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INTRODUCTION

This snapshot provides an overview of the health and wellbeing of Aboriginal and Torres Strait Islander women. Topics covered include health status, long-term health conditions, mortality, health risk factors, exposure to violence, social and emotional wellbeing, health-related actions and health screening and contraception. Unless otherwise stated, Indigenous women in this article refers to those aged 18 years and over.

DATA SOURCES

Information for this article is drawn from a range of ABS data sources including the 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), the 2004-05 National Health Survey (NHS), the 2002 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) and the 2002 General Social Survey (GSS).

INQUIRIES

For further information, please contact the Assistant Director, National Centre for Aboriginal and Torres Strait Islander Statistics, on (02) 6252 6301 or visit www.abs.gov.au


WOMEN'S HEALTH

The health and wellbeing of Aboriginal and Torres Strait Islander women is affected by a complex range of socioeconomic and environmental factors. Indigenous women are more likely than non-Indigenous women to be unemployed, to have carer responsibilities for children other than their own, to receive welfare payments and to have finished school at an earlier age (Aboriginal and Torres Strait Islander Social Justice Commissioner, 2004). Indigenous women are also more likely to be a victim of violence and to live in communities where violence is prevalent. Nevertheless, four in ten Indigenous women reported their health as excellent or very good in 2004-05. Holistic health approaches, including those that encompass spirituality and connections to family, community and country, and the sharing of Indigenous women's knowledge, skills and networks have been identified as important components in addressing the health disadvantages experienced by many Indigenous women (Thomson, 2006).

HEALTH STATUS

• In 2004-05, 39% of Aboriginal and Torres Strait Islander women aged 18 years and over reported their health as excellent or very good and 26% reported their health as fair or poor. This compared with 41% and 21% respectively for Indigenous men.
• Women who reported their health as excellent or very good health were more likely than those who reported fair/poor health to be employed (52% compared with 33%), to have completed school to Year 12 (30% compared with 17%) and to have access to higher household incomes (31% compared with 17%) (footnote 1).
• Rates of fair/poor health increased steadily with age, ranging from 15% of Indigenous women aged 18-24 years to 46% of women aged 55 years and over.
• After adjusting for the differences in age structure between the Indigenous and non-Indigenous populations, Indigenous women were twice as likely as non-Indigenous women to report fair/poor health (footnote 2).

• In 2004-05, 85% of Indigenous women aged 18 years and over reported at least one long-term health condition, compared with 77% of Indigenous men (footnote 3). The prevalence of multiple conditions was also higher among Indigenous women, with 68% reporting two or more long-term conditions compared with 58% of Indigenous men.
• The most common types of health conditions reported by Indigenous women in 2004-05 were eye/sight problems (54%), back pain/symptoms (23%), heart/circulatory diseases (23%) and asthma (22%).
• After adjusting for age differences between the two populations, Indigenous women were more than 10 times as likely as non-Indigenous women to have kidney disease; more than four times as likely to have diabetes/high sugar levels; and nearly twice as likely to have asthma.

Selected long-term health conditions(a), Women(b) - 2004-05

• Between 1996 and 2001, the life expectancy at birth for Aboriginal and Torres Strait Islander females was estimated to be 65 years - around 17 years lower than for all Australian females for the period 1998-2000 (ABS & AIHW 2005).
• In the period 2000-2004, the three leading causes of death among Indigenous females in Queensland, Western Australia, South Australia and the Northern Territory were diseases of the circulatory system, neoplasms (cancer) and endocrine, nutritional and metabolic diseases (including diabetes) (footnote 4).
• These conditions accounted for around half (51%) of all excess deaths of Indigenous females over this period (AHMAC 2006) (footnote 5).

• In 2004-05 there was little difference in the proportions of Indigenous women and men aged 18 years and over who were current daily smokers (49% compared with 51%) (ABS 2006) (footnote 6). These rates have remained unchanged since 1995.
• In remote areas, rates of smoking were lower among Indigenous women than Indigenous men (47% compared with 58%) (ABS 2006) (footnote 7).
• For both women and men, smoking was more prevalent among Indigenous than non-Indigenous adults in every age group. After adjusting for age differences between the two populations, Indigenous women were nearly two-and-a-half times as likely as non-Indigenous women to be current daily smokers.

Current daily smokers, Women(a) - 2004-05



Current daily smokers, Men(a) - 2004-05

• In 2004-05, Indigenous women were nearly twice as likely as Indigenous men to report that they had not consumed alcohol in the 12 months prior to the survey (30% compared with 17%).
• Women in remote areas were three times as likely as women in non-remote areas to report never having consumed alcohol (28% compared with 9%) (ABS 2006).
• Indigenous women were less likely than Indigenous men to report drinking at long-term risky/high risk levels (14% compared with 19%) (ABS 2006) (footnote 8).
• Women were also less likely than men to drink at short-term risky/high risk levels (footnote 9). Around one in six Indigenous women (15%) drank at short-term risky/high risk levels at least once a week in the last 12 months, compared with one-quarter (24%) of Indigenous men.
• After adjusting for age differences between the two populations, rates of long-term risky/high risk drinking were similar for both Indigenous and non-Indigenous women. However, Indigenous women were three times as likely as non-Indigenous women to drink at short-term risky/high risk levels at least once a week in the last 12 months (AHMAC 2006).

