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4720.0 - National Aboriginal and Torres Strait Islander Social Survey: Users' Guide, 2008  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 26/02/2010   
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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).

HEALTH


OVERVIEW

This chapter provides information on a range of health measures that were collected in the 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS), including:



SELF ASSESSED HEALTH STATUS

This self-assessed measure is based on the person's overall physical and mental health both generally and in comparison to the period one year prior to the survey interview. All people were asked to rate their health on the following scale:
  • excellent;
  • very good;
  • good;
  • fair; or
  • poor.

Responses for children aged 0-14 years were provided by a proxy.

People aged 1 year or older were asked to compare their general health at the time of the interview to one year prior. Responses were based on the following:
  • much better now;
  • a bit/little better now;
  • about the same;
  • a bit/little worse now; or
  • much worse.

Children aged 1-14 years were also asked whether aspects of their health had led to concerns about learning. Responses were provided by the child's proxy and could have been yes or no.


Comparison to the 2002 NATSISS

In 2002 only the first question on health status was asked and information was only collected for people aged 15 years and over.


DISABILITY OR LONG TERM HEALTH CONDITION

Types of conditions

A disability or restrictive long term health condition exists if a limitation, restriction, impairment, disease or disorder, has lasted, or is expected to last for six months or more, and restricts everyday activities. People aged 15 years and over were asked about the presence of conditions that had lasted, or were expected to last, for six months or more.

In non-remote areas these conditions included:
  • sight problems not corrected by glasses or contact lenses;
  • hearing problems not corrected by hearing aids;
  • speech problems;
  • blackouts, fits or loss of consciousness;
  • difficulty learning or understanding things;
  • limited use of arms or fingers;
  • difficulty gripping things;
  • limited use of legs or feet;
  • a condition that restricts their physical activity or physical work (eg back problems, migraines);
  • any disfigurement or deformity; or
  • any mental illness for which help or supervision is required.

In remote areas these conditions included:
  • problems with sight or seeing things;
  • any problems hearing;
  • any problems speaking;
  • blackouts or fits;
  • problems learning or understanding things because of any conditions;
  • problems using arms or fingers;
  • problems holding things or picking things up;
  • problems using legs or feet;
  • any condition, such as back problems or bad headaches, that stop or reduce them being able to do any physical activity or work; or
  • any scars, loss of limbs or other conditions that affect their appearance.

More than one response could be provided.

Conditions restricting everyday activities

People were then asked to think about any conditions lasting six months or more that restricted them in their everyday activities. If a person did not have any type of restricting condition and they had earlier said that they did not have a condition which had lasted six months or longer, they were skipped to questions in a subsequent topic. If a person had a restricting condition, they were asked to nominate the type/s of condition/s from the following:
  • shortness of breath, or difficulty breathing;
  • chronic or recurring pain;
  • a nervous or emotional condition;
  • long term effects as a result of a head injury, stroke or other brain damage;
  • a long term condition that requires treatment or medication; or
  • any other long term condition, such as arthritis, asthma, heart disease, Alzheimer's disease, dementia, diabetes (sugar problems) or kidney problems;
  • can't hear;
  • can't see; or
  • can't speak.

The wording of the response categories differed slightly between non-remote and remote areas, but were treated the same. More than one response could be provided.

Help or supervision with tasks

People were also asked about times when they needed help or supervision (or looking after) with tasks because of their condition/s. Assistance with tasks was based on the following:
  • personal needs - bathing/showering, dressing/undressing, eating/feeding, going to the toilet, bladder/bowel control;
  • moving around - moving around away from home, moving around at home, getting in or out of a bed or chair; or
  • talking with people - understanding/being understood by strangers, friends or family, including the use of sign language/lip reading.

People aged 15-64 years were asked additional questions about the impact of their condition/s on schooling or employment. People aged 65 years or more were skipped to questions in a subsequent topic.

Schooling or employment restrictions

People aged 15-64 years who were currently studying were asked whether their schooling was affected because of the condition/s reported. Responses were based on the following:
  • need time off school/study;
  • attend special school/classes;
  • other related difficulties; or
  • no difficulties.

More than one response could be provided, except for the last response category. People who were not currently studying had their response recorded as 'not attending school/further study'.

People aged 15-64 years were also asked whether their employment was affected because of the condition/s reported. Responses were based on the following:
  • can't do some types of jobs;
  • have to lower the number of hours worked;
  • can't find suitable work;
  • need time off work;
  • not able to work at all; or
  • no difficulties.

More than one response could be provided, except for the last two response categories. People who were not currently working or looking for work had their response recorded as 'not currently working'.


Disability status

In the 2008 NATSISS, the questions used to ascertain disability status differed for people living in non-remote and remote areas. In remote areas, the wording of screening questions to establish disability status was less detailed and people were not specifically asked whether they had any mental illness for which help or supervision was required.

