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4364.0.55.003 - Australian Health Survey: Updated Results, 2011-2012  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 07/06/2013  First Issue
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INTRODUCTION

1 This publication presents updated results from the 2011-13 Australian Health Survey (AHS).

2 Results in this publication are from a combined data file of both the NHS and NNPAS (referred to as the Core) and therefore differ from previously published data from the 2011-13 AHS. With a larger sample size (approximately 32,000 people), the Core provides more accurate estimates and allows for analysis at a finer level of disaggregation. However, the Core only contains those data items common to both NHS and NNPAS, and therefore does not provide the full spectrum of data items from the AHS. For more information on the structure of the AHS, see Structure of the Australian Health Survey.

3 The Updated Results, 2011-12 uses a combined sample from the National Health Survey (NHS) and the National Nutrition and Physical Activity Survey (NNPAS).The 2011-12 NHS was conducted throughout Australia from March 2011 to March 2012. This is the sixth in a series of Australia-wide health surveys conducted by the ABS; previous surveys were conducted in 1989-90, 1995, 2001, 2004-05 and 2007-08. Health surveys conducted by the ABS in 1977-78 and 1983, while not part of the NHS series, also collected similar information. The NNPAS was conducted between May 2011 and June 2012. NNPAS has not been previously collected, however in 1995 there was a National Nutrition Survey which collected similar information on Nutrition.

4 The 2011-12 Updated Results contains information about:

  • three specific long-term health conditions: heart and circulatory conditions, kidney disease and diabetes mellitus;
  • health-related aspects of people's lifestyles, such as smoking, Body Mass Index, blood pressure and fruit and vegetable intake; and
  • demographic and socioeconomic characteristics.

5 The statistics presented in this publication are those which were collected as part of the NHS and NNPAS. Further publications from the Australian Health Survey are outlined in the Release Schedule, while the list of data items available from the survey will be available in the Australian Health Survey: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

SCOPE OF THE SURVEY

6 The Updated Results contains a sample of approximately 25,000 private dwellings across Australia.

7 Urban and rural areas in all states and territories were included, while Very Remote areas of Australia and discrete Aboriginal and Torres Strait Islander communities (and the remainder of the Collection Districts in which these communities were located) were excluded. These exclusions are unlikely to affect national estimates, and will only have a minor effect on aggregate estimates produced for individual states and territories, excepting the Northern Territory where the population living in Very Remote areas accounts for around 23% of persons.

8 Non-private dwellings such as hotels, motels, hospitals, nursing homes and short-stay caravan parks were excluded from the survey. This may affect estimates of the number of people with some long-term health conditions (for example, conditions which may require periods of hospitalisation).

9 Within each selected dwelling, one adult (aged 18 years and over) and where possible, one child ( aged 2 years and over) were randomly selected for inclusion in the survey. Sub-sampling within households enabled more information to be collected from each respondent than would have been possible had all usual residents of selected dwellings been included in the survey.

10 The following groups were excluded from the survey:
  • certain diplomatic personnel of overseas governments, customarily excluded from the Census and estimated resident population
  • persons whose usual place of residence was outside Australia
  • members of non-Australian Defence forces (and their dependents) stationed in Australia
  • visitors to private dwellings.

DATA COLLECTION

11 Trained ABS interviewers conducted personal interviews with selected residents in sampled dwellings. One person aged 18 years and over in each dwelling was selected and interviewed about their own health characteristics. An adult, nominated by the household, was interviewed about one child (aged 2 years and over) in the household. Selected children aged 15-17 years may have been personally interviewed with parental consent. An adult, nominated by the household, was also asked to provide information about the household, such as the income of other household members.

SURVEY DESIGN

12 For both NHS and NNPAS, dwellings were selected at random using a multistage area sample of private dwellings.

For the Updated Results, the combined sample consisted of 30,721 dwellings after sample loss (for example, households selected in the survey which had no residents in scope of the survey, vacant or derelict buildings, buildings under construction). Of these, 25,080 (or 81.6%) were fully or adequately responding, yielding a total sample for the survey of 31,837 persons (age 2 years and over).


NHS, APPROACHED SAMPLE, FINAL SAMPLE AND RESPONSE RATES

New South
Wales
Victoria
Queensland
South
Australia
Western
Australia
Tasmania
Northern
Territory
Australian Capital Territory
Australia

Households approached (after sample loss)
3 269
3 051
2 907
2 285
2 385
1 635
1 307
1 516
18 355
Households in sample
2 736
2 516
2 457
1 962
2 144
1 469
975
1 306
15 565
Response rate (%)
83.7
82.5
84.5
85.9
89.9
89.8
74.6
86.1
84.8
Persons in sample
3 602
3 287
3 244
2 508
2 847
1 909
1 304
1 725
20 426



NNPAS, APPROACHED SAMPLE, FINAL SAMPLE AND RESPONSE RATES

New South
Wales
Victoria
Queensland
South
Australia
Western
Australia
Tasmania
Northern
Territory
Australian Capital Territory
Australia

