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4828.0.55.001 - Self-assessed Health in Australia: A Snapshot, 2004-05  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 28/05/2007   
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NOTES

INTRODUCTION

This article presents a brief overview of how Australians assess their own health status. Factors examined in relation to self-assessed health include age, sex, socioeconomic status, health conditions, weight, exercise, alcohol consumption and smoking.


DATA SOURCES

Unless otherwise stated, this article uses data from the 2004-05 ABS National Health Survey (NHS). This article also draws on information from the 2006 General Social Survey, the 2004-05 National Aboriginal and Torres Strait Islander Health Survey and 2003 Survey of Disability, Ageing and Carers.

The NHS question used to determine self-assessed health status was, "In general, would you say your health is: Excellent, Very good, Good, Fair or Poor?". Data for this question was collected for all those aged 15 years and over, but data for persons aged 15-17 years may have been reported by an adult within the household, usually a parent.


INQUIRIES

For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070 or email
client.services@abs.gov.au.


SELF-ASSESSED RATINGS OF HEALTH

Self-assessed health is a commonly used measure of health status. While it may not always be equivalent to health status as measured by a medical professional, it does reveal something about a person's perception of his or her own health at a given point in time. Analysis of self-assessed health status may provide insights into how people perceive their own health in relation to being overweight or obese, high risk drinkers, smokers or having a sedentary lifestyle. Research has also shown that self-assessed health is a predictor of mortality and morbidity (Gerdtham et al 1999; McCallum et al, 1994).

  • In 2004-05, 56% of Australians aged 15 and over rated their health as very good or excellent and 16% as fair or poor.
  • Around 21% of people reported excellent health, 35% very good health, 28% good health, 11% fair health, and 4% reported poor health.
  • After taking into account age differences in the population over time (footnote 1), Australians assessed their health in a similar way in 2004-05 as in previous survey years.

Self-assessed health (a), 1995, 2001 and 2004-05
Graph: Self-assessed health (a), 1995, 2001 and 2004-05


AGE AND SEX
  • With increasing age, self-assessed ratings of very good or excellent health steadily decrease and ratings of fair or poor health increase. This is consistent with the rise in the number of health conditions experienced with increasing age (ABS 2006a).
  • In 2004-05, 70% of people aged 15-24 years reported very good or excellent health compared with 31% of those aged 75 years and over (ABS 2006a).
  • Correspondingly, 7% of people aged 15-24 years reported fair or poor health compared with 35% of those aged 75 years and over (ABS 2006a).

Self-assessed health by age group, 2004-05
Graph: Self-assessed health by age group, 2004-05

  • In 2004-05, women were slightly more likely to report very good or excellent health (58%) than were men (55%) (ABS 2006a).
  • Women reported better health than men across most age groups, with the most pronounced difference occurring in people aged 35-44 years where 66% of women compared with 57% of men reported very good or excellent health (ABS 2006a).


INDIGENOUS AUSTRALIANS
  • In 2004-05, 43% of Aboriginal and Torres Strait Islander Australians aged 15 years and over assessed their health as very good or excellent and 22% as fair or poor (ABS 2006d).
  • After taking into account age differences between the populations, Indigenous people were almost twice as likely as non-Indigenous people to report fair or poor health (ABS 2006d).


LONG-TERM CONDITIONS
  • In 2004-05, 18% of Australians aged 15 years and over who reported a long-term health condition also reported fair or poor health compared with 4% of people with no long-term condition (footnote 2) (ABS 2006a).
  • Among those aged 15 years and over, fair or poor health was reported by 48% of people with diabetes, 34% of people with arthritis, 29% of people with cancer, 26% of people with heart and circulatory conditions and 20% of people with asthma (ABS 2006a).
  • Very good or excellent health was reported by 50% of people with asthma, 43% of people with cancer or heart and circulatory problems, 35% of people with arthritis and 21% of people with diabetes (ABS 2006a).
  • Differences in self-assessed health may be due in part to the varying age-structure of the population with each condition (footnote 3).

Self-assessed health for selected health conditions, 2004-05
Graph: Self-assessed health for selected health conditions, 2004-05


DISABILITY
  • According to the 2003 ABS Survey of Disability, Ageing and Carers, 38% of people with a disability assessed their health as fair or poor, which was almost three times the proportion of people without a disability (13%) (ABS 2004a).
  • Fair or poor health was reported by 67% of people with a profound core activity limitation and 56% of those with a severe core activity limitation (ABS 2004a) (footnote 4).


PARTICIPATION IN THE COMMUNITY
  • According to the 2006 ABS General Social Survey, 65% of people who had undertaken unpaid voluntary work in the past 12 months reported very good or excellent health compared with 54% of people who had not undertaken voluntary work (ABS 2007).
  • In addition, 70% of people who were actively involved in a sporting or physical recreational group and 61% of people who were involved in another type of community group (such as an arts, heritage or religious group) reported very good or excellent health compared with 52% of people who did not actively participate in any community group (footnote 5) (ABS 2007).