Responses provided about the type/s of condition/s, whether any condition restricted everyday activities and whether help or supervision was ever required were used to categorise a person by disability status. The disability status categories for non-remote and remote areas appear the same, however, in non-remote areas people who nominated the condition 'any mental illness for which help or supervision is required' were also included. For comparisons between non-remote and remote areas, the population can be limited to the set of criteria used to identify disability in remote areas.

Disability status:
  • profound or severe core-activity limitation - a specified condition for which the person requires help or supervision in one or more core activities (eg self-care, mobility or communication);
  • unspecified limitation or restriction - a specified condition that may or may not have restricted the person's everyday activities; or
  • no disability or long-term health condition - the person does not have any of the specified conditions.

Other than people with a profound or severe core-activity limitation, the severity of restrictions for people with a disability or long term health condition was not determined. This measurement differs from other ABS surveys and therefore is not strictly comparable to other sources.


Disability type

Responses provided about the type/s of condition/s and whether any condition restricted everyday activities were used to categorise a person by disability type. The disability type categories for non-remote and remote areas appear the same, however, in non-remote areas people who nominated the condition 'any mental illness for which help or supervision is required' were included in the psychological category. For comparisons between non-remote and remote areas, the population can be limited to the set of criteria used to identify disability in remote areas.

Disability type:
  • sight, hearing, speech;
  • physical;
  • intellectual;
  • psychological;
  • type not specified; or
  • has no disability or long term health condition.

Type not specified includes people whose condition/s that restricted everyday activities were:
  • a long term condition that requires treatment or medication; or
  • any other long term condition, such as arthritis, asthma, heart disease, Alzheimer's disease, dementia, diabetes (sugar problems) or kidney problems.

A person may have been categorised to more than one disability type.

Types of restrictions

Responses provided about the type/s of condition/s and the condition/s that restricted everyday activities were used to categorise the type of restriction/s. The type of restriction/s categories for non-remote and remote areas differ as people in non-remote areas who nominated the condition 'any mental illness for which help or supervision is required' are also included. For comparisons between non-remote and remote areas, the population can be limited to the set of criteria used to identify disability in remote areas.

Type of restrictions:
  • sight problems (not corrected by glasses or contact lenses);
  • hearing problems;
  • speech problems;
  • blackouts, fits or loss of consciousness;
  • difficulty learning or understanding things;
  • limited use of arms or fingers;
  • difficulty gripping things;
  • limited use of legs or feet;
  • any condition that restricts physical activity or physical work (eg back problems, migraines);
  • any disfigurement or deformity;
  • shortness of breath or difficulty breathing;
  • chronic or recurring pain;
  • a nervous or emotional condition;
  • long term effects as a result of a head injury, stroke or other brain damage;
  • any other long term condition that requires treatment or medication;
  • any other long term condition, such as arthritis, asthma, heart disease, Alzheimer's disease, dementia, etc; or
  • no disability or long term health condition.

In non-remote areas, the type of restrictions also included any mental illness for which help or supervision is required. A person may have had more than one type of restriction.


Comparison to the 2002 NATSISS

Disability status differs between the two surveys. In 2008, there were two additional response categories available to people living in remote areas, which were not available in 2002:
  • any condition such as back problems or bad headaches, that stop or reduce their being able to do any physical activity or work; and
  • any scars, loss of limbs or other conditions that affect their appearance.

Disability type also differs between the two surveys. In 2008, there were two additional categories available to people living in remote areas for conditions restricting everyday activities:
  • fears or any emotional problems, such as depression, that make doing things hard; and
  • a long-term health condition such as arthritis, asthma, heart disease, diabetes/sugar problems or kidney problems.


HEALTH RISK FACTORS

People were asked a series of questions relating to health risk factors, specifically those related to lifestyle behaviours. There were three main themes:

Smoking

People aged 15 years and over were asked questions about their smoking habits and the extent to which they were smoking at the time of the interview. Smoking refers to the regular smoking of tobacco products, including:
  • manufactured (packet) cigarettes;
  • roll-your-own cigarettes; and
  • cigars and pipes.

Chewing tobacco and the smoking of non-tobacco products (eg marijuana) were excluded. Based on this information, people were characterised as:
  • current smoker - they currently smoke daily, weekly or other regular pattern (but less than weekly);
  • ex-smoker - they previously smoked daily or had smoked 100 or more cigarettes in their lifetime or had smoked pipes, cigars or other tobacco products at least 20 times in their lifetime; or
  • never smoked - they had never smoked daily.

If a person smoked at least once a week they were asked how many cigarettes or roll-your-own cigarettes they usually smoked per day or week. These people and anyone identified as an ex-smoker were also asked whether they had tried to quit or reduce the amount being smoked in the 12 months prior to interview. Responses were based on the following:
  • tried to quit;
  • tried to reduce consumption;
  • both; or
  • no.

