4384.0 - National Health Survey: Injuries, Australia, 2001

ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 19/11/2003

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Explanatory Notes Glossary	INTRODUCTION 1 This publication presents results from the National Health Survey (NHS) which was conducted throughout Australia from February to November 2001. This is the fifth in the series of health surveys conducted by the ABS; previous surveys were conducted in 1977-78, 1983, 1989-90 and 1995. 2 The survey collected information about: the health status of the population, including long-term medical conditions experienced and recent injuries use of health services such as consultations with health practitioners and visits to hospital and other actions people have recently taken for their health health related aspects of people's lifestyles, such as smoking, diet, exercise and alcohol consumption demographic and socioeconomic characteristics. 3 The statistics presented in this publication are a selection of the information available. 4 A supplementary health survey of Aboriginal and Torres Strait Islander people was conducted in association with the 2001 NHS. Information about that survey, together with summary results is published separately in National Health Survey: Aboriginal and Torres Strait Islander Results, Australia, 2001 (cat. no. 4715.0). SCOPE OF THE SURVEY 5 The NHS was conducted in a sample of 17,918 private dwellings across Australia. Both urban and rural areas in all states and territories were included, but sparsely settled areas of Australia were excluded. Non private dwellings such as hotels, motels, hostels, hospitals, nursing homes and short-stay caravan parks were not included in the survey. 6 Within each selected household, a random sub-sample of usual residents was selected for inclusion in the survey as follows: one adult (18 years of age and over) all children aged 0-6 years one child aged 7-17 years. 7 Sub-sampling of respondents enabled more information to be collected from each respondent than would have been possible had all usual residents of selected dwellings been included in the survey. 8 The following groups were excluded from the survey: certain diplomatic personnel of overseas governments, customarily excluded from the census and estimated resident population figures persons whose usual place of residence was outside Australia members of non-Australian defence forces (and their dependants) stationed in Australia visitors to private dwellings. DATA COLLECTION 9 Trained ABS interviewers conducted personal interviews with selected residents of sampled dwellings. One person aged 18 years and over in each dwelling was selected and interviewed about their own health characteristics. An adult resident, nominated by the household, was interviewed about all children aged 0-6 years and one selected child aged 7-17 years in the dwelling. Adult female respondents were invited to complete a small additional questionnaire covering supplementary women's health topics. SAMPLE DESIGN SAMPLE SIZE AND SELECTION 10 Dwellings were selected at random using a multi-stage area sample of private dwellings. The initial sample selected for the survey consisted of approximately 21,900 dwellings; this reduced to a sample of approximately 19,400 after sample loss (e.g.households selected in the survey which had no residents in scope for the survey, vacant or derelict buildings, buildings under construction). Of those remaining dwellings, around 92% were fully responding, yielding a total sample for the survey of 26,863 persons. 11 To take account of possible seasonal effects on health characteristics, the sample was spread throughout the 10 months enumeration period. Conduct of the survey was suspended during the six weeks from 28 July to 10 September during the 2001 Census of Population and Housing enumeration period. 12 At the request of the relevant health authorities: the sample in the Northern Territory (NT) was reduced to a level such that NT records contribute appropriately to national estimates but cannot support reliable estimates for the NT. This was requested to enable a larger NT sample to be used in the General Social Survey conducted by the ABS in 2002. As a result, estimates for NT are not shown separately in this publication. the sample in the Australian Capital Territory was increased by around 60% to improve the reliability of estimates. WEIGHTING, BENCHMARKING AND ESTIMATION WEIGHTING 13 Weighting is the process of adjusting results from a sample survey to infer results for the total population. To do this, a 'weight' is allocated to each sample unit. The weight is a value which indicates how many population units are represented by the sample unit. 14 The first step in calculating weights for each person was to assign an initial weight, which was equal to the inverse of the probability of being selected in the survey. For example, if the probability of a person being selected in the survey was 1 in 600, then the person would have an initial weight of 600 (that is, they represent 600 others). BENCHMARKING 15 The weights were calibrated to align with independent estimates of the population of interest, referred to as 'benchmarks', in designated categories of sex by age by area of usual residence categories. Weights calibrated against population benchmarks compensate for over or under-enumeration of particular categories of persons and ensure that the survey estimates conform to the independently estimated distribution of the population by age, sex and area of usual residence, rather than to the distribution within the sample itself. 