Households approached (after sample loss)
2 227
1 983
1 988
1 551
1 545
1 155
911
1 006
12 366
Households in sample
1 666
1 371
1 525
1 211
1 334
1 003
592
817
9 519
Response rate (%)
74.8
69.1
76.7
78.1
86.3
86.8
65.0
81.2
77.0
Persons in sample
2 139
1 749
1 964
1 526
1 706
1 245
763
1 061
12 153




Updated Results (the core), APPROACHED SAMPLE, FINAL SAMPLE AND RESPONSE RATES

New South
Wales
Victoria
Queensland
South
Australia
Western
Australia
Tasmania
Northern
Territory
Australian Capital Territory
Australia

Households approached (after sample loss)
5 496
5 034
4 895
3 836
3 930
2 790
2 218
2 522
30 721
Households in sample
4 401
3 886
3 982
3 173
3 477
2 472
1 567
2 122
25 080
Response rate (%)
80.1
77.2
81.3
82.7
88.5
88.6
70.6
84.1
81.6
Persons in sample
5 598
4 925
5 084
3 964
4 461
3 091
2 002
2 712
31 837



13 The physical measures module of the AHS was voluntary. For Australia in 2011-12, 83.5% of persons aged 2 years and over had their height and weight measured. Therefore, BMI data presented as part of the AHS relates to the measured population only. Analysis of the characteristics of people who agreed to be measured compared to those who declined indicated that age and sex were factors in non-response. Females were more likely to decline, and non-response increased with age.

14 For Australia in 2011-12, 85.5% of persons aged 18 years and over agreed to have their blood pressure measured, and had a valid blood pressure reading obtained. Therefore, blood pressure data presented as part of the AHS relates to the measured population only. Analysis of the characteristics of people who agreed to be measured compared to those who declined indicated that age and sex were factors in non-response. Females were more likely to decline, and non-response increased with age.

15 More information on response rates is available in the Australian Health Survey: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

16 To take account of possible seasonal effects on health characteristics, the NHS and NNPAS samples were spread randomly across two 12-month enumeration periods. Between August and September 2011, survey enumeration was suspended due to field work associated with the 2011 Census of Population and Housing.

WEIGHTING, BENCHMARKING AND ESTIMATION

17 Weighting is a process of adjusting results from a sample survey to infer results for the in-scope total population. To do this, a weight is allocated to each sample unit; for example, a household or a person. The weight is a value which indicates how many population units are represented by the sample unit.

18 The first step in calculating weights for each person was to assign an initial weight, which was equal to the inverse of the probability of being selected in the survey. For example, if the probability of a person being selected in the survey was 1 in 600, then the person would have an initial weight of 600 (that is, they represent 600 others). An adjustment was then made to these initial weights to account for the time period in which a person was assigned to be enumerated.

19 The weights are calibrated to align with independent estimates of the population of interest, referred to as 'benchmarks', in designated categories of sex by age by area of usual residence. Weights calibrated against population benchmarks compensate for over or under-enumeration of particular categories of persons and ensure that the survey estimates conform to the independently estimated distribution of the population by age, sex and area of usual residence, rather than to the distribution within the sample itself.

20 The Updated Results were benchmarked to the estimated resident population living in private dwellings in non-Very Remote areas of Australia at 31 October 2011. Excluded from these benchmarks were persons living in discrete Aboriginal and Torres Strait Islander communities, as well as a small number of persons living within Collection Districts that include discrete Aboriginal and Torres Strait Islander communities. The benchmarks, and hence the estimates from the survey, do not (and are not intended to) match estimates of the total Australian resident population (which include persons living in Very Remote areas or in non-private dwellings, such as hotels) obtained from other sources.

21 Survey estimates of counts of persons are obtained by summing the weights of persons with the characteristic of interest. Estimates of non-person counts (for example, number of conditions) are obtained by multiplying the characteristic of interest with the weight of the reporting person and aggregating.

RELIABILITY OF ESTIMATES

22 All sample surveys are subject to sampling and non-sampling error.

23 Sampling error is the difference between estimates, derived from a sample of persons, and the value that would have been produced if all persons in scope of the survey had been included. For more information refer to the Technical Note. Indications of the level of sampling error are given by the Relative Standard Error (RSE) and 95% Margin of Error (MOE).

24 In this publication, estimates with an RSE of 25% to 50% are preceded by an asterisk (e.g. *3.4) to indicate that the estimate has a high level of sampling error relative to the size of the estimate, and should be used with caution. Estimates with an RSE over 50% are indicated by a double asterisk (e.g. **0.6) and are generally considered too unreliable for most purposes. These estimates can be used to aggregate with other estimates to reduce the overall sampling error.

25 The MOEs are provided for all proportion estimates to assist users in assessing the reliability of these types of estimates. Users may find this measure is more convenient to use, rather than the RSE, in particular for small and large proportion estimates. The estimate combined with the MOE defines a range which is expected to include the true population value with a given level of confidence. This is known as the confidence interval. This range should be considered by users to inform decisions based on the estimate.