If a person had tried to quit and/or reduce consumption they were asked for all the reasons why they tried to do this, based on the following:
  • general health;
  • smoking related health condition;
  • medical advice;
  • cost;
  • increased awareness of risks due to advertisements;
  • encouraged by family or friends to stop/reduce;
  • concerned about effect on others in household;
  • too many non-smoking areas;
  • improve fitness;
  • other; or
  • no reason.

More than one response could be provided.

Household smokers

For each selected household, one person aged 15 years and over was asked to respond to questions about household smoking habits and smokers. This person was asked if anyone (or if they were a current daily smoker, then anyone else) in the household smoked regularly, that is, at least once a day. This question was asked in relation to multi-person households only.

Where at least one person in a household was identified as smoking regularly, the household spokesperson was asked whether anyone usually smokes inside the house. The response could be yes, no or don't know.


Comparison to the 2002 NATSISS

The 2002 survey contained less detailed information on smoking. New questions in the 2008 survey included:
  • number of cigarettes smoked per day or week;
  • number of cigarettes or tobacco products smoked in lifetime;
  • whether had tried to quit; and
  • reasons had tried to quit.

Information on household smokers was not collected in 2002.


Alcohol consumption

People aged 15 years and over were asked about their consumption of alcoholic drinks/grog in the 12 months prior to interview. Where a person had consumed alcohol/grog in the 12 months prior to interview, they were asked how often they drank. Responses were based on the following:
  • every day;
  • six days a week;
  • five days a week;
  • four days a week;
  • three days a week;
  • two days a week;
  • one day a week;
  • three days a fortnight;
  • one day a fortnight or less;
  • one day a month or less; or
  • one day a year or less.

More detailed questions were only asked of people who consumed alcohol/grog more than one day a year. People were asked to think about the days when they had a drink and to indicate the amount which they usually drank in a day. From the type of drink and volumes/quantities provided, the number of standard drinks per day was calculated.

People were also asked whether they had a drink of alcohol/grog in the two weeks prior to interview. If a person had a drink in the specified period, they were asked to think about the day when they drank the most. From the type of drink and volumes/quantities provided, the number of standard drinks was calculated.

Standard drinks

The collection of accurate data on the quantity of alcohol consumed is difficult, particularly in a recall situation, and considering the nature and possible circumstances of consumption. Where possible, information was collected in terms of standard containers or measures (eg stubbie, nip, 10 oz glass). Reported quantities of drinks consumed were converted to millilitres (mls) of alcohol present in those drinks and then summed to the drink type. To convert drinks to millilitres of alcohol consumed:

alcohol content of the drink consumed (%) x the number of drinks (of that type) consumed x the vessel size (in mls).

Information was collected separately for each of the following categories of alcoholic drinks:
  • beer - light, mid-strength and full-strength (heavy);
  • cider;
  • fortified wine;
  • spirits; and
  • wine.

A standard drink contains 12.5 ml of alcohol. The serving size determines the number of standard drinks per serve, as shown by the examples in the following table.

STANDARD DRINKS, by serving size

Type of alcohol/grog
Serving size
Standard drinks

Beer
1 can or stubbie (375 ml) light beer
0.8
1 can or stubbie (375 ml) mid-strength beer
1.0
1 can or stubbie (375 ml) full-strength (heavy) beer
1.5
1 long-neck bottle (750 ml) full-strength beer
3.0
Fortified wine
Cask/flagon (2 lt) port/sherry
28.0
Wine (9-13%)
1 bottle wine (750 ml)
7.0
1 wine cask (4 lt)
36.0
Spirits
1 nip (30 ml)
1.0
1 bottle (340 ml) pre-mixed spirirts and soft drink
1.5



Where the person reported sharing drinks with other people the number of standard drinks was adjusted.

Alcohol consumption risk level

Two measures of alcohol consumption risk level were derived from the 2008 NATSISS. The first measure was based on a person's reported usual daily consumption of alcohol and the frequency of consumption in the 12 months prior to interview. The second was based on the largest quantity of alcohol consumed in a single day during the two weeks prior to interview. The relative risk levels, as defined by the National Health and Medical Research Council (NHMRC) in 2001, are provided in the following table.

ALCOHOL CONSUMPTION RISK LEVEL, by consumption per day

Relative risk
Males
Females

Low
Less than 50 mls
Less than 25 mls
Moderate
50-75 mls
25-50 mls
High
Greater than 75 mls
Greater than 50 mls



The risk levels as defined by the 2001 NHMRC guidelines are based on 'usual' levels of alcohol consumption. The second measure of alcohol consumption risk did not take into account whether the largest quantity of alcohol consumed in a single day during the previous two weeks was more, less, or the same as usual.

Comparison to the 2002 NATSISS

The questions on alcohol consumption and the measures used to indicate risk level are comparable for the 2002 and 2008 surveys.