16 The survey was benchmarked to the estimated population living in private dwellings in non-sparsely settled areas at 30 June 2001 based on results from the 2001 Census of Population and Housing. Hence the benchmarks relate only to persons living in private dwellings, and therefore do not (and are not intended to) match estimates of the total Australian resident population (which include persons living in non-private dwellings, such as hotels) obtained from other sources. ESTIMATION 17 Survey estimates of counts of persons are obtained by summing the weights of persons with the characteristic of interest. Estimates of non-person counts (e.g. days away from work) are obtained by multiplying the characteristic of interest with the weight of the reporting person and aggregating. STANDARDISATION 18 Many health characteristics are age-related and to enable comparisons across population groups (e.g. between states) the age profile of the populations being compared needs to be considered. The age standardised percentages are those which would have prevailed should the actual population have the standard age composition. In this publication the standard population is the benchmark population; i.e. the population at 30 June 2001 based on the 2001 Census of Population and Housing, adjusted for the scope of the survey. It should be noted that minor discrepancies in totals may occur between standardised and non-standardised estimates or percentages, as a result of the standardisation process. RELIABILITY OF ESTIMATES 19 The estimates provided in this publication are subject to sampling and non-sampling error. SAMPLING ERROR 20 Sampling error is the difference between the published estimates, derived from a sample of persons, and the value that would have been produced if all persons in scope of the survey had been included. For more information refer to the Technical Notes. In this publication, estimates with a relative standard error of 25% to 50% are preceded by an asterisk (e.g. 3.4) to indicate that the estimate should be used with caution. Estimates with a relative standard error over 50% are indicated by a double asterisk (e.g.0.6) and should be considered unreliable for most purposes. NON SAMPLING ERROR* 21 Non-sampling error may occur in any data collection, whether it is based on a sample or a full count such as a census. Sources of non-sampling error include non-response, errors in reporting by respondents or recording of answers by interviewers, and errors in coding and processing data. 22 Non-response occurs when people cannot or will not cooperate, or cannot be contacted. Non-response can affect the reliability of results and can introduce a bias. The magnitude of any bias depends upon the rate of non-response and the extent of the difference between the characteristics of those people who responded to the survey and those who did not. 23 The following methods were adopted to reduce the level and impact of non-response: face-to-face interviews with respondents the use of interviewers who could speak languages other than English where necessary follow-up of respondents if there was initially no response weighting to population benchmarks to reduce non-response bias. 24 By careful design and testing of questionnaires, training of interviewers, asking respondents to refer to records where appropriate, and extensive editing and quality control procedures at all stages of data processing, other non-sampling error has been minimised. However, the information recorded in the survey is essentially 'as reported' by respondents, and hence may differ from information available from other sources, or collected using different methodology. In particular it should be noted that: information about medical conditions was not medically verified and most were not necessarily based on diagnosis by a medical practitioner. Conditions which have a greater effect on people's wellbeing or lifestyle, or those which were specifically mentioned in survey questions are expected in general to have been better reported than others. CLASSIFICATIONS RECENT INJURIES MODULE Definition 25 The recent injuries module refers to selected events occurring in the four weeks prior to interview which resulted in injury, and which in turn resulted in medical consultation or treatment, or a