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4363.0.55.001 - Australian Health Survey: Users' Guide, 2011-13  
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This document was added 12/13/2013.



GLOSSARY

This document presents definitions for some of the terms used in this Users' Guide. Further definitions are contained in the individual topic pages. It should be noted that the definitions used in the Australian Health Survey are not necessarily the same as those used for concepts or data items in other collections, and care should be taken when comparing data from different sources to ensure they are similarly defined.


24-hour dietary recall

This was the methodology used to collect detailed information on food and nutrient intake in the National Nutrition and Physical Activity Survey (NNPAS). The 24-hour dietary recall collected a list of all foods, beverages and supplements consumed the previous day from midnight to midnight, and the amount consumed. For more information, see the 24-Hour Dietary Recall of the AHS: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

Accessibility/Remoteness Index of Australia

Accessibility/Remoteness Index of Australia (ARIA) was developed by the Commonwealth Department of Health and Ageing (DoHA) and the National Key Centre for Social Applications of GIS (GISCA). ARIA measures the remoteness of a point based on the physical road distance to the nearest Urban Centre in each of five size classes. For more information on how ARIA is defined see Information Paper: ABS Views on Remoteness, 2001 (cat. no. 1244.0) and Information Paper: Outcomes of ABS Views on Remoteness Consultation, Australia, Jun 2001 (cat. no. 1244.0.00.001). Also refer to Census Geography Paper 03/01 - ASGC Remoteness Classification - Purpose and Use, available from the ABS web site.

ASGC and ASGS Remoteness Structure

The Remoteness Structure for the Australian Standard Geographical Classification (ASGC) 2006 and the Australian Statistical Geography Standard (ASGS) 2011, has 5 categories based on an aggregation of geographical areas which share common characteristics of remoteness, determined in the context of Australia as a whole. The criteria for these categories are based on the Accessibility/Remoteness Index of Australia (ARIA). For more details, see Accessibility/Remoteness Index of Australia definition above and the Geographic Classifications topic in this Users’ Guide.

Australian Health Survey (AHS)

The Australian Health Survey 2011-13 is composed of three separate surveys:

  • National Health Survey (NHS) 2011-12
  • National Nutrition and Physical Activity Survey (NNPAS) 2011-12
  • National Health Measures Survey (NHMS) 2011-12.

In addition to this, the AHS Survey contains a Core dataset, which is produced from questions that are common to both the NHS and NNPAS. See Australian Health Survey Core Dataset for details.

Australian Health Survey (AHS) Core Dataset

The AHS Core Dataset is produced from the question sets that are common to both NHS and NNPAS. The questions set include the following topics:
  • self-assessed health
  • self-assessed body mass
  • smoking
  • physical measurements (height, weight and waist circumference)
  • adult physical activity
  • dietary behaviour
  • blood pressure
  • female life stages
  • cardiovascular disease
  • diabetes
  • kidney disease.

Australian Register of Therapeutic Goods (ARTG) classifications

The ARTG identification numbers fall into two different types of classifications:
  • AUST R medicines - these include all prescription medications and many over the counter products such as those used for pain relief, coughs and colds and antiseptic creams
  • AUST L medicines - these are much lower risk self-medication products which include sunscreens, vitamins, minerals, and herbal and homoeopathic products.

Basal Metabolic Rate (BMR)

Basal metabolic rate (BMR) is the amount of energy needed for a minimal set of functions necessary for life over a defined period of time. BMR is given in kilojoules (kJ) per 24 hours and is calculated using age, sex and weight (kg).

Between-person variation

Between-person variation refers to the differences between individuals. In the usual nutrient intakes publication, it refers to the variance in nutrient intakes between different respondents. In the NCI method, part of this may be estimated by the relationship of covariates to the reported intakes, if covariates are used. The remaining between-person variation not explained by the covariates is modelled using a residual between-person variation error term. This term is also referred to as 'person-specific effects'.

Biomarker

In the National Health Measures Survey (NHMS), a biomarker generally refers to a measured characteristic, which may be used to indicate a health risk factor or condition. For more information about the biomarkers measured in the NHMS, see Biomedical Measures.

Body Mass Index (BMI)

BMI scores are derived for measured height and weight. Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2). For more information, see Body Mass and Physical Measurements and Appendix 4: Classification of BMI for children.