26 Non-sampling error may occur in any data collection, whether it is based on a sample or a full count such as a census. Non-sampling errors occur when survey processes work less effectively than intended. Sources of non-sampling error include non-response, errors in reporting by respondents or in recording of answers by interviewers, and occasional errors in coding and processing data.

27 Non-response occurs when people cannot or will not cooperate, or cannot be contacted. Non-response can affect the reliability of results and can introduce a bias. The magnitude of any bias depends on the rate of non-response and the extent of the difference between the characteristics of those people who responded to the survey and those who did not.

28 The following methods were adopted to reduce the level and impact of non-response:
  • face-to-face interviews with respondents
  • the use of interviewers, where possible, who could speak languages other than English
  • follow-up of respondents if there was initially no response
  • weighting to population benchmarks to reduce non-response bias.

29 By careful design and testing of the questionnaire, training of interviewers, and extensive editing and quality control procedures at all stages of data collection and processing, other non-sampling error has been minimised. However, the information recorded in the survey is essentially 'as reported' by respondents, and hence may differ from information available from other sources, or collected using different methodology. For example:
  • Information about medical conditions was self-reported and while not directly based on diagnosis by a medical practitioner in the survey, respondents were asked whether they had ever been told by a doctor or nurse that they had a particular health condition. Conditions which have a greater effect on people's wellbeing or lifestyle, or those which were specifically mentioned in survey questions, are expected in general to have been better reported than others.

CLASSIFICATIONS

30 Long-term health conditions described in this publication are classified to a classification developed for use in the NHS (or variants of that classification), based on the International Classification of Diseases (ICD). The classification of data from the 2001, 2004-05, 2007-08 and 2011-12 AHS surveys is based on the 10th revision of the ICD.

31 Country of birth was classified to the Standard Australian Classification of Countries (cat. no. 1269.0).

32 Main language spoken at home was classified according to the Australian Standard Classification of Languages (cat. no. 1267.0).

33 Descriptions for data items such as Body Mass Index and blood pressure are included in the Glossary to this publication.

RESULTS OF THE SURVEY

34 Summary results of previous National Health Surveys were published separately in National Health Survey: Summary of Results, Australia, 1989-90, 1995, 2001, 2004-05 and 2007-08 (cat. no. 4364.0). Summary of the National Nutrition Survey, 1995, was published in National Nutrition Survey: Selected Highlights, Australia, 1995 (cat. no. 4802.0).

35 While some changes between estimates from different reference periods can be attributed at least in part to conceptual, methodological and/or classification differences, there are some instances where the degree or nature of the change suggests other factors are contributing to the movements, including changes in community awareness or attitudes to certain conditions, changes in common terminology affecting how characteristics are reported/described by respondents, improvements in diagnosis or management of conditions, etc. The degree of change attributable to all these factors relative to the actual change in prevalence cannot be determined from information collected in this survey.

36 Further information about the comparability of data between surveys is in the Australian Health Survey: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

CONFIDENTIALITY

37 The Census and Statistics Act, 1905 provides the authority for the ABS to collect statistical information, and requires that statistical output shall not be published or disseminated in a manner that is likely to enable the identification of a particular person or organisation. This requirement means that the ABS must take care and make assurances that any statistical information about individual respondents cannot be derived from published data.

38 Some techniques used to guard against identification or disclosure of confidential information in statistical tables are suppression of sensitive cells, random adjustments to cells with very small values, and aggregation of data. To protect confidentiality within this publication, some cell values may have been suppressed and are not available for publication but included in totals where applicable. As a result, sums of components may not add exactly to totals due to the confidentialisation of individual cells.

ROUNDING

39 Estimates presented in this publication have been rounded. As a result, sums of components may not add exactly to totals.

40 Proportions presented in this publication are based on unrounded figures. Calculations using rounded figures may differ from those published.

ACKNOWLEDGEMENTS

41 ABS publications draw extensively on information provided freely by individuals, businesses, governments and other organisations. Their continued cooperation is very much appreciated; without it, the wide range of statistics published by the ABS would not be available. Information received by the ABS is treated in strict confidence as required by the Census and Statistics Act, 1905.

PRODUCTS AND SERVICES

42 Summary results from this survey, compiled separately for Australia and each state and territory, are available in spreadsheet form from the 'Downloads' tab in this release.

43 For users who wish to undertake more detailed analysis of the survey data, Survey Table Builder will also be made available in 2013. Survey Table Builder is an online tool for creating tables from ABS survey data, where variables can be selected for cross-tabulation. It has been developed to complement the existing suite of ABS microdata products and services including Census TableBuilder and CURFs. Further information about ABS microdata, including conditions of use, is available via the Microdata section on the ABS web site.

44 Special tabulations are available on request. Subject to confidentiality and sampling variability constraints, tabulations can be produced from the survey incorporating data items, populations and geographic areas selected to meet individual requirements. A list of data items is available from the Australian Health Survey: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

RELATED PUBLICATIONS

45 Other ABS publications which may be of interest are shown under the 'Related Information' tab of this release.

46 Current publications and other products released by the ABS are listed on the ABS website <www.abs.gov.au>. The ABS also issues a daily Release Advice on the website which details products to be released in the week ahead.

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