4727.0.55.002 - Australian Aboriginal and Torres Strait Islander Health Survey: Users' Guide, 2012-13  
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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 Aboriginal and Torres Strait Islander 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 NATSINPAS. 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 section of the Australian Health Survey: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

Aboriginal and/or Torres Strait Islander

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

Aboriginal and Torres Strait Islander household

A household in an occupied private dwelling with at least one resident (including children) who has been identified as being of Aboriginal or Torres Strait Islander origin. Other residents of the household may have been identified as being of Aboriginal or Torres Strait Islander origin, non-Indigenous, or have Indigenous status unknown.

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.

Age standardisation

Age standardisation is a technique used to enhance the comparability of rates between populations with different age structures. As many population characteristics are age-related, (for example, long-term health conditions and employment patterns), adjustments are made to account for the confounding effects of the different age structures on the prevalence of these characteristics. The Aboriginal and Torres Strait Islander population has a larger proportion of young people and a smaller proportion of older people than the non-Indigenous population.

As age is strongly related to many health measures, as well as labour force status, estimates of prevalence which do not take account of age may be misleading. The age standardised estimates of prevalence are those rates that 'would have occurred' should the Indigenous and non-Indigenous populations both have the standard age composition. For this reason, where appropriate, estimates for Aboriginal and Torres Strait Islander people and non-Indigenous people in AATSIHS publications have both been age standardised to reflect the age structure of the same population — the total estimated resident population of Australia as at 30 June 2001.

ASGS Remoteness Structure

The Remoteness Structure for 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 Aboriginal and Torres Strait Islander Health Survey (AATSIHS)

The Australian Aboriginal and Torres Strait Islander Health Survey 2012-13 is composed of three survey components:

  • National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) 2012-13
  • National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS) 2012-13
  • National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS) 2012-13.

In addition to this, the AATSIHS contains a Core dataset, which is produced from the question set that is common to both NATSIHS and NATSINPAS. See Australian Aboriginal and Torres Strait Islander Health Survey Core Dataset for details.

Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) Core Dataset

The AATSIHS Core Dataset is produced from the question set that is common to both NATSIHS and NATSINPAS. In addition to general demographics, the question set includes the following topics:
  • self-assessed health
  • self-assessed body mass
  • smoking
  • physical measurements (height, weight, waist and hip circumference)
  • physical activity (non-remote adult, non-remote child (5-17 years) and remote (5 years and over))
  • dietary behaviour
  • blood pressure
  • cardiovascular disease
  • diabetes
  • food security
  • kidney disease.

Biomarker

In the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS), 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 NATSIHMS, 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 m² and no presence of albuminuria
  • Stage1 - eGFR greater than or equal to 90 mL/min/1.73 m² & albuminuria
  • Stage 2 - eGFR 60 to 89 mL/min/1.73 m² & albuminuria
  • Stage 3a - eGFR 45–59 mL/min/1.73 m²
  • Stage 3b - eGFR 30–44 mL/min/1.73 m²
  • Stage 4–5 - eGFR less than 30 mL/min/1.73 m²

For more information, see Chronic Kidney Disease biomarkers.

Co-morbid conditions

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

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 may be 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.

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

Dietary Guidelines refers to guidelines produced by the National Health and Medical Research Council that aim: to promote health and wellbeing; reduce the risk of diet-related conditions; and reduce the risk of chronic disease. The AATSIHS was developed when the 2003 Guidelines were current. However data has been published using the 2013 Australian Dietary Guidelines. For more information, see Dietary Behaviours.

Discrete Aboriginal and Torres Strait Islander Communities

A discrete Aboriginal and Torres Strait Islander community refers to Statistical Area 1's with approximate populations of over 90 that are inhabited or intended to be inhabited by predominantly Aboriginal and Torres Strait Islander people, with housing or infrastructure that is either owned or managed on a community basis. Resources such as language groups, information from persons with local knowledge of certain communities, and transport networks have all been used to maximise the extent to which SA1s contain interrelated Aboriginal and Torres Strait Islander populations.

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 NATSIHMS) 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.

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.

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.

Health risk factors

Specific lifestyle related factors impacting on health, including:

  • tobacco smoking
  • alcohol consumption
  • physical activity
  • dietary behaviours
  • 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 spokesperson

A household spokesperson is a person aged 18 years or over who is identified as the best person to provide information about the household, including household income and food security. Non-Indigenous persons were not eligible for selection in the NATSIHS and NATSINPAS sample, however they may have acted as the household spokesperson.

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 2012-13 AATSIHS 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.

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.

Known diabetes

In this survey, a person (who participated in the NATSIHMS) 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.

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.

National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS)

The National Aboriginal and Torres Strait Islander Health Measures Survey, which is sometimes referred to as the biomedical component of the AATSIHS, focused on early lifestyle related diseases through blood and urine testing. Information was collected on:
  • diabetes
            • fasting plasma glucose
            • glycated haemoglobin (HbA1c)
  • cardiovascular disease
            • apolipoprotein B (Apo B)
            • high-density lipoprotein (HDL) cholesterol
            • low-density lipoprotein (LDL) cholesterol
            • total cholesterol
            • triglycerides
  • 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 eighteen years and over, who were selected for either NATSIHS or NATSINPAS and agreed to also participate in the NATSIHMS.

For more information about the tests, see Biomedical Measures.

National Aboriginal and Torres Strait Islander Health Survey (NATSIHS)

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
  • blood pressure
  • dietary behaviour and food security
  • exercise
  • physical measurements (height, weight, waist and hip circumference)
  • use of medication and supplements
  • use of tobacco, alcohol and substances
  • breastfeeding
  • disability status
  • social and emotional well-being
  • cultural identification
  • family 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 Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS)

The National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey focused on collecting information on:
  • dietary behaviour (including 24-hour dietary recall) and food security
  • 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
  • physical activity and sedentary behaviour (including 8 day pedometer component)
  • use of tobacco
  • physical measurements (height, weight, waist and hip circumference).

Non-remote

Refers to the Major Cities, Inner Regional and Outer Regional areas as categorised by the ASGS Remoteness Areas. See ASGS Remoteness Areas for more information.

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.

Psychological distress (Kessler-5)

The Kessler-5 (K5) measure of psychological distress, consists of a subset of five questions from the Kessler Psychological Distress Scale-10 (K10), which was designed to measure levels of negative emotional states in the four weeks prior to interview. For more information, see the Health Conditions chapter.

Remote

Refers to the Remote and Very Remote areas as categorised by the ASGS Remoteness Areas. See ASGS Remoteness Areas for more information.

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.

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 2012-13 AATSIHS data are those compiled from the 2011 Census of Population and Housing. For further information about the indexes, see Household and family characteristics.

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 ABS Health Surveys based on the 10th revision of the International Classification of Diseases and Health Related Problems (ICD-10). See also ICD-10.