Child proxy

See Proxy

Chronic kidney disease stages

Chronic kidney disease stages were derived using a combination of participants' estimated glomerular filtration rate (eGFR) results with their albumin creatinine ratio (ACR) results. The different stages were defined as follows:
  • No indicators of chronic kidney disease - eGFR greater than or equal to 60 mL/min/1.73 m and no presence of albuminuria
  • Stage1 - eGFR greater than or equal to 90 mL/min/1.73 m & albuminuria
  • Stage 2 - eGFR 60 to 89 mL/min/1.73 m & albuminuria
  • Stage 3a - eGFR 45–59 mL/min/1.73 m
  • Stage 3b - eGFR 30–44 mL/min/1.73 m
  • Stage 4–5 - eGFR less than 30 mL/min/1.73 m

For more information, see Chronic Kidney Disease biomarkers.

Comorbid conditions

In this survey, comorbid conditions refers to two or more medical conditions, which a respondent has reported as current long-term conditions they have. See also Comorbidity.

Comorbidity

In this survey, comorbidity is a term used to describe the occurrence of two or more conditions. Some biomedical and self report comorbidity data items have been produced for specific combinations of conditions to aid this type of analysis.

However, it is possible to utilise the available condition data in the ICD-10 data items to undertake analysis of additional combinations of health conditions. Different restrictions (for example whether a condition is diagnosed, or whether a condition is current) can also be applied to individual conditions when undertaking analysis.

For more information on the comorbidity data items available and the definitions used for the conditions within these items, see Biomedical comorbidity and Self report comorbidity.

Conditions

See long-term medical condition.

Condition status

Condition status brings together information about whether or not a person has ever been told by a doctor or nurse they have a condition, whether a condition was current at the time of the survey, and if current whether the condition was long-term (i.e. had lasted or was expected to last for 6 months or more).

Dietary Guidelines

The National Health and Medical Research Council (NHMRC) 2013 Australian Dietary Guidelines use the best available scientific evidence to provide information on the types and amounts of foods, food groups, and dietary patterns that aim to:

  • Promote health and wellbeing
  • Reduce the risk of diet-related conditions
  • Reduce the risk of chronic disease.

The guidelines are for use by health professionals, policy makers, educators, food manufacturers, food retailers and researchers.

The content of the Australian Dietary Guidelines applies to all healthy Australians, as well as those with common diet-related risk factors such as being overweight. They do not apply to people who need special dietary advice for a medical condition, or to the frail elderly.

Dyslipidaemia

Refers to a number of different lipid disorders (that is, conditions where there are too many fats in the blood). In this survey, a person (who participated in the NHMS) was considered to have dyslipidaemia if they had one or more of the following:

  • Taking cholesterol-lowering medication
  • Total cholesterol greater than or equal to 5.5 mmol/L
  • HDL cholesterol less than 1.0 mmol/L for men and less than 1.3 mmol/L for women
  • LDL cholesterol greater than or equal to 3.5 mmol/L
  • Triglycerides greater than or equal to 2.0 mmol/L

For more information, see Cardiovascular disease biomarkers.

Energy

Energy, measured in kilojoules (kJ), is required by the body for metabolic processes, physiological functions, muscular activity, heat production and growth and development. All energy reported in the Australian Health Survey (AHS) is energy including that from dietary fibre.

Equivalised income

Equivalisation is a process whereby reported household income is adjusted to take account of the size and composition of the household. For further details see Household and family characteristics.

Family

Two or more persons, one of whom is at least 15 years of age, who are related by blood, marriage (registered or de facto), adoption, step or fostering; and who are usually resident in the same household. The basis of a family is formed by identifying the presence of a couple relationship, lone parent-child relationship or other blood relationship. Some households will, therefore, contain more than one family.

Family composition

The differentiation of families based on the presence or absence of couple relationships, parent-child relationships, child dependency relationships or other blood relationships, in that order of preference.

Food code

Each food, beverage and supplement reported by NNPAS respondents in the 24-hour dietary recall was coded to a unique 8-digit food code (the lowest level of the Food classification).

Food classification or Food groups

Food and beverages reported by NNPAS respondents in the 24-hour dietary recall were collected and coded at a detailed level, but for output purposes are categorised within a food classification with Major (2-digit), Sub-major (3-digit), and Minor group (5-digit) levels. The classification was developed by Food Standards Australia New Zealand, along with the Nutrient Database, specifically for the Australian Health Survey. At the broadest level (the Major group) there are 24 groups. These groups were designed to categorise foods that share a major component or common feature. Because many foods are in fact mixtures of different ingredients, the food groups will not exclusively contain the main food of that group. For more information see AUSNUT 2011-13.