People who reported very good or excellent health by participation in voluntary work and age, 2006
Graph: People who reported very good or excellent health by participation in voluntary work and age, 2006


SOCIOECONOMIC FACTORS
  • In 2004-05, the proportion of people aged 15 years and over who reported very good or excellent health increased with higher levels of socioeconomic status - from 47% of people in the most disadvantaged areas (those in the lowest quintile of the index of socioeconomic disadvantage) to 64% of people in the least disadvantaged areas (those in the highest quintile of the index of socioeconomic disadvantage) (ABS 2006a) (footnote 6).
  • Correspondingly, 22% of people living in the most disadvantaged areas reported fair or poor health compared with 10% of those in the least disadvantaged areas.

Education
  • In 2004-05, a higher proportion of people with post-school qualifications reported very good or excellent health (59%) than did people with no post-school qualification (50%) (ABS 2006a).
  • Correspondingly, 12% of people with a post-school qualification reported fair or poor health compared with 21% of those with no post school qualification (ABS 2006a).
  • People with a diploma, bachelor's degree or above reported a higher rate of very good or excellent health (65%) than did people with a vocational certificate (52%) (ABS 2006a).
  • Correspondingly, 9% of people with a diploma, bachelor's degree or above reported fair or poor health compared with 17% of people with a vocational certificate (ABS 2006a).

Employment
  • People who are employed generally report higher levels of self-assessed health than do people who are unemployed or not in the labour force (ABS 2006a).
  • In 2004-05, 64% of people who were employed, 53% of people who were unemployed and 47% of those not in the labour force reported very good or excellent health (ABS 2006a).
  • Of employed people, 9% reported fair or poor health compared with 15% of unemployed people (ABS 2006a).
  • Of people not in the labour force, 30% overall and 27% of those of working age (15-64 years) reported fair or poor health (ABS 2006a).
  • Among the major occupation groups, labourers and related workers had the lowest proportion of self-assessed very good or excellent health (57%) and highest proportion of fair or poor health (13%) (ABS 2006a).
  • Professionals had the highest proportion of self-assessed very good or excellent health (72%) among the major occupation groups (ABS 2006a).

Self-assessed health by occupation, 2004-05 (a)
Graph: Self-assessed health by occupation, 2004-05 (a)


HEALTH RISK FACTORS

Body mass
  • In 2004-05, among people aged 15 years and over and who were classified as overweight/obese, 50% reported their health as very good or excellent, 31% as good and 19% as fair or poor (footnote 7) (ABS 2006a).
  • Of people classified in the normal weight range, 64% rated their health as very good or excellent compared with 57% of those classified as underweight, 55% of those classified as overweight and 40% of those classified as obese (ABS 2006a).
  • Correspondingly, 12% of people classified in the normal weight range rated their health as fair or poor compared with 18% of those classified as underweight, 16% of those classified as overweight and 25% of those classified as obese (ABS 2006a).

Self-assessed health by weight, 2004-05 (a)
Graph: Self-assessed health by weight, 2004-05 (a)


Exercise
  • In 2004-05, of people 15 years and over classified as either having a low level of exercise or being sedentary, 51% reported very good or excellent health, 30% reported good health and 19% reported fair or poor health (ABS 2006a).
  • Further, 78% of people classified as having a high level of exercise reported very good or excellent health compared with 64% of people with a moderate level of exercise, 58% of those with a low level of exercise and 45% of people classified as sedentary (footnote 8) (ABS 2006a).
  • Correspondingly, 5% of people classified as having a high level of exercise reported fair or poor health compared with 11% of people with a moderate level of exercise, 14% of those with a low level of exercise and 24% of people classified as sedentary (ABS 2006a).

Alcohol consumption and tobacco smoking
  • In 2004-05, 19% of people aged 18 years and over classified as drinking alcohol at high risk levels reported fair or poor health compared with 13% of people who drank at low risk levels (footnote 9) (ABS 2006a).
  • Of those aged 18 years and over, 21% of daily smokers reported fair or poor health compared with 10% of people who smoked less frequently, 19% of ex-smokers and 13% of those who had never smoked (footnote 10) (ABS 2006a).