Substance use

Substance use refers to the misuse of prescription drugs and/or the use of illicit drugs. The collection method for this topic varied between non-remote and remote areas. Due to the potentially sensitive nature of the questions, responses to these questions were voluntary. In non-remote areas, people answered questions through a voluntary self-completion substance use form. In remote areas, people were personally interviewed.

Permission from a parent/guardian was required before people aged 15-17 years could answer any questions. The parent/guardian was able to view the uncompleted form/content of the questions, however, they were not allowed to see/hear the responses, as these are confidential and protected under the Census and Statistics Act 1905.

People aged 15 years and over were asked whether they had ever used the following types of prescription drugs:
  • pain killers or analgesics;
  • tranquilisers or sleeping pills; or
  • methadone.

If a person had used these types of drugs, they were asked if they had used them for non-medical purposes/when they were not sick. If so, they were then asked if they had used the drug in this way in the 12 months prior to interview. People were also asked whether they had ever:
  • used marijuana, hashish or cannabis resin;
  • sniffed petrol; or
  • used Kava.

In non-remote areas people were asked whether they had ever used other inhalents (eg chroming, laughing gas, whippits, nitrous, snappers, poppers, pearlers, rushamines, locker room, bolt, bullet, rush, climax, red gold). In remote areas people were asked whether they had ever sniffed glue, solvents, paint thinners, aerosols or anything else. If a person had used these types of drugs at some point in their lifetime, they were also asked if they had used them in the 12 months prior to interview.

The collection of information on the following types of substance use differed slightly between non-remote and remote areas. In non-remote areas, people were asked whether they had ever used each of the following substances:
  • amphetamines or speed;
  • heroin;
  • cocaine;
  • LSD or synthetic hallucinogens;
  • naturally occurring hallucinogens; or
  • ecstasy or designer drugs.

In remote areas, people were asked if they had ever tried any other other substances that could be injected, sniffed, chewed, smoked or used in some other way. Where possible, the responses were attributed to one of the substance categories, but they may have also been classified as 'other'.

If a person had used a substance at some point in their lifetime, they were also asked if they had used that substance in the 12 months prior to interview.

Comparison to the 2002 NATSISS

In 2002, information on substance use was collected for people aged 15 years and over and is available for non-remote areas only.

In 2008, the 'Type of substances used' data items (ever used and used in last 12 months) included an additional category - Methadone for non-medical purposes. In 2008, the 'Number of substances used' data items (ever used and used in last 12 months) were output as a numerical value from 0 to 13, whereas in 2002 these data items were output as follows:
  • one type;
  • two types;
  • three types;
  • four types; or
  • five or more types.


SOCIAL AND EMOTIONAL WELLBEING

Several measures, designed to provide a broad understanding of social and emotional wellbeing, were collected in the 2008 NATSISS. The two measures described in this topic include:
Apart from these measures, information on cultural identification, removal from family and stressors may help to provide further understanding of social and emotional wellbeing. These topics are covered in the following chapters:

Psychological distress (Kessler-5)

The Kessler-5 (K5) measure of psychological distress is a subset of five questions from the Kessler Psychological Distress Scale-10 (K10). The K10 is a non-specific psychological distress scale consisting of 10 questions designed to measure levels of negative emotional states experienced by people in the four weeks prior to interview.

The 2008 NATSISS included questions from the K5 to provide a broad measure of people's social and emotional wellbeing. People aged 15 years and over were asked about how often in the four weeks prior to interview they felt:
  • nervous;
  • without hope;
  • restless or jumpy;
  • everything was an effort; and
  • so sad that nothing could cheer them up.

For each K5 question, an answer was provided using a five-level response scale, based on the amount of time a person reported experiencing the problem. The response scale was as follows:
  • all of the time;
  • most of the time;
  • some of the time;
  • a little of the time; or
  • none of the time.

A person may have also responded that they did not know or did not want to answer the question/s. If a person answered none of the time or a mixture of none of the time, don't know or they did not want to answer for all K5 questions, they were skipped to later questions on happiness and energy levels.

People who answered the K5 questions with responses ranging from 'a little of the time' to 'all of the time' were asked whether there were any days in the four weeks prior to interview when they were totally unable to work or carry out normal activities because of their feelings. If so, they were then asked how many days were like that. A response from 1 to 28 was possible.

People were also asked to think about the K5 questions and whether their feelings in the four weeks prior to interview happened:
  • more often than usual;
  • about the same as usual; or
  • less often than usual.

A person may have also responded that they did not know.

K5 score

Responses to the K5 questions were put together, resulting in a minimum possible score of 5 and a maximum possible score of 25. Low scores indicate low levels of psychological distress and high scores indicate high levels of psychological distress. Scores were grouped and output as follows:
  • low/moderate 5-11;
  • high/very high 12-25; or
  • not stated.

Assistance seeking behaviour

People were asked whether in the four weeks prior to interview they needed to see a doctor or health professional about their feelings. If so, they were asked how many times they had to see someone. A response from 1 to 99 was possible.