reduction in usual activities. The types of events included were: accidents (e.g. a fall, vehicle accident, hitting or being hit by something) harmful incidents (e.g. bites and stings, attack by another person, near drowning) exposures to harmful factors (e.g. poisoning (other than food poisoning), electric shock, loud sounds) other events resulting in injuries such as cuts, scalds, dislocations, sprains, fractures, etc. 26 The topic aimed to cover all injuries, from minor scrapes and cuts through to serious injuries such as broken bones and burns, and included birth injuries if these occurred in the previous four weeks. Detailed information was collected about those events resulting in injury for which some action was taken. Food poisoning and minor insect bites were not regarded as an injury for the purposes of this survey. 27 The data items included in the NHS module on recent injuries are based on the National Minimum Data Set for Injury Surveillance in the National Health Data Dictionary. They include items describing the event, the type of injury and its bodily location, the place of occurrence and the activity when injured. Methodology 28 Respondents were asked (with the aid of prompt cards) whether any of the events listed above had happened to them in the previous four weeks and if so, whether those events had resulted in the respondent taking one or more of the following actions: consulting a health professional seeking medical advice receiving medical treatment reducing usual activities treating the injury themselves, such as using a bandage, applying an ice-pack, taking medication, bed rest, etc. 29 For those who reported an event for which one or more of those actions was taken, information was collected to establish the number and types of event(s) which had occurred in that period. Further information was then collected about each of the three most recent events in that four-week period. This information covered details of the event (activity at the time of the injury, and location of event) and consequences of the event (type and bodily location of injury, medical treatment and days of reduced activity resulting from the injury). Prompt cards were used to assist respondents in reporting type of injury, activity at time of event, location of event, and medical consultation arising from the event. 30 Respondents reporting an injury while working for an income were asked if this was in the same occupation as previously reported in the interview; that is, occupation in the main job the respondent had at the time of the survey. For those not in the labour force, not currently employed, or who have changed occupation since their injury, details of the occupation at the time of the injury were not recorded. 31 A small number of cases were recorded in the survey where after the initial screening questions, it was found that no injury had resulted from the reported event. In these cases no further information about the event or consequences of the event were recorded. These are included in counts of events, but not in counts of injuries or injury events; see diagram later in this section. Population 32 Information was collected for all persons in scope of the survey. Data items 33 Items available for reported events: whether had event resulting in defined action(s) being taken type of event number of events in the four weeks prior to interview 34 Items available for reported injury events separately for each of most recent/second most recent/and third most recent event which resulted in injury - type of injury event: vehicle accident low fall (one metre or less) high fall (more than one metre) hitting or being hit by something attack by another person near drowning exposure to fire exposure to chemicals bite or sting other event requiring action type(s) of injury: fractures, internal injury, dislocations, sprains, strains, torn muscles/ligaments open wounds bruising burns and scalds concussion choking poisoning other part(s) of body injured: eyes head (excluding eyes) neck (excluding spine) shoulder (including collar bone) arms (including wrists) hands/fingers back/spine hip trunk (including chest, internal organs, groin and buttocks) legs/feet whole body activity at time of event whether injury received while working (for income or as volunteer): occupation at time of injury (some events only) sports leisure resting, sleeping, eating or other personal activities being nursed or cared for attending school/college/university domestic activities other Place of occurrence: inside own/someone else's home outside own/someone else's home at school/college/university residential institution health-care facility sports facility, athletics field/park street/highway commercial place industrial place farm other type of hospital attendance type of medical professional consulted whether had days away from work or school/study resulting from injury whether cut down on usual activities as a result of injuries. Interpretation 