Australian Bureau of Statistics

Rate the ABS website
ABS Home > Statistics > By Catalogue Number
ABS @ Facebook ABS @ Twitter ABS RSS ABS Email notification service
4364.0.55.005 - Australian Health Survey: Biomedical Results for Chronic Diseases, 2011-12  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 05/08/2013  First Issue
   Page tools: Print Print Page Print all pages in this productPrint All RSS Feed RSS Bookmark and Share Search this Product  
Contents >> Comparisons with other Australian surveys


COMPARISONS WITH OTHER AUSTRALIAN SURVEYS

The National Health Measures Survey (NHMS) is the first ABS survey to include a voluntary blood and urine collection. However, biomedical results have been collected at the population level in Australia before, most recently at the national level by BakerIDI Heart and Diabetes Institute and for Victoria only by the Victorian Department of Health. There is strong interest in how the results from the NHMS compare with these two studies.

The 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab) was conducted by BakerIDI. This was a national cross-sectional survey of around 11,000 people aged 25 years and over and was primarily designed to measure the prevalence of diabetes and associated risk factors.1

The 2009–10 Victorian Health Monitor (VHM) was conducted by the Victorian Department of Health. This was a cross-sectional, statewide survey of around 3,600 Victorians aged 18–75 years and included biomedical measures for diabetes, cardiovascular disease and indicators of chronic kidney disease.2

A summary of the surveys is shown below.
Summary of surveys

AusDiabVictorian Health MonitorNHMS



    Year
1999–20002009–102011–12
    Scope
Adults aged 25 years and over in 99 Collection Districts in all states and in the Northern Territory. Excludes the ACT and Very Remote areas. Adults aged 18–75 years in 50 randomly selected Collection Districts in metropolitan and rural areas of Victoria.Adults and children aged 5 years and over in 2,700 Collection Districts across Australia, randomly selected as part of the Australian Health Survey. Excludes persons in Very Remote areas.
    Sample size
Approx 11,000Approx 3,600Approx 11,000

Note: A Collection District (CD) is the second smallest geographic area defined in the Australian Standard Geographical Classification (ASGC), the smallest being the Mesh Block. The CD was designed for use in the Census of Population and Housing as the smallest unit for collection and processing.

The following sections outline how the results from these two surveys compare with those from the NHMS.
DIABETES

The NHMS and VHM both used fasting plasma glucose blood tests to determine diabetes status. For a detailed description of how diabetes was defined in the NHMS, see the Measuring diabetes - definitions section of this publication.

As shown in the table below, the results from the two surveys were very similar. The NHMS found that 4.3% of people aged 18–75 years in Victoria had diabetes compared with 4.6% found in VHM. VHM had a slightly higher number of people with impaired fasting plasma glucose - 4.3% compared with 3.1% in the NHMS - however the overlapping confidence intervals for these two estimates suggest that this difference is not statistically significant.

Persons aged 18–75 years in Victoria: Comparison of diabetes results for NHMS and VHM

NHMS 2011–12(a)
VHM 2009–10(b)


%
95% CI
%
95% CI
    Known diabetes(c)
3.5
2.2 – 4.8
3.4
2.6 – 4.5
    Newly diagnosed diabetes(d)
0.9
0.2 – 1.5
1.2
0.7 – 1.9
    Total with diabetes
4.3
3.0 – 5.7
4.6
3.7 – 5.7
    Impaired fasting plasma glucose(e)
3.1
2.0 – 4.2
4.3
3.3 – 5.7

(a) Based on the fasting population. Estimates are not age-standardised.
(b) Data sourced from Department of Health 2012, The Victorian Health Monitor, State Government of Victoria, Melbourne. Estimates are age-standardised to the 2006 population.
(c) A person 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 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 the cut off point for diabetes (that is, ≥7.0 mmol/L).
(d) A person was considered to have newly diagnosed diabetes if they reported no prior diagnosis of diabetes but had a fasting plasma glucose value ≥7.0 mmol/L.
(e) A person was considered to have impaired fasting plasma glucose if they did not currently have diabetes, but had a fasting blood glucose level ranging from 6.1 mmol/L to less than 7.0 mmol/L.