It should be noted that while the questions on needing to see and seeing a doctor or health professional appear similar to concepts collected in the 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), the differing wording of the questions means that these items are not strictly comparable. More information on the 2004-05 NATSIHS data items is available from the National Health Survey and National Aboriginal and Torres Strait Islander Health Survey: Data Reference Package, 2004-05 (cat. no. 4363.0.55.002).

Physical health issues

People were also asked how often physical health problems had been the main cause of the feelings. Responses were based on the following:
  • all of the time;
  • most of the time;
  • some of the time;
  • a little of the time; or
  • none of the time.

A person may have also responded that they did not know or did not want to answer the question/s.


Feelings of happiness and energy levels

The Short Form 36 (SF-36) is an international survey instrument containing questions which provide an indication of general health status. The SF-36 measures a range of concepts, including vitality (energy/fatigue) and mental health. Four questions from the SF-36 were included in the 2008 NATSISS.

People aged 15 years and over were asked about their feelings in the four weeks prior to interview and how often they:
  • felt calm and peaceful;
  • had been a happy person;
  • felt full of life; and
  • had a lot of energy.

For each question an answer was provided using the following response scale:
  • all of the time;
  • most of the time;
  • some of the time;
  • a little of the time; or
  • none of the time.

People may have also responded that they did not know or did not want to answer the question/s.


Comparison to the 2002 NATSISS

This information was not collected in 2002.


CHILD HEALTH

This topic contains the following themes:

Infant and maternal health

The 2008 NATSISS collected information on children aged 0-3 years and the health of their birth mother during pregnancy and childbirth. Responses were provided by the child's proxy who may or may not have been their birth mother. It should be noted that although the child has been identified as Indigenous, the birth mother may not be.

Pregnancy and childbirth

If the child's proxy was not the birth mother, they were asked if they would be able to answer some questions about the mother's pregnancy and when the child was born. If the proxy responded they were unable to do so they were skipped to questions in a subsequent topic. If the proxy responded that they did not know, they were still asked further questions.

The proxies of children aged 0-3 years were asked whether the child was born late, on time or early. Responses were based on the following:
  • late birth - 42 weeks or more;
  • on time - 37 to 41 weeks;
  • somewhat early - 33 to 36 weeks;
  • very early - 32 weeks or less; or
  • don't know.

Information about children aged 0-3 years and their weight at birth was also collected. Responses could be provided in kilograms/grams or pounds/ounces, or they may have said that they did not know. Responses were output numerically as a value ranging from 1 to 9994 grams.

Child's birth

For children aged 0-3 years, the proxy was asked to think about where the child's mother lived and when the child was born. They were asked to provide a location for where the child was born, based on the following:
  • in the closest hospital;
  • in another hospital;
  • at a birthing clinic;
  • at a general medical clinic or facility;
  • at home;
  • somewhere else; or
  • don't know.

If the child was born at a hospital or clinic the proxy was also asked how far away from the mother's home this was, based on the following:
  • less than 10 kilometres;
  • 10-24 kilometres;
  • 25-49 kilometres;
  • 50-99 kilometres;
  • 100-249 kilometres;
  • 250 kilometres or more; or
  • don't know.

If the child's mother gave birth in a hospital or clinic the proxy was also asked the number of nights the mother spent at the facility. A response of 0 to 99 was possible, or they may have said they did not know.

The proxy was asked whether the child's mother had to spend any time in hospital, other than to give birth (where applicable), because of the pregnancy. If the mother did spend time in hospital the proxy was asked the number of nights. A response of 0 to 99 was possible, or they may have said they did not know.

Health during pregnancy

The proxy of children aged 0-3 years also provided information on whether the child's mother had any check-ups during the pregnancy. If the child's mother did not have or the proxy did not know if they had any pregnancy check-ups they were skipped to subsequent questions on pregnancy issues. If the child's mother had check-ups during pregnancy the proxy was asked whether the check-ups were regular, that is, at least one check-up every two months. They were also asked who the child's mother saw for check-ups during the pregnancy, based on the following:
  • doctor or GP;
  • obstetrician;
  • midwife or nurse;
  • Aboriginal or Torres Strait Islander health worker;
  • birthing grandma;
  • someone else; or
  • don't know.

More than one response could be provided.

The proxies of children aged 0-3 years were asked about any issues the child's mother may have had during the pregnancy and whether after the mother found out she was pregnant she was told by a doctor or nurse that she had:
  • diabetes or sugar problems; or
  • high blood pressure.

The response could be yes, no or don't know.

The proxy was asked whether the child's mother took any supplements that included folic acid or folate prior to or during pregnancy. Responses were based on the following:
  • yes, both prior to and during pregnancy;
  • yes, prior to pregnancy;
  • yes, during pregnancy;
  • no; or
  • don't know.

The proxy was also asked whether during the pregnancy the child's mother took any other medications or supplements, like heart tablets, iron tablets or cold and flu tablets. The response could be yes, no or don't know.