35 Points to be considered in interpreting data for this topic include the following: As respondents may report more than one event, and each event can result in more than one injury, care should be taken to ensure that the data used are appropriate to the purpose for which they are intended; in particular to ensure that data relate to events, injury events or injuries as required, and that the units used (e.g. events or persons) are appropriate. The identification of events and injury events was entirely at the discretion of respondents and reflected their perceptions of the elements of intent, neglect, etc. which may have been factors in the occurrence and their willingness to identify such occurrences. For example, although inter-personal violence was conceptually within the scope of the topic, it is expected such occurrences will be under-reported in this survey. Similarly, although all events in the previous four weeks resulting in injury were within scope of the topic, events resulting in minor injuries, and particularly those occurring earlier in the reference period, were less likely to be reported than other events. The degree to which events resulting in minor injuries were reported could also be expected to differ between population groups. While the survey identified those injury events which in the respondent's opinion occurred while they were working, the data are not necessarily indicative of injuries which would be considered work-related under workers' compensation provisions. In 2001, no respondents reported a 'near drowning' event. This result is most likely to reflect the relative rarity of this event. For example, in 1997-98 the estimated incident number of near drowning cases requiring hospitalisation was 721 (AIHW 2002). LONG-TERM MEDICAL CONDITIONS 36 All reported long-term medical conditions were coded to a list of approximately 1,000 condition categories which was prepared for this survey. Information about medical conditions classified at this level of detail will not generally be available for output from the survey; however, they can be regrouped in various ways for output. Three standard output classifications developed by the ABS for this survey are available: a classification based on the International Classification of Diseases, 10th revision (ICD-10) a classification based on the 2 plus edition of the International Classification of Primary Care (ICPC) a classification based on the International Classification of Diseases, 9th revision (ICD-9), which is similar to the classification of conditions used in the 1995 NHS. 37 In this publication, medical conditions data from the 2001 NHS are shown classified to the ICD-10-based classification, or variants of that classification. LONG-TERM MEDICAL CONDITIONS: REPORTED CAUSE Definition 38 This topic refers to the cause; work-related or as a result of an injury (including injury at work) of current long-term conditions, as reported by respondents. Methodology 39 Respondents who earlier in the survey had reported one or more current long-term conditions were asked whether that/any of the condition(s) was work related , and whether that/any of the condition(s) was the result of an injury. The type of condition was recorded in either case; provision was made to record up to five conditions as work-related and five conditions as due to an injury. The same condition may have been reported and recorded as both work related and due to an injury. 40 Respondents who reported one or more conditions as due to an injury were asked, in respect of each condition, whether the injury was received while at work (for those aged 15 years and over) or at school (for those aged under 15 years), in a motor vehicle accident or during exercise or sport. Population 41 Information was collected in respect of all persons for whom one or more current long-term condition had been reported. Data items whether any long-term condition was work related type of long-term condition(s) work related whether any long-term condition was due to an injury type of long-term condition experienced due to an injury whether received injury at work/school, in motor vehicle accident, during exercise or sport. Interpretation 42 Points to be borne in mind in interpreting data from the survey relating to the reported cause of long-term conditions: The data are self-reported, and reflect the respondent's view of causality and responsibility. Conditions identified as work related or due to an injury at work are not necessarily consistent with those which might be deemed to be work related for workers compensation purposes. The questions were asked only in respect of conditions which had previously been reported during the survey interview. To the extent that respondents had failed to previously report a condition the work related or injury cause was not established. Some work-related conditions, or conditions resulting from an injury may not be identified in the survey as a