The 1999–2000 AusDiab study used an Oral Glucose Tolerance Test (OGTT), together with self-reported information on doctor diagnosis and medication use, to determine diabetes. An OGTT involves an initial fasting plasma glucose blood test, followed by a drink of a solution containing 75g of glucose. The person's blood sugar levels are then checked again two hours later. Participants who reported a history of physician diagnosed diabetes and who were 1) taking oral hypoglycemic tablets or insulin injections or 2) had a fasting plasma glucose (FPG) level ≥7.0 mmol/L or 2-hour plasma glucose (2hPG) level ≥11.1 mmol/L were classified as having known diabetes. Participants not reporting diabetes and who had FPG ≥7.0 mmol/L or 2hPG ≥11.1 mmol/L were classified as having newly diagnosed diabetes.3

BakerIDI has supplied the ABS with previously unpublished 1999–2000 AusDiab diabetes figures based on FPG test results alone. This allows for a more direct comparison with the NHMS results. The FPG rate for AusDiab was slightly lower than that for the NHMS (5.5%), although this is unlikely to be a significant difference given that the confidence intervals overlap.

The largest difference between the surveys was for newly diagnosed diabetes. More people had newly diagnosed diabetes in AusDiab than in the NHMS, even when using the FPG test.

Persons aged 25 years and over(a): Comparison of diabetes results for NHMS and AusDiab

NHMS 2011–12(b)
AusDiab 1999–2000

FPG test
FPG test(c)
OGTT(c)(d)



%
95% CI
%
95% CI
%
95% CI
    Known diabetes
4.5
3.9 – 5.1
3.1
2.3 – 4.0
3.7
2.8 – 4.6
    Newly diagnosed diabetes
1.0
0.7 – 1.3
1.8
1.4 – 2.3
3.7
3.0 – 4.4
    Total with diabetes
5.5
4.9 6.1
4.9
3.8 – 6.1
7.4
5.9 – 8.8

(a) Based on the fasting populations.
(b) Estimates age-standardised to the 2001 standard population.
(c) Estimates are not age-standardised. Data has been weighted to match the age and sex distribution of the 1998 estimated resident population of Australia aged 25 years and over.
(d) Data sourced from Dunstan et al 2002, The Rising Prevalence of Diabetes and Impaired Glucose Tolerance, The Australian Diabetes, Obesity and Lifestyle Study, Diabetes Care 25: 829–834.

For other NHMS diabetes results, including for all Australians aged 18 years and over, see the Diabetes prevalence section of this publication.

CARDIOVASCULAR DISEASE

The NHMS and VHM included several blood tests for risk factors of cardiovascular disease, including cholesterol levels and triglycerides. Both surveys used the same cut-offs for normal and abnormal tests results and included the same definition of dyslipidaemia.

Again, there was little difference in the results between the two surveys for people aged 18–75 years in Victoria, particularly for total cholesterol and LDL cholesterol. The VHM had slightly higher rates of abnormal triglycerides and lower rates of abnormal HDL cholesterol than the NHMS.

Persons aged 18–75 years in Victoria: Comparison of cardiovascular test results for NHMS and VHM

NHMS 2011–12(a)
VHM 2009–10(b)


%
95% CI
%
95% CI
    Abnormal total cholesterol (≥5.5 mmol/L)
33.6
30.8 – 36.3
35.6
33.4 – 37.9
    Abnormal LDL cholesterol (3.5 mmol/L)(c)
32.5
28.8 – 36.3
32.3
29.6 – 35.1
    Abnormal HDL cholesterol (<1.0 mmol/L for men and <1.3 mmol/L for women)
22.3
19.2 – 25.4
15.4
13.0 – 18.2
    Abnormal triglycerides (2.0 mmol/L)(c)
10.5
8.2 – 12.9
14.0
12.5 – 15.8
    Dyslipidaemia(c)
58.6
54.2 – 62.9
56.8
53.7 – 59.9

(a) Estimates are not age-standardised.
(b) Data sourced from Department of Health 2012, The Victorian Health Monitor, State Government of Victoria, Melbourne. Estimates are age-standardised to the 2006 population.
(c) Based on the fasting population.

AusDiab also included tests for cholesterol and triglycerides, using these same thresholds. The prevalence of abnormal total cholesterol and abnormal LDL cholesterol was higher in AusDiab than for the NHMS. AusDiab also had a higher proportion of people with elevated triglycerides. Rates of HDL cholesterol could not be compared due to the use of different cut-offs.

Persons aged 25 years and over: Comparison of cardiovascular test results for NHMS and AusDiab

NHMS 2011–12(a)
AusDiab 1999–2000(b)


%
95% CI
%
95% CI
    Abnormal total cholesterol (≥5.5 mmol/L)
35.7
34.3 – 37.1
51.2
48.9 – 53.6
    Abnormal LDL cholesterol (3.5 mmol/L)(c)
35.5
33.8 – 37.3
45.7
43.6 – 47.8
    Abnormal triglycerides (2.0 mmol/L)(c)
15.2
13.9 – 16.6
20.6
18.0 – 22.9

(a) Estimates are age standardised to the 2001 standard population.
(b) Data sourced from International Diabetes Institute 2001, Diabesity & Associated Disorders in Australia - 2000. The Accelerating Epidemic, The Australian Diabetes, Obesity and Lifestyle Study (AusDiab), Melbourne.4 Estimates are not age standardised. Data has been weighted to match the age and sex distribution of the 1998 estimated resident population of Australia aged 25 years and over.
(c) Based on the fasting population.