Self-assessed health by smoker status (a), 2004-05
Graph: Self-assessed health by smoker status (a), 2004-05


FOOTNOTES

1. Since many health characteristics are age-related, the age profile of the populations being compared needs to be considered when interpreting the data. To account for the differences in age structure, where noted, some estimates within this publication are shown as age standardised percentages, using the Australian estimated resident population at June 30 2001 as the standard population. Back

2. A long-term condition is defined as one which (in the respondent's opinion) has lasted for 6 months or more, or which he or she expects will last for six months or more. Some conditions reported were assumed to be long-term conditions. These included asthma, cancer, diabetes insipidus, diabetes mellitus types 1 and 2, rheumatic heart disease, heart attack and stroke. Back

3. Noting that self-assessed health generally declines with age, among people aged 15 years and over who answered the self-assessed health question the median age for people with asthma was 39 years, heart and circulatory problems 57 years, cancer 59 years, arthritis 60 years and diabetes 64 years. Back

4. Having a profound core activity limitation means a person is unable to do, or always needs help with, a core activity task (communication, mobility or self care). Having a severe core activity limitation means a person sometimes needs help with a core activity task, has difficulty understanding or being understood by family or friends and can communicate more easily using sign language or other non-spoken forms of communication (ABS 2004). Back

5. Community groups include sport or physical recreation, arts or heritage, religious, craft, adult education, ethnic or multicultural groups and social clubs (ABS 2007). Back

6. The Index of disadvantage is one of four Socio Economic Indexes for Areas (SEIFAs) compiled by the ABS following each Census of Population and Housing. The indexes are compiled from various characteristics of persons resident in particular areas; the index of disadvantage summarises attributes such as low income, low educational attainment, high unemployment and jobs in relatively unskilled occupations. For further information about SEIFAs see Chapter 6 of the 2004-05 National Health Survey: Users' Guide. Back

7. Body Mass Index (BMI) is calculated from reported height and weight information, using the formula weight (kg) divided by the square of height (m). To produce a measure of the prevalence of overweight or obesity in adults, BMI values are grouped according to the table below which allows categories to be reported against both the World Health Organization (WHO) and National Health and Medical Research Council (NHMRC) guidelines.

BODY MASS INDEX GROUPS
UnderweightLess than 18.5
Normal range18.5 to less than 20.0
20.0 to less than 25.0
Overweight25.0 to less than 30.0
Obese30.0 and greater
Back

8. Respondents were asked about walking for sport, recreation or fitness, moderate exercise (causing a moderate increase in heart rate or breathing) and vigorous exercise (causing a large increase in heart rate or breathing) they had done in the previous two weeks. The application of these definitions reflects the respondent's perception of the level and purpose of particular physical activities. Responses may have varied according to the type of activity performed, the intensity with which it was performed, the level of fitness of the participant, and their general health and other characteristics (e.g. age). Back

9. Alcohol risk levels were derived from the average daily consumption of alcohol in the seven days prior to interview and are grouped into relative risk levels as defined by the National Health and Medical Research Council (NHMRC) as follows:

ALCOHOL RISK LEVEL(a), CONSUMPTION PER DAY
Risk level
Males
Females
Low risk50 mLs or less25 mLs or less
Risky More than 50 mLs, up to 75 mLs More than 25 mLs, up to 50 mLs
High riskMore than 75 mLs More than 50 mLs
(a) One standard drink contains 12.5mls of alcohol. Back

10. Ex-smokers were classified as those who do not smoke but have previously smoked daily, had at least 100 cigarettes in their life, or smoked cigars/pipes etc at least 20 times in their life. This is in contrast to the 2001 survey where ex-smokers were classified as those who do not smoke but previously smoked on a daily basis (ABS 2006b). Back


LIST OF REFERENCES

Australian Bureau of Statistics 2007, General Social Survey, Australia 2007, unpublished data, ABS, Canberra.

Australian Bureau of Statistics 2006, National Health Survey: Summary of Results, Australia 2004-05, cat. no. 4364.0, ABS, Canberra.

Australian Bureau of Statistics 2006a, National Health Survey, Australia 2004-05, unpublished data, ABS, Canberra.

Australian Bureau of Statistics 2006b, National Health Survey: Users' Guide, Australia 2004-05, cat. no. 4363.0.55.001, ABS, Canberra.

Australian Bureau of Statistics 2006c, Health of Older People in Australia: A Snapshot, 2004-05, cat. no. 4833.0.55.001, ABS, Canberra.

Australian Bureau of Statistics 2006d, National Aboriginal and Torres Strait Islander Health Survey 2004-05, cat no. 4715.0, ABS, Canberra.

Australian Bureau of Statistics 2004, Disability, Ageing and Carers, Summary of Findings, 2003, cat. no. 4430.0, ABS, Canberra.

Australian Bureau of Statistics 2004a, Disability, Ageing and Carers, Australia 2003, unpublished data, ABS, Canberra.

Gerdtham, U; Johannesson, M; Lundberg, L and Isacson, D 1999, A note on validating Wagstaff and Dooslairs health measure in the analysis of inequality in health. Journal of Health Economics, vol. 18, pp. 117-224.

McCallum, J; Shadbolt, B and Wang, D 1994, Self-rated health and survival: a 7-year follow-up study of Australian elderly, American Journal of Public Health, vol. 84, no. 7, pp. 1100-1105.

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