result. The injury component was asked following the work-related question, and although conceptually separate, some respondents may not have reported a condition as due to an injury if they had just reported it as work-related. The extent to which this may have occurred is not known. Where it has occurred, conditions due to injuries will be under-estimated. GEOGRAPHIC CHARACTERISTICS 43 In this publication, survey results are shown compiled for Australia, individual states and the ACT. RESULTS OF THE SURVEY COMPARABILITY WITH PREVIOUS NATIONAL HEALTH SURVEYS 44 Summary results of the three NHSs were published in National Health Survey: Summary of Results, 1989-90, 1995 and 2001 (cat. no. 4364.0). A range of other publications was also released from each of these surveys; see paragraph 51. 45 The 2001 NHS is similar in many ways, particularly to the 1995 NHS, however there are important differences in sample design and coverage, survey methodology and content, definitions and classifications. These will affect the degree to which data are directly comparable between the surveys. 46 The main differences between the 1995 and 2001 NHSs which may affect comparability of data presented in this publication with previous publications are shown below. Differences in the recent injuries module and long-term conditions caused by injury or injury event meant that comparability between the 1995 and 2001 NHSs was not possible. For example: For the reported cause of long-term conditions, in addition to the different scopes of the topic in each survey, data for this topic are not directly comparable between surveys for methodological reasons, as outlined below: in the 1995 NHS respondents were initially asked about previously reported conditions caused by an accident, incident or exposure. Of those reported as due to accident, incident or exposure respondents were asked which were work related i.e. work related conditions was a subset of conditions caused by accident, incident or exposure. in contrast the 2001 survey asked respondents initially about conditions which were work related, then about conditions due to injury (without mention of accident, incident or exposure). Work-related conditions were therefore much more narrowly defined in 1995 than 2001, and while the injuries were conceptually the same, the specific reference in 1995 to the accident, incident or exposure coverage of the question could be expected to have elicited a different response to that obtained by the more generic 'injury' terminology used in 2001. For the recent injuries module, data obtained in the 2001 NHS related to injury events occurring in the four weeks prior to interview. In the 1995 survey injuries data referred to injuries current at the time of the survey irrespective of how long ago they occurred. As a result of these conceptual differences injuries data from the 2001 survey are not comparable with 1995 data. 47 Other issues for comparability between the 1995 and 2001 NHSs included the following: While the number of dwellings sampled was slightly smaller in 2001, sub-sampling of persons within households has meant the number of persons sampled in 2001 was about half that in 1995 (in which several states purchased additional sample). This has reduced the reliability of some estimates. The sample for the 1995 survey included some non-private dwellings and covered sparsely settled areas. The 2001 NHS survey included private dwellings in urban and rural areas only. However, both the sparsely settled and special dwelling populations are quite small and hence their exclusion in 2001 is regarded as having minimal impact on comparability, particularly at the data levels shown in this publication. All persons in sampled dwellings were included in the 1995 survey, and only records from fully responding households were retained on the data file. In contrast the 2001 survey sub-sampled persons within households (one adult, all children 0-6 years, one child 7-17 years). To the extent that some health characteristics may be clustered within households, the different sampling approaches may impact slightly on comparability between surveys. The 2001 survey was effectively enumerated over about a ten-month period, compared with a 12-month period for the 1995 survey. The 2001 survey was not enumerated in December or January, nor during a 6 week period mid-winter (coinciding with conduct of the 2001 Census of Population and Housing). Data relating to asthma, cancer and cardiovascular conditions were collected in detailed topic-specific question modules in 2001, whereas in 1995 the topics were covered in the context of general long-term conditions. There is expected to be a greater tendency among respondents to report conditions in response to direct questions rather than in response to more general questions. The coding systems and classifications used for long-term conditions and alcohol consumption differed between surveys. The coverage of other health