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Health Status: The health of Indigenous people
Causes of death After standardising for the difference in the age structure of the population, the Indigenous death rate in 1994 was 1,959 per 100,000 population compared to 710 per 100,000 for the total population. Ischaemic heart disease was the leading cause of Indigenous deaths, followed by respiratory diseases, cancer and stroke. These four causes were also the main causes of death in the total population, but in a different order with cancer leading and respiratory diseases fourth. CAUSES OF DEATH PER 100,000 POPULATION, 1994
Source: Causes of Death, Australia (unpublished data) Self-assessed health status In 1994, 32% of Indigenous people reported their health as good and 32% reported it as very good. A further 24% reported their health as excellent. Indigenous men were more likely than Indigenous women to report their health as excellent or very good. A person's self-assessed health status varies according to many factors, such as their awareness and expectations of health and their level of health relative to other people in their community. However, there is also a link between self-assessed health status and illness. In 1994, Indigenous people who reported suffering an illness were more likely than those who had not reported an illness to assess their health status as fair or poor. Among those who reported suffering an illness condition, those with a long-term illness were more likely than those with a recent illness to report their health status as fair or poor. SELF-ASSESSED HEALTH STATUS OF INDIGENOUS PEOPLE(a), 1994 (a) Percentage calculations exclude self-assessed health status not stated. Source: National Aboriginal and Torres Strait Islander Survey, 1994: Detailed findings (cat. no. 4190.0)
Illness experienced In 1994, 41% of Indigenous people reported that they had experienced a recent illness. Men and women reported similar rates of occurrence of recent illness. The recent illness conditions that people reported may have been related to a long-term illness condition. The most commonly reported recent illness conditions were diseases of the respiratory system (35%). This includes conditions such as asthma, bronchitis and emphysema, as well as minor illnesses such as colds and sore throats. In 1994, 35% of Indigenous people reported that they suffered from a long-term illness condition. The most common long-term illness condition was asthma (13%), followed by ear or hearing problems (9%) and high blood pressure (6%). Females were slightly more likely than males to report suffering from most long-term illness conditions. The type of illness that people suffer can be affected by their participation in health risk behaviours. For example, diseases of the respiratory system, which were the most common recent illnesses among Indigenous people, are affected by health risk behaviours such as smoking. In 1994, half of all Indigenous people aged 13 and over were smokers (see Health risk factors and Indigenous people). The type of illness that a person suffers also varies according to their age. For example, long-term illnesses such as heart problems, diabetes and high blood pressure were most common among Indigenous people aged 45 and over. The presence of such conditions may also be related to factors such as poor diet and lack of exercise. INDIGENOUS PEOPLE WHO EXPERIENCED A RECENT ILLNESS, 1994
Source: National Aboriginal and Torres Strait Islander Survey, 1994: Detailed findings (cat. no. 4190.0) INDIGENOUS PEOPLE WHO EXPERIENCED SELECTED LONG-TERM ILLNESS CONDITIONS, 1994
Source: National Aboriginal and Torres Strait Islander Survey, 1994: Detailed findings (cat. no. 4190.0) Health actions In 1994, 44% of Indigenous people took some health action, such as seeing a health professional or taking medication, in the two weeks prior to the survey. The most common action was taking medication (32%). This was followed by consulting a doctor (19%) and reducing daily activities (13%). Females were more likely than males to have undertaken a health action (47% compared to 42%). Indigenous people living in capital cities were more likely than those living in other urban or rural areas to take a health action. This may be due to better access to health facilities, as well as to higher levels of health education among Indigenous people living in capital cities. The actions undertaken by Indigenous people also varied according to geographic location. Indigenous people living in rural areas were less likely to consult a doctor than those living in capital cities or other urban areas. However, they were more likely to visit an emergency or outpatients clinic, consult an Aboriginal health worker or consult a nurse. This may be due to differences in access to various types of health services. People in rural areas are less likely than those living in capital cities or other urban areas to have access to a doctor. HEALTH ACTIONS UNDERTAKEN BY INDIGENOUS PEOPLE, 1994
Source: National Aboriginal and Torres Strait Islander Survey, 1994: Detailed findings (cat. no. 4190.0) Access to health services In 1994, 89% of Indigenous households had permanent access (access at least 3 days per week) within 25km to a nurse, 82% had access to a doctor, 80% to a baby health service and 69% to a dentist. Indigenous people living in rural areas were less likely to have permanent access within 25km to health services than those living in urban areas. In 1994, 41% of Indigenous households in rural areas had access to a doctor, compared to 96% of Indigenous households in capital cities and 95% in other urban areas. However, the majority (70%) of Indigenous households in rural areas had access to a nurse. Many people who do not have permanent access to various health services have visiting access, which is access between 2 days per week and once a month. Visiting access is particularly important in rural areas where 39% of households had visiting access within 25km to a doctor or GP, and 33% to baby health services. An important type of visiting health care, especially in rural areas, are flying medical services. In 1994, 21% of Indigenous people had access to flying medical services. As expected, a greater proportion of Indigenous people in rural areas (43%) than those in capital cities (3%) or other urban areas (23%) had access to flying medical services. The availability of transport also affects a person's access to various health services. For example, a person who has no transport and lives 25km from a permanent health service is likely to have more difficulty accessing the service than a person who lives further away but has a car or regular public transport service available. In addition, the type of health service a person has access to may not be an accurate measure of the service they obtain. For example, a nurse working in an area where there are only limited health services may perform some duties that another health professional would normally perform. Therefore, if a person does not have access to a baby health service they may still have access to a doctor or nurse who can provide similar services. HOUSEHOLDS WITH ACCESS(a) TO HEALTH SERVICES WITHIN 25KM, 1994
Source: National Aboriginal and Torres Strait Islander Survey, 1994: Detailed findings (cat. no. 4190.0) Attitudes to health services In 1994, most of Indigenous people aged 13 and over reported that they had no problems with their local health service. Of those who did report problems, the most commonly reported problem was having to wait too long for treatment (55%), followed by inadequate facilities or staffing (22%) and inadequate hours of operation (14%). Females were more likely than males to report problems with their local health services. This is probably because females are more likely to use their local health services. People in rural areas were more likely than people in the capital cities or other urban areas, to report problems with their local health services. This is related to lower levels of access to health services in rural areas. Endnotes 1 Australian Institute of Health and Welfare (1995) Australian health trends, 1995. 2 National Health Strategy (1992) Enough to make you sick: How income and environment affect health Research Paper No. 1, September 1992. 3 Reid, J. & Trompf, P. (1991) The Health of Aboriginal Australia Harcourt Brace Jovanovich. 4 Australian Institute of Health and Welfare (1992) Aboriginal Health Information Bulletin, No. 17.
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