Food model booklet

Interviewers used a Food Model Booklet (available from the Downloads tab of this publication) to assist NNPAS respondents with describing the amount of food and beverages consumed for the 24-hour dietary recall.

HbA1c test

The HbA1c test provides an indication of the presence and management of diabetes. Also referred to as glycated haemoglobin, it measures the amount of glucose in the blood that binds to the haemoglobin present in red blood cells. If glucose amounts are below 7% and stable then tests should be performed every 6 months; if they are higher than that then tests should be performed every 3 months. For more information about the test, see Glycated haemoglobin.

Health risk factors

Specific lifestyle related factors impacting on health, including:

  • tobacco smoking
  • alcohol consumption
  • exercise
  • body mass
  • breast-feeding
  • blood pressure.

Heart, stroke and vascular conditions

A subset of reported long-term conditions comprising the following:
  • Angina, heart attack and other ischaemic heart diseases
  • Stroke and other cerebrovascular diseases
  • Heart failure
  • Oedema
  • Diseases of arteries, arterioles and capillaries.

Household

A household is defined as one or more persons, at least one of whom is at least 15 years of age, usually resident in the same private dwelling.

Household income

Reported as the sum of the personal cash incomes of all household members aged 15 years and over. Household income is available in dollar amounts and deciles/quintiles, in reported and equivalised form. For further details see Income sources.

Household structure

Refers to the composition of the household to which the respondent belonged. For further details see Population characteristics.

ICD-10

ICD-10 refers to the tenth revision of the International Classification of Diseases and Health Related Problems. The classification of long-term conditions most commonly used in output from the 2011-13 AHS was developed for use in this survey based on the ICD-10. See Appendix 2: Classification of health conditions for the content of the classifications.

Inadequate intake

In general, inadequate intake of a nutrient is likely to increase a person's risk of adverse health effects, by negatively affecting the normal functions of the body. Inadequate intake of nutrient occurs when a person does not meet their requirements for a nutrient, as given in the Nutrient Reference Values for Australia and New Zealand (NRVs). Inadequate intakes of specific nutrients will have different effects on health within different age and sex groups. For example, if children and adolescents have inadequate intakes of calcium it reduces their ability to develop strong, healthy bones. For more information on the scientific basis for the NRVs and likely health effects of not meeting requirements for each nutrient, see Nutrient Reference Values for Australia and New Zealand.

Incidence

Incidence refers to the number of new cases of a particular characteristic, such as cancer, which occur within a certain period. This differs from prevalence, which refers to the number of cases of a particular characteristic that are present in a population at one point in time.

Indigenous

Refers to people who identified themselves, or were identified by another household member, as being of Aboriginal and/or Torres Strait Islander origin.

Known diabetes

In this survey, a person (who participated in the NHMS) was considered to have known diabetes if:
  • they had ever been told by a doctor or nurse that they have diabetes and they were taking diabetes medication (either insulin or tablets) OR
  • they had ever been told by a doctor or nurse that they have diabetes and their blood test result for fasting plasma glucose was greater than or equal to the cut off point for diabetes (that is, greater than or equal to 7.0 mmol/L).

People who had been told by a doctor or nurse that they have diabetes, but who were not taking medication for diabetes and did not have a fasting plasma glucose level of 7.0 mmol/L or greater, were classified as not having diabetes.

People with known diabetes were further classified as having Type I, Type II or Type unknown, based on the type of diabetes that a doctor or nurse told them they had. Women with gestational diabetes were excluded.

The corresponding diabetes cut-off for HbA1c is a value of 6.5% or greater.

For more information, see Diabetes Biomarkers.

Long-term medical 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.

Macronutrient

Macronutrients are nutrients that provide energy and raw materials for body tissues and processes. They include protein, fats, carbohydrates and alcohol.

Margin of Error

Margin of Error describes the distance from the population value that the sample estimate is likely to be within, and is specified at a given level of confidence. Confidence levels typically used are 90%, 95% and 99%. For example, at the 95% confidence level the MoE indicates that there are about 19 chances in 20 that the estimate will differ by less than the specified MoE from the population value (the figure obtained if all dwellings had been enumerated). For further information see Technical Note and Data quality.

MET

Metabolic Equivalent of Task (MET) or intensity values are a measure of the energy expenditure required to carry out physical activity, expressed as a multiple of the resting metabolic rate (RMR). MET is defined as the ratio of metabolic rate (and therefore the rate of energy consumption) during a specific physical activity to a reference rate of metabolic rate at rest. MET or intensity values operate as a factor when determining level of exercise. For further information see the adult and child (5-17 years) Physical activity pages.

