private dwellings selected throughout non-sparsely settled areas of Australia. The sample design ensured that within each State or Territory each person had an equal chance of selection. Information was obtained about one adult, all children aged 0 to 6 years, and one child aged 7 to 17 years in each selected household. A total of 26,863 persons fully responded to the survey.


Trained ABS interviewers personally interviewed the selected adult member of the household. A parent or guardian was asked to answer questions in respect of their children aged less than 18 years - this person was referred to as the child proxy. Although the survey was conducted over 10 months, selected households were interviewed only once in that period. Medical records were not required and no medical tests or physical measures were taken as part of this survey.

Information sought during the 2001 NHS(G) interviews included details of long-term medical conditions experienced by respondents, recent injury events, consultations with health professionals, other actions people had recently taken in regard to their health (e.g. taken days away from work, used medication), aspects of their lifestyle and other factors which may affect their health such as smoking, alcohol consumption, diet, exercise and immunisation. In addition to the interview questionnaire, adult female respondents were invited to complete a small additional questionnaire relating to specific aspects of women's health. The survey design enables information for all topics to be analysed in relation to other topics, and in relation to a range of demographic and socioeconomic characteristics.


2001 NHS(I)

The sample of Aboriginal and Torres Strait Islander peoples in the 2001 NHS(G) was supplemented to improve the reliability of Indigenous estimates and to allow, for the first time, results to be presented for Indigenous persons living in remote areas. The 2001 NHS(I) was conducted throughout Australia from June to November 2001.

A total of 3,198 Aboriginal and Torres Strait Islander adults and children were included in the 2001 NHS(I) sample. The 2001 NHS(I) sample was combined with the 483 Indigenous Australians enumerated in the 2001 NHS(G) sample to provide a total sample of 3,681 Indigenous persons (referred to as the "total Indigenous sample" in this Users' Guide).

The 2001 NHS(I) sample covered all areas of Australia, including sparsely settled areas (see Glossary for definitions). The sample conducted in sparsely settled areas will be referred to as the "Sparse NHS(I)" in this Users' Guide. The sample conducted in non-sparsely settled areas will be referred to as the "Non-sparse NHS(I)" in this Users' Guide.
    Data were collected differently for the 2001 NHS(I) sample according to whether respondents lived in sparsely settled areas (described as "Sparse NHS(I)" in this publication), or non-sparsely settled areas (described as "Non-sparse NHS(I)" in this publication).

    The survey content of the 2001 non-sparse NHS(I) was similar to the 2001 NHS(G) apart from information on mental well-being, which was not collected. However, in sparse NHS(I) the survey content was reduced to approximately 50% of the non-sparse content because of data quality concerns and/or limited relevance to the sparse population.

    During enumeration the ABS developed a new Australian Standard Geographic Classification (ASGC) which is based on the Accessibility/Remoteness Index of Australia (ARIA). The classification contains the following categories: 'Major cities of Australia', 'Inner regional Australia', 'Outer regional Australia', 'Remote Australia', and 'Very remote Australia'. The ARIA and ASGC are now the ABS standard measures of geographic accessibility/remoteness, so the 2001 NHS data are presented according to the new ASGC classification even though the data were collected according to sparsely settled and non-sparsely settled areas. As the 2001 NHS(I) sample was relatively small, the categories for ASGC were aggregated to just two categories, 'Non-remote' (which includes Major cities, Inner regional and Outer regional) and 'Remote' (which includes Remote Australia and Very remote Australia), for the publication and for other Indigenous estimates released. See the table below for the relationship between the ASGC classification and the sparsely settled, and non-sparsely settled areas according to which the data were collected.

    TABLE 1.1: Comparison between the sparse/non-sparse and the remote/non-remote classifications(a)

    Non-sparse Indigenous record counts
    Sparse Indigenous record counts
    Total

    Classified as 'Non-remote' in ASGC
    2,124
    -
    -
    Classified as 'Remote' in ASGC
    603
    954
    1,557
    Total
    2,727
    954
    3,681a

    (a) Record counts in the table are based on the 'total Indigenous sample' which includes the 483 Indigenous respondents living in non-sparsely settled areas collected as part of the 2001 NHS(G) sample.


    As Table 1.1 above illustrates, 603 records collected as part of the non-sparse sample were classified as 'Remote' under the ASGC categories. The data for these 603 records were therefore collected as respondents living in non-sparsely settled areas but are output as 'Remote'. As more information was collected for respondents living in non-sparsely settled areas but these respondents are now being considered 'Remote', some data collected for these respondents will not be used. Including these 603 people as 'Remote' rather than as 'non-sparse' has increased the reliability of 'Remote' estimates because they are based on a larger sample (i.e. there are 1,557 'Remote' respondents as opposed to 954 sparse respondents). This has allowed a more thorough analysis of persons living in remote areas than would have been allowed if output was produced by sparsely settled/non-sparsely settled.

    In this
    Users' Guide the terms "Sparsely settled areas (abbreviated to sparse)" and "Non-sparsely settled areas (abbreviated to non-sparse)" will be used in relation to collection issues because this was the geographic division that data collection was based on. However, when discussing output related issues, the terms "Remote" and "Non-remote" will be used because this was how the data were output. These terms are also defined in the Glossary for reference.