Substance use

If the proxy of a child aged 0-3 years was the child's mother, questions were asked about tobacco and alcohol/grog use during pregnancy. Due to the potentially sensitive nature of the questions, responses to these questions were voluntary. The child's mother was asked whether after finding out she was pregnant, during the pregnancy she:
  • drank any alcohol/grog;
  • smoked any cigarettes or chewed any tobacco; or
  • used any other substances like smoking marijuana, drinking Kava, sniffing petrol or taking any other illicit drugs.

If the child's mother did not, did not know or did not want to answer she was skipped to subsequent questions. If the child's mother drank or smoked during the pregnancy, she was asked how much she did so compared to before she was pregnant, based on the following:
  • more;
  • about the same; or
  • less.

The child's mother may have also said that she did not know or did not want to answer the question. This question was not asked in relation to the use of other substances.

Pregnancy or birth advice

If the proxy of a child aged 0-3 years was also the child's mother, they were asked whether they sought or got any advice or information about pregnancy or giving birth during their pregnancy. If they did not seek or get advice or information they were skipped to later questions on the child's birth. If the child's mother sought or got information they were asked where this was from, based on the following:
  • single class or seminar (presentation, talk);
  • series of classes or group sessions (more than one attended);
  • individual counselling/discussion with health service provider;
  • accessing books, videos/DVDs or websites;
  • discussion/advice from family or friends;
  • discussion/advice from community elders or traditional medicine woman;
  • other; or
  • don't know.

More than one response could be provided.


Nutrition

Breastfeeding and weaning

Information was collected on the nutrition and feeding experiences of children aged 0-3 years. The child's proxy provided information on whether the child was ever breastfed. If a child was not or if it was unknown if they were breastfed, the proxy was skipped to later questions about drinking milk.

If a child aged 0-3 years had been breastfed at some point in their lifetime, the proxy was asked whether the child was still being breastfed. If not, they were asked how old the child was when they stopped being completely breastfed. Responses could be provided in months or weeks, or they may have said they did not know. Responses were output numerically as a value ranging from 1 to 995 weeks. If the child was less than one week old or the age when they stopped being breastfed was unknown, then the proxy was skipped to later questions about drinking milk.

If a child was still being breastfed, the proxy was asked whether the child drank anything other than breastmilk. If the child did not or it was unknown, the proxy was skipped to later questions on solid food.

The proxy was asked whether the child aged 0-3 years regularly drank any (other) type of milk, based on the following:
  • infant formula;
  • cow's milk;
  • soya bean milk or soy milk;
  • goat's milk;
  • evaporated milk;
  • coconut milk;
  • only drinks breast milk;
  • does not drink milk/no other milk drunk regularly; or
  • none of the above.

More than one response could be provided.

If a child regularly drank some type of milk, other than breast milk, the proxy was asked at what age the child was first regularly given this other milk. Responses could be provided in months or weeks, or they may have said they did not know. Responses were output numerically as a value ranging from 1 to 995 weeks. If the child was less than one week old or the age when they were first given other types of milk was unknown, the proxy was skipped to later questions about other types of drinks.

The proxy was also asked whether the child aged 0-3 years regularly drank any other types of drinks, apart from milk or formula, based on the following:
  • water;
  • fruit juices;
  • cordial;
  • fizzy or soft drinks;
  • tea or coffee;
  • herbal drinks;
  • other;
  • don't know; or
  • does not regularly have other drinks.

More than one response could be provided.

The proxies of children aged less than 6 months were asked whether the child had ever been given solid food and if so, were then asked questions related to solid food. Children aged less than 6 months who had not yet had solid food were skipped to questions in a subsequent topic.

The proxy was asked at what age the child was first given solid food regularly. Responses could be provided in months or weeks, or they may have said they did not know. Responses were output numerically as a value ranging from 1 to 995 weeks. If the child was less than one week old or the age when they were first given solid food regularly was unknown, they were skipped to questions in a subsequent topic.

Fruit and vegetables

Information was collected on the fruit and vegetable consumption of children aged 1-14 years. More detailed information is available for children living in non-remote areas than those living in remote areas. The proxies of children aged 1-14 years were asked how many days per week the child usually ate:
  • fruit - including fresh, frozen, tinned or dried; and
  • vegetables - including raw or cooked, fresh, frozen or tinned.

Responses were based on the following:
  • 1-2 days per week;
  • 3-4 days per week;
  • 5-6 days per week;
  • every day;
  • doesn't usually eat fruit; or
  • don't know.

The proxies of children in non-remote areas, who responded at least one day per week, were asked how many serves of fruit and/or vegetables the child usually ate in a day. Responses were based on the following:
  • 1 serve or less;
  • 2 serves;
  • 3 serves;
  • 4 serves;
  • 5 serves or more; or
  • don't know.