Minerals

Minerals are chemical elements required for a very wide variety of functions including cell function, muscle function, bone formation, hormone production and fluid balance. Some minerals are essential for health and are classified into major and trace elements according to the quantity required by the body.

National Health Measures Survey (NHMS)

The National Health Measures Survey, which is sometimes referred to as the biomedical component of the AHS, focused on early lifestyle related diseases through blood and urine testing. Information was collected on:
  • cardiovascular disease
            • apolipoprotein B (Apo B)
            • high-density lipoprotein (HDL) cholesterol
            • low-density lipoprotein (LDL) cholesterol
            • total cholesterol
            • triglycerides
  • diabetes
            • fasting plasma glucose
            • glycated haemoglobin (HbA1c)
  • chronic kidney disease
            • estimated glomerular filtration rate (eGFR)
            • urinary albumin creatinine ratio (ACR)
  • liver function
            • alanine aminotransferase (ALT)
            • gamma-glutamyl transferase (GGT)
  • risk factors
            • serum cotinine
  • nutrition status
            • haemoglobin (Hb)
            • serum ferritin
            • soluble transferrin receptor (sTfR)
            • serum folate
            • red cell folate (RCF)
            • serum vitamin B12
            • serum 25- hydroxyvitamin D [25(OH)D]
            • urinary sodium
            • urinary potassium
            • urinary iodine.

Participants were those people aged five years and over, who were selected for either NHS or NNPAS and agreed to also participate in the NHMS. Children aged 5 to 11 were only asked to provide urine samples. For more information about the tests, see Biomedical Measures.

National Health Survey (NHS)

The National Health Survey focused on collecting information on:
  • medical conditions that had lasted, or were expected to last for six months or more
  • consultations with health professionals
  • actions taken in regard to improving or maintaining health
  • female life stages
  • blood pressure
  • diet
  • exercise
  • physical measurements (height, weight and waist circumference)
  • use of medication and supplements
  • use of tobacco and alcohol
  • breastfeeding
  • disability status
  • social and emotional well-being
  • family, personal and financial stress.

National Health Priority Areas (NHPA)

Comprises:
  • asthma
  • cancer
  • diabetes/high sugar levels
  • heart and circulatory conditions
  • musculoskeletal conditions (arthritis and osteoporosis/osteopenia)
  • mental health.

National Nutrition and Physical Activity Survey (NNPAS)

The National Nutrition and Physical Activity Survey focused on collecting information on:
  • dietary behaviour and food avoidance (including 24-hour dietary recall)
  • selected medical conditions that had lasted, or were expected to last for six months or more
    • cardiovascular and circulatory conditions
    • diabetes and high sugar levels
    • kidney disease
  • blood pressure
  • female life stages
  • physical activity and sedentary behaviour (including 8 day pedometer component)
  • use of tobacco
  • physical measurements (height, weight and waist circumference).

National Nutrition Survey

The 1995 National Nutrition Survey focussed on collecting information on:

  • food and beverage intake (including 24-hour dietary recall)
  • physical measurements (height, weight and waist circumference)
  • food-related habits and attitudes
  • average food consumption over the last 12 months.
Normal distribution

A normal distribution is a true symmetric distribution of observed values. When a histogram is constructed on values that are normally distributed, the shape of columns form a symmetrical bell shape. This is why the normal distribution is also known as a 'normal curve' or 'bell curve'.

Key features of the normal distribution are:

  • a symmetrical shape
  • the mode, median and mean are the same and are together in the centre of the curve
  • there is only one mode (i.e. there is only one value which is most frequently observed)
  • most of the data are clustered around the centre, while the more extreme values on either side of the centre become less rare as the distance from the centre increases.
Nutrient

Nutrients are chemical substances provided by food that are used by the body to provide energy, structural materials, and biochemical cofactors to support the growth, maintenance, and repair of body tissues. Major food sources of nutrients are available in Australian Health Survey: Nutrition First Results – Foods and Nutrients, 2011-12 (cat. no. 4364.0.55.007).

Nutrient Database

The Nutrient Database used to derive energy and nutrient estimates for the 24-hour dietary recall data was developed by Food Standards Australia New Zealand. See AUSNUT 2011-13.