• In 2004-05, of those who reported their height and weight, 36% of Indigenous women were a normal or healthy weight, 24% were overweight and 34% were obese (footnote 10).
• Rates of overweight/obesity were similar for Indigenous women (58%) and men (62%).
• Indigenous women were around one-and-a-half times as likely as non-Indigenous women to be overweight or obese. Overall, the disparity in rates of overweight/obesity between Indigenous and non-Indigenous people was greater for females than for males.

Overweight/obese, Women(a) - 2004-05



Overweight/obese, Men(a) - 2004-05

• In 2004-05, 87% of Indigenous women reported eating fruit daily and 95% reported eating vegetables daily. Rates were lower among Indigenous women living in remote areas, where fresh fruit and vegetables may be less accessible.
• In non-remote areas, 44% of Indigenous women consumed the recommended daily intake of fruit and 12% consumed the recommended daily intake of vegetables.
• Women were more likely than men to consume the recommended daily intake of fruit and vegetables in both the Indigenous and non-Indigenous populations.
• In non-remote areas, a higher proportion of Indigenous women (84%) than Indigenous men (71%) were sedentary or engaged in low levels of exercise in the two weeks prior to interview (footnote 11).
• After adjusting for age differences between the two populations, rates of sedentary/low levels of exercise were similar for both Indigenous and non-Indigenous women.

• According to the 2002 NATSISS, 22% of Indigenous women aged 18 years and over had been a victim of physical or threatened violence in the last 12 months.
• Rates of victimisation were similar for women living in non-remote and remote areas (23% compared with 20%) and for Indigenous women and men overall (22% compared with 24%).

Victims of physical or threatened violence, Indigenous persons(a) - 2002

• Younger women were more likely than older women to have been a victim of physical or threatened violence in 2002, with those aged 18-24 years having the highest rate of any age group (31%).
• Over half (55%) of Indigenous women who had been a victim of physical or threatened violence had primary caring responsibility for a child aged 12 years or under.
• Women who were victims of physical or threatened violence in 2002 reported higher rates of fair/poor health (31% compared with 24%) and lower rates of excellent or very good health (32% compared with 42%) than those who had not been victimised. They were also around one-and-a-half times as likely to usually consume alcohol at long-term risky/high risk levels (21% compared with 12%) and to regularly smoke (63% compared with 45%).
• After adjusting for age differences between the two populations, Indigenous women were more than two-and-a-half times as likely as non-Indigenous women to have been a victim of physical or threatened violence.

• In 2004-05, 70% of Indigenous women aged 18 years and over reported feeling happy and around half (51%) reported feeling full of life all/most of the time in the four weeks prior to interview (footnote 12).
• Women who reported feeling happy all/most of the time were more likely than those who reported feeling happy a little/none of the time to be employed (47% compared with 35%), to report excellent/very good health ( 45% compared with 20%) and to have access to higher household incomes (27% compared with 16%).
• Two-thirds (66%) of Indigenous women reported low/moderate levels of psychological distress and 32% reported high/very high levels of psychological distress in the four weeks prior to interview (footnote 13).
• Indigenous women were more likely than Indigenous men to report high/very high levels of psychological distress (32% compared with 21%). Rates were similar for women living in both non-remote and remote areas (32% compared with 33%).
• Indigenous women with a long-term health condition were more likely to report high/very high levels of psychological distress than women with no long-term health condition (34% compared with 21%).
• High/very high levels of psychological distress were particularly common among women with cancer (54%), back pain/problems (45%), kidney disease (44%) and arthritis (44%).
• Women with high/very high levels of psychological distress were more likely than women with low/moderate levels of distress to have consulted a doctor (35% compared with 25%) or other health professional (30% compared with 22%) in the two weeks prior to interview.
• After adjusting for age differences between the two populations, Indigenous women were twice as likely as non-Indigenous women to report high/very high levels of psychological distress.

• Indigenous women aged 18 years and over were more likely than Indigenous men to have accessed health care in 2004-05. Twenty-eight percent of Indigenous women had consulted a doctor in the two weeks prior to interview, 25% had seen another type of health professional and 6% had visited the casualty or outpatients departments of a hospital. This compared with 21% (consulted doctor), 18% (consulted other health professional) and 6% (visited casualty) of Indigenous men.
• Women in remote areas were more likely than women in non-remote areas to have consulted Aboriginal health workers, nurses or other types of health professionals (35% compared with 22%).
• In 2004-05, 3% of Indigenous women reported visiting a dentist in the last two weeks. Women in remote areas were more than three times as likely as women in non-remote areas to have never visited a dentist or other health professional about their teeth (20% compared with 6%).