professionals (OHPs) has expanded with each NHS. Data about consultations with audiologists, hypnotherapists, occupational therapists and speech therapists were first collected in the 1995 survey. Aboriginal health worker (n.e.c.), accredited counsellor and alcohol and drug worker (n.e.c.) consultations were introduced in 2001. As a result data for consultations with OHPs at the aggregate level are not directly comparable although the expanded coverage in part reflects expanded use of OHPs. 48 Further information about comparability between surveys is contained in National Health Survey, Users' Guide, Australia, 2001 and the Occasional Paper: Long-term Health Conditions - A Guide To Time Series Comparability From The National Health Survey,(cat. no. 4816.0.55.001). Both the User's Guide and the Occasional Paper are available through this site. In addition, the ABS can offer advice, if required, on the comparison of the 2001 survey results with those from the 1995 or earlier surveys. HEALTH PRODUCTS AND SERVICES MICRODATA 49 Users wishing to undertake more detailed analysis of the survey data may apply for access to either the BASIC or EXPANDED NHS Confidentialised Unit Record Files (CURFs). All clients wishing to access the NHS CURFs should refer to the 'Access to ABS CURFs' section located on the ABS web site, and read the Responsible Access to ABS Confidentialised Unit Record Files (CURFs) Training Manual, and other relevant information, before downloading the Application and Undertaking to apply for access. Any queries relating to Conditions of Sale should be referred to curf.management@abs.gov.au SPECIAL TABULATIONS 50 Special tabulations are available on request. Subject to confidentiality and sampling variability constraints, tabulations can be produced from the survey incorporating data items, populations and geographic areas selected to meet individual requirements. These can be provided in printed or electronic form. A list of data items available from the survey is available free of charge on this site. Further information about the survey and associated products is available from the National Information and Referral Service. Details are listed at the front of this publication. RELATED PUBLICATIONS 51 Other ABS thematic publications and web-based papers which may be of interest are shown below. Most of these are available at <www.abs.gov.au>: Thematic publications National Health Survey, Summary of Results, 1989-90, 1995 and 2001, cat. no. 4364.0 National Health Survey, Summary Results, Australian States and Territories, 1995 and 2001, cat. no. 4368.0 National Health Survey, Users' Guide, 1989-90, 1995 and 2001, cat. no. 4363.0 National Health Survey, Private Health Insurance, Australia, 1995, cat. no. 4334.0 National Health Survey: Diabetes, Australia, 1995, cat. no. 4371.0 National Health Survey: Cardiovascular and Related Conditions, Australia, 1995, cat. no. 4372.0 National Health Survey: Asthma and Other Respiratory Conditions, Australia, 1995, cat. no. 4373.0 National Health Survey: Injuries, Australia, 1995, cat. no. 4384.0 National Health Survey: SF36 Population Norms, Australia, 1995, cat. no. 4399.0 Mental Health and Wellbeing of Adults: Profile of Adults, Australia, 1997, cat. no. 4326.0 National Survey of Mental Health and Wellbeing of Adults: Users' Guide, 1997, cat. no. 4327.0 National Nutrition Survey: Selected Highlights, Australia, 1995, cat. no. 4802.0 National Nutrition Survey: Foods Eaten, Australia, 1995, cat. no. 4804.0 National Nutrition Survey: Nutrient Intakes and Physical Measurements, Australia, 1995, cat. no. 4805.0 National Nutrition Survey: Users' Guide, 1995, cat. no. 4801.0 Children's Health Screening, 1995, cat. no. 4337.0 Children's Immunisation Survey, Australia, 1995, cat. no. 4352.0 Disability, Ageing and Carers, Australia: Summary of Findings, 1998, cat. no. 4430.0 Web-based papers Breastfeeding in Australia, cat. no. 4810.0.55 .001 Occasional Paper: Vaccination Coverage in Australian Children - ABS Statistics and the Australian Childhood Immunisation Register (ACIR), cat. no. 4813.0.55.001 Occasional Paper: Measuring Dietary Habits in the 2001 National Health Survey, Australia, cat. no. 4814.0.55.001 National Health Survey: Private Health Insurance, Australia, cat. no. 4815.0.55.001 Occasional Paper: Long-term Health Conditions - A Guide to Time Series Comparability From The National Health Survey, Australia, cat. no. 4816.0.55.001 Information Paper: Use of the Kessler Psychological Distress Scale in ABS Health Surveys, Australia, cat. no. 4817.0.55.001 52 Current publications and other products released by the ABS are listed in the Catalogue of Publications and Products (cat. no. 1101.0). The Catalogue is available from any ABS office or on this site. The ABS also issues a daily Release Advice on the web site which details products to be released in the week ahead. BACK TO MAIN FEATURES Document Selection These documents will be presented in a new window.