Nutrient Reference Values (NRVs)

The Nutrient Reference Values (NRVs) are a set of recommendations made by the NHMRC and New Zealand Ministry of Health in 2006 for nutritional intake, based on currently available scientific knowledge. See Nutrient Reference Values for Australia and New Zealand.

Prevalence

The number of cases, of a particular characteristic (e.g. a specific long-term condition such as cancer), that are present in a population at one point in time. This differs from incidence, which refers to the number of new cases of a particular characteristic occurring within a certain period.

Proxy

A proxy is a person who answers the survey questions when the person selected for the interview is incapable of answering for themselves. Reasons the selected person may not be able to answer for themselves include illness/injury or language difficulties. A proxy also answers on behalf of a child under 15 years of age; or for a child aged 15-17 years when parental consent is not given to interview them personally. For further information see the Interviews section of Data collection.

Requirements distribution

Each person will vary in their actual personal requirements for a nutrient, due to, for example, differences in their age, gender, body weight, physiology, and health. Collectively, variations in these personal requirements within a population are described as the requirements distribution.

SAS

SAS is a software package for preparing and executing computerised data analysis.

Significance testing

To determine whether a difference between two survey estimates is a real difference in the populations to which the estimates relate, or merely the product of different sampling variability, the statistical significance of the difference can be tested. This is particularly useful for interpreting apparent changes in estimates over time. The test is done by calculating the standard error of the difference between two estimates and then dividing the actual difference by the standard error of the difference. If the result is greater than 1.96, there are 19 chances in 20 that there is a real difference in the populations to which the estimates relate. For further information see Data quality and interpretation of results.

Skewed

A distribution of data that are not symmetrical are often referred to as a ‘skewed distribution’. Skewness is the tendency for values to be more frequent around the either the high or low ends of the x-axis, than in a true normal distribution. When a histogram is constructed for skewed data it is possible to identify skewness by looking at the shape of the distribution. For example, a distribution is said to be positively skewed when the tail on the ride side of the histogram is longer than the left. In contrast, a distribution is said to be negatively skewed when the tail on the left side of the histogram is longer.

Socio-Economic Indexes for Areas (SEIFAs)

Four Indexes compiled by the ABS following each population Census. Each index summarises different aspects of the socio-economic condition of areas. The Index of Disadvantage is the SEIFA index most frequently used in health analysis.

The Indexes available for use with 2011-12 NHS and NNPAS data are those compiled from the 2006 and 2011 Census of Population and Housing. For further information about the indexes, see Household and family characteristics.

Stratification

Stratification involves dividing a population or dataset in to like groups and can be used in sampling or statistical analysis. For the usual nutrient intake publication, the data was stratified into three subgroups – children aged two to eight years, males aged nine years and over, and females aged nine years and over. The model was run separately for each of these subgroups.

Supplements

For the purpose of the AHS, dietary supplements refer to products defined as Complementary Medicines under the Therapeutic Goods Regulations 1990 and that are not intended for inhalation or use on the skin. They include products containing ingredients that are nutrients, such as multi-vitamin or fish oil products.

Type of condition

The type of medical condition as reported by respondents and/or office coded by ABS from the description provided by respondents. All reported long-term medical conditions are coded to a classification developed by the ABS for use in the Australian Health Survey based on the 10th revision of the International Classification of Diseases and Health Related Problems (ICD-10). See also ICD-10.

Usual intakes

Usual intakes represent food and nutrient intake over a long period of time. For a single person, dietary intake varies day-to-day. A single 24-hour dietary recall does not represent the usual, or long term, intake of a person because of this 'within-person' variation. In the 2011-12 NNPAS, all respondents were asked for follow-up contact phone details in order to conduct a second 24-hour recall over the phone at least eight days later. A second 24-hour recall was collected from 64% of respondents. The second 24-hour recalls were used to estimate and remove within-person variation in order to derive a usual nutrient intake distribution for the population.

Vitamins

Vitamins are organic compounds found naturally in foods and are either fat or water soluble. They are required in small amounts. Vitamins enable the human body to function efficiently by regulating biochemical processes such as growth metabolism, cell reproduction, digestion, and oxidation of the blood.

Within-person variation

Within-person variation, or day-to-day variation, refers to the fluctuations in an individual’s intake (e.g. of nutrients) from each day to the next. In the usual nutrient intakes publication, the NCI method estimates within-person variation in a population group, by comparing each person's nutrient intake from their first 24-hour recall to their nutrient intake from their second 24-hour recall. The NCI method then omits within-person variation from the output usual nutrient intake distribution, as this does not contribute to usual nutrient intakes.


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