For children in non-remote areas whose proxy said they did not know how many days per week the child ate fruit and/or vegetables, it was assumed that the number of serves eaten would also be unknown. The proxies of children in remote areas were not asked how many serves of fruit and/or vegetables the child consumed.


Sleep

Information was collected on the sleep habits of children aged 0-14 years. The child's proxy was asked whether in the month prior to interview the child had any trouble getting to sleep or staying asleep at night. The response could be yes, no or don't know. For children aged 0-2 years, an additional response category, does not sleep through the night, was available.

The proxies of children who had trouble getting to sleep or sleeping were then asked about the reason/s for the difficulty, based on the following:
  • household noise;
  • bedwetting;
  • nightmares;
  • afraid of the dark/to be alone/other fear;
  • overexcitement/overstimulation;
  • child goes to bed late;
  • child wakes up early;
  • noisy neighbourhood/community;
  • too hot or too cold;
  • toothache;
  • illness or pain;
  • other; or
  • don't know.

More than one response could be provided.

The proxies of children aged 0-3 years were asked what position the child usually sleeps in, based on the following:
  • on back;
  • on side;
  • on front/tummy; or
  • don't know.

The proxy was also asked how many people sleep in the same room as the child. A response of 0 to 30 was possible, or they may have said they did not know. In some instances, the number of people who slept in the same room as the child equalled or exceeded the total number of people identified as living in the household. This may have been due to visitors being included in the count, the child not being excluded from the count, or because the question does not include reference to the 'usual' situation.


Exercise

Physical activities and organised sport

Information was collected on the physical activities and participation in organised sport by children aged 4-14 years. The child's proxy was asked how many days in the week prior to interview the child was physically active for a total time of at least 60 minutes. Physically active meant the child did an activity of moderate to vigorous intensity. This did not need to be continuous time, but could be made up of shorter bursts of activity. Responses were based on the following:
  • no days;
  • 1 day;
  • 2 days;
  • 3 days;
  • 4 days;
  • 5-6 days;
  • every day; or
  • don't know.

The proxies of children aged 4-14 years were asked whether the child had played or trained for any organised sport, through either a club or school in the 12 months prior to interview. If the child was currently at school, then this activity was specified as being undertaken outside school hours. If the child did not participate or it was unknown if they had participated, the proxy was skipped to later questions on barriers to participation. If a child had participated in sport they were asked to nominate the types of sport they had played or trained for, from the following list:
  • swimming;
  • soccer (outdoor);
  • soccer (indoor);
  • netball;
  • tennis;
  • basketball;
  • Australian rules football;
  • cricket (outdoor);
  • cricket (indoor);
  • martial arts;
  • athletics/track and field;
  • rugby league;
  • gymnastics;
  • hockey; or
  • other.

More than one response could be provided. If a child had participated in less than three organised sports, they were asked about barriers to participation. The child's proxy was asked what stops the child from playing/playing more organised sport, based on the following:
  • don't want to do any/more sport;
  • (more) organised sport is not available;
  • health reasons;
  • costs too much;
  • lack of appropriate training or equipment;
  • not enough time;
  • preferred sport is seasonal;
  • other; or
  • don't know.

More than one response could be provided.

The proxies of children aged 4-14 years who had participated in organised sports in the 12 months prior to interview were also asked how many hours in the previous two weeks the child spent playing or training outside school hours for all organised sports. A response of 0 to 336 hours was possible, where 0 represented less than one hour or no time.

Inactivity

The proxies of children aged 5-14 years, who had not used a computer or the Internet in the 12 months prior to interview, were asked whether the child, on average, spends more than 2 hours per day watching television (TV), videos, or DVDs. For children aged 5-14 years who had used a computer and/or the Internet in the 12 months prior to interview, the proxy was also asked if the child had, on average, used a computer for more than 2 hours per day. A response of yes, no or don't know was possible.


Health services

The proxies of children aged 0-14 years were asked where the child usually goes when they have a problem with their health. Responses were based on the following:
  • Aboriginal Medical Service (AMS);
  • other community health clinic;
  • a maternal and child health centre;
  • hospital (including casualty, outpatients or emergency area);
  • a doctor/General Practitioner (GP) (outside AMS, health clinic or hospital);
  • traditional healer;
  • chemist;
  • a relative or other community person;
  • other health professional (eg naturopath, dietician); or
  • don't usually seek health care.

More than one response could be provided.


Health problems

Information about the following child health problems was collected in the 2008 NATSISS:
Eye or sight problems

The proxies of children aged 0-14 years were asked whether the child had any problems with their eyes or sight. If the child did not have or it was unknown if they had any problems, the proxy was skipped to subsequent questions on ear or hearing problems. If the child had problems with their eyes or sight, the proxy was asked to identify which one/s from the following:
  • difficulty reading/seeing close up (long sightedness);
  • difficulty seeing far away (short sightedness);
  • totally blind in both eyes;
  • totally blind in one eye;
  • partially blind in both eyes;
  • partially blind in one eye;
  • glaucoma;
  • cataracts;
  • trachoma;
  • lazy eye;
  • retinopathy;
  • other; or
  • don't know.