• In 2004-05, just over half (52%) of Indigenous women aged 18 years and over reported having regular pap smear tests, similar to rates reported in 2001 (53%) (ABS 2006).
• Although there was a slight decline in the proportion of women in non-remote areas who had regular pap smear tests, the rates among women in remote areas increased from 56% in 2001 to 65% in 2004-05 (ABS 2006).
• In 2004-05, one-third (32%) of Indigenous women aged 40 years and over reported having regular mammograms, with 29% having one at least every two years (ABS 2006).
• Indigenous women in remote areas were more likely than women in non-remote areas to report never having had a mammogram (38% compared with 28%) (ABS 2006).
• In 2004-05, condoms (21%) were the most common type of contraceptive used by Indigenous women aged 18-49 years, followed by the contraceptive pill (14%) and contraceptive injection (8%) (ABS 2006).
• Overall, condoms and the contraceptive pill were more commonly used among Indigenous women living in non-remote areas, while contraceptive injections and implants were more frequently used by Indigenous women in remote areas (ABS 2006).

Selected indicators of health and wellbeing, Men and Women - 2004-05
			Indigenous women	Indigenous men	Indigenous female to non- Indigenous female rate ratio(a)	Indigenous male to non- Indigenous male rate ratio(a)
Self-assessed health status
	Excellent/Very good	%	38.6	41.1	0.6	0.6
	Good	%	35.3	37.4	1.3	1.2
	Fair/Poor	%	26.1	21.4	2.0	1.7
Long-term conditions
	Arthritis	%	17.6	15.1	1.1	1.3
	Asthma	%	21.6	10.6	1.9	1.5
	Back pain/symptoms	%	22.5	23.9	1.2	1.2
	Diabetes/high sugar levels	%	11.9	9.9	4.2	2.8
	Ear/hearing problems/diseases	%	13.6	16.9	(b)1.2	(b)0.8
	Eye/sight problems	%	53.9	39.8	1.0	0.9
	Heart and circulatory problems/diseases	%	23.4	17.0	1.3	1.2
	Kidney disease	%	2.9	2.9	12.6	20.8
	Neoplasms/cancer	%	1.4	1.4	0.7	0.6
	Osteoporosis	%	1.8	*1.3	0.5	1.8
Health risk behaviours
	Current daily smoker	%	48.9	51.3	2.4	2.0
	Long-term risky/high risk alcohol consumption	%	13.8	19.5	1.1	1.2
	Overweight/obese(c)	%	58.1	62.2	1.4	1.1
	No usual daily fruit intake	%	12.7	17.2	2.4	1.9
	No usual daily vegetable intake	%	4.6	6.6	6.4	7.9
	Sedentary/low level of exercise(d)	%	83.6	70.5	1.1	1.1
Health-related actions
	Admitted to hospital	%	24.1	17.0	1.4	1.3
	Visited casualty/outpatients(e)	%	6.3	5.6	2.2	2.9
	Doctor consultation(e)	%	28.2	20.8	1.1	1.2
	Dental consultation(e)	%	3.3	3.1	0.6	0.7
	Consultation with other health professional(e)	%	25.3	17.8	1.5	1.5
Total persons aged 18 years and over		'000	137.8	120.5	. .	. .
* estimate has a relative standard error of 25% to 50% and should be used with caution
. . not applicable
(a) Age-standardised rates. Indigenous to non-Indigenous rate ratios are calculated by dividing the proportion of Indigenous people with a particular characteristic by the proportion of non-Indigenous people with the same characteristic.
(b) Data used to calculate Indigenous to non-Indigenous rate ratios have not been age-standardised.
(c) Proportions were calculated excluding persons for whom height and weight were not known.
(d) Persons in non-remote areas only.
(e) In the last two weeks.
Source: National Aboriginal and Torres Strait Islander Health Survey 2004-05, National Health Survey 2004-05

REFERENCES

Aboriginal and Torres Strait Islander Social Justice Commissioner 2004 Walking with the Women- Addressing the needs of Indigenous women exiting prison, Chapter 2, Social Justice Report 2004, viewed 18 December 2006 <http://www.hreoc.gov.au/Social_Justice/familyviolence/family_violence2006.html#e>

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

ABS & AIHW 2005, The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples 2005, ABS cat. no. 4704.0, AIHW cat. no. IHW 14, ABS & AIHW, Canberra.

Australian Health Ministers Advisory Council (AHMAC) 2006, Aboriginal and Torres Strait Islander Health Performance Framework Report 2006, AHMAC, Canberra.

Thomson, N (Ed) 2006, Women's health, Australian Indigenous HealthInfonet, viewed 18 December 2006 <http://www.healthinfonet.ecu.edu.au/html/html_population/population_subgroups_women.htm#summary>