05/04/2013 Note: 2002 and 2008 NATSISS alcohol data by risk level have been revised. For more information, see the Information Paper (Catalogue No. 4714.0.55.005).

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	ADULT HEALTH: RISK FACTORS AND SOCIOECONOMIC STATUS
	This article is part of a comprehensive series released as The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples

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KEY MESSAGES Low socioeconomic status is associated with poor health and higher rates of smoking. Health risk factors tend to coexist and certain combinations of risk factors may impact on health in different ways.

Compared with non-Indigenous Australians, Aboriginal and Torres Strait Islander people experience disadvantage across a range of socioeconomic indicators including education, employment and income. There is evidence from Australia and other developed countries that low socioeconomic status is associated with poor health and increased exposure to health risk factors (Endnotes 1, 2 and 3).

This topic presents results from the 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) which provides the most recent data for selected socioeconomic characteristics and health risk factors.

In 2008, Aboriginal and Torres Strait Islander people who were unemployed were more likely than those who were employed to be a current daily smoker (58% compared to 41%) and to use illicit substances (30% compared with 21%). Likewise, rates of smoking were higher among people who had lower levels of educational attainment (compared with those who had completed Year 12) (table 3.1). Previous analysis also shows a relationship between exposure to health risk factors and income; as well as between educational attainment and nutrition and exercise, with people completing Year 12 more likely to eat fruit and vegetables on a daily basis and less likely to engage in low levels of exercise - for more information see the discussion on risk factors and socioeconomic status in the 2008 edition of this report.

However, it is important to note that it is difficult to measure and quantify relationships between health and socioeconomic variables in household surveys. This is due to the close association between particular socioeconomic variables (e.g. education and employment); because casual relationships between health and socioeconomic variables can sometimes work both ways (e.g. unemployment may lead to poor health but poor health may also lead to unemployment); and also because other factors may also be influencing both (e.g. access to employment opportunities and health services). Likewise, it is also difficult to assess health risk factors in isolation, as they too tend to coexist and be interactive in their effects. Therefore the level of risk attached to a particular factor may depend on whether other factors are also present, and certain combinations of risk factors may impact on health in different ways.

		Highest year of school completed(a)			Labour force status
		Year 12	Year 9 or below(b)		Employed	Unemployed
Current daily smoker	%	34.5	54.4		41.1	58.3
Chronic risky/high risk alcohol consumption(c)	%	(e)16.5	(e)18.4		(f)19	(f)18.4
Acute risky/high risk alcohol consumption(d)	%	43.6	34.9		(f)43.9	(f)39.5
Has used illicit substances in last 12 months	%	(e)20.0	(e)20.5		21.3	29.5
All persons aged 15 years and over	no.	66 220	102 085		169 098	33 414

(a) Excludes persons still attending secondary school.
(b) Includes persons who never attended school.
(c) Based on the amount of alcohol (mls) consumed on an average drinking day.
(d) Based on largest amount of alcohol (mls) consumed in one day during the fortnight prior to interview.
(e) Difference between Year 12 and Year 9 or below is not statistically significant.
(f) Difference between Employed and Unemployed is not statistically significant.
Source: 2008 National Aboriginal and Torres Strait Islander Social Survey. These estimates are also available for download in the Adult Health datacube.
ENDNOTES

1. Blakely, T., Hales, S., and Woodward, A. 2004, 'Poverty: Assessing the Distribution of Health Risks by Socioeconomic Position at National and Local Levels', World Health Organisation Environmental Burden of Disease Series no. 10, World Health Organisation, Geneva.

2. Carson, B., Dunbar, T., Chenhall, R., and Bailie, R. (eds) 2007, 'Social Determinants of Indigenous Health', Allen & Unwin, Crows Nest.

3. Turrell, G., and Mathers, C. 2000, 'Socioeconomic Status and Health in Australia', Medical Journal of Australia, vol. 172, no. 9, pp. 434–38.

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