The child's proxy was asked for how long the child had the eye or sight problem/s. Responses could be provided in months or years, or the child may have had the problem/s since they were born. Responses were output numerically as a value ranging from 1 to 997 months.

The child's proxy was also asked what type of treatment the child had been given for their eye or sight problem/s, based on the following:
  • wears glasses/contact lenses;
  • medication (including eye drops);
  • surgery;
  • checked by an eye or sight specialist;
  • a walking stick or guide dog;
  • other;
  • no treatment sought;
  • no treatment available; or
  • unable to afford treatment.

More than one response could be provided.

Ear or hearing problems

The proxies of children aged 0-14 years were asked whether the child had any problems with their ears or hearing. If the child did not have or it was unknown if they had any problems the proxy was skipped to subsequent questions on teeth or gum problems. If the child had ear or hearing problems, the proxy was asked to identify which one/s from the following:
  • total deafness;
  • deaf in one ear;
  • hearing loss/partially deaf;
  • ringing in ears (tinnitus);
  • runny ears or glue ear (otitis media);
  • tropical ear/swimmer's ear (otitis externa);
  • other; or
  • don't know.

The child's proxy was asked for how long the child had the ear or hearing problem/s. Responses could be provided in months or years, or the child may have had the problem/s since they were born. Responses were output numerically as a value ranging from 1 to 997 months.

The child's proxy was also asked what type of treatment the child had been given for their ear or hearing problem/s, based on the following:
  • wears a hearing aid;
  • medication (including eardrops);
  • surgery;
  • checked by an ear or hearing specialist;
  • cochlear implant;
  • other;
  • no treatment sought;
  • no treatment available; or
  • unable to afford treatment.

More than one response could be provided.

Teeth or gum problems

Teeth cleaning habits

The proxies of children aged 0-14 years (who had teeth) were asked how often the child brushes their teeth. For children aged 0-8 years, brushing included where someone else cleaned their teeth. Responses were based on the following:
  • more than twice a day;
  • twice a day;
  • once a day;
  • 5-6 days a week;
  • 3-4 days a week;
  • 1-2 days a week;
  • doesn't clean teeth; or
  • doesn't have teeth.

The proxies of children aged 0-18 months were first asked whether the child had any teeth and if so, were then asked about teeth cleaning. If not, they were skipped to questions in a subsequent topic.

Dental problems

The proxies of children aged 0-14 years (who had teeth) were asked whether the child had any of the following problems:
  • cavities (holes) or dental decay;
  • tooth or teeth filled because of dental decay;
  • teeth pulled out because of dental decay;
  • an accident caused breakage or loss of teeth;
  • bleeding or sore gums;
  • other problems with teeth or gums;
  • none; or
  • don't know.

The wording of the response categories differed slightly between non-remote and remote areas, but were treated the same. More than one response could be provided. If the child did not have or it was unknown if there were any problems, the proxy was skipped to subsequent questions about dental visits. If the proxy reported that the child had at least one teeth or gum problem, they were asked how long the child had the problem/s. Responses could be provided in months or years. Responses were output numerically as a value ranging from 1 to 997 months.

Dental visits

The proxies of children aged 0-14 years (who had teeth) were asked about the child's visits to the dentist. They were asked when the last time was that the child went to a dentist about their teeth, based on the following:
  • less than 3 months ago;
  • 3 months to less than 6 months ago;
  • 6 months to less than a year ago;
  • 1 year ago to less than 2 years ago;
  • 2 years ago or more;
  • never; or
  • don't know.

The proxies of all children, except those who had never been to a dentist, were then asked where the child last went to the dentist. Responses were based on the following:
  • dentist at the Aboriginal Medical Service;
  • dentist at an other community health clinic;
  • school dental service;
  • government dental clinic (including dental hospitals);
  • private dental practice (including specialists);
  • other; or
  • don't know.

The proxies of children aged 0-14 years (who had teeth) were also asked whether in the 12 months prior to interview there was ever a time when the child needed to go to a dentist but didn't. If the child did not need to, or it was unknown if they needed to go, the proxy was skipped to questions in a subsequent topic.

The proxies of children who needed to go to the dentist, but didn't, were then asked why the child didn't go, based on the following:
  • cost;
  • treated badly because Aboriginal or Torres Strait Islander;
  • service not culturally appropriate;
  • language problems;
  • transport/distance;
  • waiting time too long or not available at the time required;
  • not available in the area;
  • couldn't find the time (for the child) to be taken (including personal/family responsibilities);
  • dislikes service/professional/afraid/embarrassed;
  • felt it would be inadequate;
  • decided not to seek care (for the child); or
  • other.

More than one response could be provided.


Comparison to the 2002 NATSISS

This information was not collected in 2002.


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Commonwealth of Australia 2014

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