    General

    The 2001 NHS was conducted under the authority of the Census and Statistics Act 1905. The ABS sought the willing cooperation of households in the survey. The confidentiality of all information provided by respondents is guaranteed. Under its legislation the ABS cannot release identifiable information about households or individuals.

    The success of the 2001 NHS was dependent on the high level of cooperation received from the community. Their continued cooperation is very much appreciated; without it, the range of health and other statistics published by the ABS would not be possible.

    BACKGROUND TO THE SURVEY

    Development of the 2001 NHS began in 1998 in the context of a review of the Household Survey Program conducted by the ABS. Impetus for this review came from:
    • a recognition that the level of demand for information from ABS household surveys exceeded the capacity of ABS survey vehicles and resources, resulting in gaps in the statistics available.
    • a lack of flexibility in the survey program resulting from either commitments to regular ('core') surveys in particular areas or from constraints imposed by the survey vehicles, and
    • the stop/start approach to some user funded surveys, which caused problems for the scheduling of surveys, the timeliness of statistical outputs, and for the maintenance of a skilled survey workforce.

    During the course of the review, consultations (involving both formal meetings and informal discussions) were undertaken with key government data users at both State and Commonwealth level. Information was also circulated to, and input obtained from, a wider group of stakeholders. These consultations initially focussed on the overall program of population surveys, but later focussed on particular surveys within the program, including the National Health Survey series. A key outcome of this review was the introduction of a new series of three-yearly National Health Surveys, made possible by a 6 year partnership agreement between the ABS and Department of Health and Ageing (DoHA) under which DoHA provided supplementary funding for the conduct of health and related surveys.

    Within the overall parameters of the survey established by the review, government agencies and other interested parties were further consulted regarding priorities for the specific health topics or issues to be included in the 2001 NHS. The NHS Reference Group was established to assist the ABS in the ongoing consultation process and to advise on data requirements. This group comprises representatives of the Department of Health and Ageing Care, the Australian Institute of Health and Welfare, State health authorities, academic and research centres, professional and community health organisations and the ABS. Reports on the development and testing process were prepared for consideration by the group, and distributed to other interested organisations and individuals on request. Expert groups outside the committee were consulted on specific issues as required e.g. diabetes and injuries.

    The range of topics and of items within topics requested in submissions and through discussions with users for inclusion in the survey far outstripped the capacity of the survey. All topics identified through this consultation process were assessed, and relative priorities were established with the assistance of the NHS Reference Group. Topics ultimately selected for inclusion in the survey were those identified as being of highest priority and which could be appropriately addressed in an ABS household survey of this type. The content of the 2001 NHS(I) conducted in sparsely settled areas of Australia was reduced from the
    2001 NHS(I) conducted in non-sparsely settled areas. Topics which were considered culturally inappropriate, of limited relevance to the Indigenous population in sparsely settled areas, or for which previous surveys or testing indicated that data may be of poor quality, were omitted from the survey or reduced in coverage or detail.

    Some topics proposed for inclusion in the 2001 NHS underwent cognitive testing to ensure the concepts were understood by respondents, and to enable questions and associated procedures to be developed to elicit
    the information required. The survey questionnaires and associated procedures, classifications, etc. were tested to ensure the survey instruments were effectively covering and accurately addressing the issues intended, and to investigate respondent reaction to the survey. A pilot test for the 2001 NHS(G) was conducted in May 2000 in Brisbane and a dress rehearsal was conducted in Melbourne in October 2000. The survey instruments for the 2001 NHS(I) were separately field tested in August and September 2000, and a dress rehearsal was conducted in February 2001.

    The proposal to conduct the 2001
    NHS(G) was tabled in federal parliament in November 2000; the proposal to survey the Indigenous supplementary sample was tabled in May 2001. All aspects of the NHS's implementation were designed to conform to Information Privacy Principles set out in the Privacy Act 1988, and the Privacy Commissioner was informed of the details of the proposed surveys.


    Chapter 1 - Introduction

    Chapter 2 - Survey Design and Operation

    Chapter 3 - Health Status Indicators

    Chapter 4 - Health Related Actions

    Chapter 5 - Health Risk Factors

    Chapter 6 - Population Characteristics

    Chapter 7 - Data Quality and Interpretation of results

    Chapter 8 - Data Output and Dissemination
    Appendix 1 - Glossary of Terms Used

    Appendix 2 - Sample Counts and Weighted Estimates

    Appendix 3 - Classification of Long-term Medical Conditions: Based on ICD-10

    Appendix 4 - Classification of Long-term Medical Conditions: Based on ICD-9

    Appendix 5 - Classification of Long-term Medical Conditions: ICPC Based

    Appendix 6 - Classification of Type of Medication

    Appendix 7 - Classification of Country of Birth

    Appendix 8 - Classification of Language Spoken at Home
    Appendix 9 - Classification of Occupation

    Appendix 10 - Classification of Industry of Employment

    Appendix 11 - Classification of Types of Alcoholic Drinks

    Appendix 12 - Standard Errors

    Appendix 13 - Content of the 2001 National Health Survey (Indigenous)

    Appendix 14 - List of Abbreviations




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