For other NHMS cholesterol and triglycerides results, including for all Australians aged 18 years and over, see the Cardiovascular disease section of this publication.

KIDNEY FUNCTION

The NHMS and VHM included estimated glomerular filtration rate (eGFR) and presence of albuminuria as measures of kidney function. The prevalences of abnormal eGFR and albuminuria for people aged 18–75 years in Victoria were similar for both surveys.

Persons aged 18–75 years in Victoria: Comparison of kidney function test results for NHMS and VHM

NHMS(a)
VHM(b)


%
95% CI
%
95% CI
    Abnormal eGFR(c)
2.1
0.9 – 3.2
3.5
2.7 – 4.6
    Presence of albuminuria(d)
6.0
4.2 – 7.7
6.4
5.3 – 7.6

(a) Estimates are not age-standardised.
(b) Data sourced from Department of Health 2012, The Victorian Health Monitor, State Government of Victoria, Melbourne. Estimates are age-standardised to the 2006 population.
(c) Abnormal kidney function using eGFR is defined as a reading of less than 60 mL/min/1.73m.
(d) The presence of albuminuria is defined as an albumin creatinine ratio (ACR) reading of 2.5 mg/mmol for males and 3.5 mg/mmol for females.

The NHMS also included information on chronic kidney disease stages, using a combination of participants' eGFR and urinary albumin creatinine ratio (ACR) results. The AusDiab Kidney Study shows that the prevalence for chronic kidney disease based on the CKD-EPI equation was 11.5%.5 This was similar to the corresponding rate in the NHMS for people aged 25 years and over (10.4%).

Persons aged 25 years and over: Comparison of Chronic Kidney Disease results for NHMS and AusDiab

NHMS(a)
AusDiab 1999–2000(b)


%
95% CI
%
95% CI
    Chronic kidney disease
10.4
9.7 – 11.1
11.5
9.4 – 14.1

(a) Estimates are age-standardised to the 2001 standard population.
(b) Data sources from White et. al. 2010, Comparison of the Prevalence and Mortality Risk of CKD in Australia Using the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study GFR Estimating Equations: The AusDiab (Australian Diabetes, Obesity and Lifestyle) Study. Estimates are not age standardised. Data has been weighted to match the age and sex distribution of the 1998 estimated resident population of Australia aged 25 years and over.

For other NHMS kidney function results, including for all Australians aged 18 years and over, see the Chronic kidney disease section of this publication.


ENDNOTES

1 Dunstan et al. 2002, The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) – methods and response rates, Diabetes Research and Clinical Practice 57:119–129. Back to top
2 Department of Health 2012, The Victorian Health Monitor, <http://docs.health.vic.gov.au/docs/doc/CC6A20C055B5AA75CA257A80001A7128/$FILE/VHM%20report.pdf>, Last accessed 05/07/2013. Back to top
3 Dunstan et al. 2002, The Rising Prevalence of Diabetes and Impaired Glucose Tolerance, The Australian Diabetes, Obesity and Lifestyle Study, Diabetes Care 25: 829–834. Back to top
4 Diabetes Institute 2001, Diabesity & Associated Disorders in Australia - 2000. The Accelerating Epidemic, The Australian Diabetes, Obesity and Lifestyle Study (AusDiab), <http://www.health.gov.au/internet/main/publishing.nsf/Content/pq-diabetes-pubs-diabesity>, Last accessed 05/07/2013. Back to top
5 White et al. 2010, Comparison of the Prevalence and Mortality Risk of CKD in Australia Using the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study GFR Estimating Equations: The AusDiab (Australian Diabetes, Obesity and Lifestyle) Study, <http://www.kidney.org/news/keep/pdf/adr2010/2_Stevens_KEEP_2010.pdf>, Last accessed 05/07/2013. Back to top

Previous Page

Bookmark and Share. Opens in a new window


Commonwealth of Australia 2014

Unless otherwise noted, content on this website is licensed under a Creative Commons Attribution 2.5 Australia Licence together with any terms, conditions and exclusions as set out in the website Copyright notice. For permission to do anything beyond the scope of this licence and copyright terms contact us.