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).

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	ADULT HEALTH: ALCOHOL CONSUMPTION
	This article is part of a comprehensive series released as The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples

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KEY MESSAGES In 2008, around one in six Aboriginal and Torres Strait islander people aged 15 years and over (17%) drank at chronic risky/high risk levels, similar to the rate reported in 2002 (15%).

Alcohol is second only to tobacco as a preventable cause of drug-related death and hospitalisation (Endnote 1). It has been associated with a range of factors that may cause ill-health including cardiovascular disease, cancers, liver diseases, mental health problems, injury, self-harm and exposure to violence. In 2003, alcohol was associated with 7% of all deaths and an estimated 6% of the total burden of disease for Aboriginal and Torres Strait Islander people (Endnote 2). Excessive alcohol consumption also accounted for the greatest proportion of the burden of disease and injury for young Aboriginal and Torres Strait Islander men (aged 15-34 years) and the second highest (after intimate partner violence) for young women.

In 2001, the National Health and Medical Research Council (NHMRC) published the Australian Drinking Guidelines, which outlined alcohol consumption risk levels separately for males and females. In 2009, the NHMRC introduced revised guidelines, with a general recommendation that both men and women should not consume more than two standard drinks on any one day (Endnote 1). In order to be consistent with earlier ABS reporting on alcohol risk level, the data in this discussion is based on the 2001 guidelines only.

This topic presents results from the 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) which provides the most recent data on alcohol consumption. Two broad measures of alcohol consumption risk level were derived from the 2002 and 2008 NATSISS:

• chronic alcohol consumption
• binge drinking.

The first measure was designed to capture long-term or chronic risk and was based on the person's self-reported amount of alcohol (in mls) consumed on a usual drinking day, as well as the frequency of consumption, in the previous 12 months. The second measure was designed to capture short-term risk, or binge drinking, and was based on the self-reported largest quantity of alcohol consumed in a single day during the fortnight prior to interview. Note that due to conceptual and methodological differences, the 2008 NATSISS alcohol measures are not comparable to those used in the 2004–05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) or the 2007–08 National Health Survey (NHS) (Endnote 3).


CHRONIC ALCOHOL CONSUMPTION

In 2008, 17% of Aboriginal and Torres Strait Islander people aged 15 years and over reported drinking at chronic risky/high risk levels in the last 12 months, representing no significant change from 2002 (15%). A further 46% were low risk drinkers and over one-third (35%) had abstained from drinking alcohol (i.e. had not consumed alcohol in the last 12 months or had never consumed alcohol).

Men were more likely than women to drink at chronic risky/high risk levels (20% compared with 14%) and this difference was evident in every broad age group (graph 5.1). Overall, chronic risky/high risk drinking was highest among those aged 35-44 years (22%) and lowest among those aged 55 years and over (10%). While rates of risky/high risk drinking were similar for Aboriginal and Torres Strait Islander people in remote and non-remote areas, people in remote areas were more likely than those in non-remote areas to be abstainers (46% compared with 31%).



In 2008, chronic risky/high risk alcohol consumption was associated with lower rates of excellent/very good health (35% compared with 49% for low-risk drinkers) and higher rates of psychological distress (38% compared with 29%). Risky/high risk drinkers were also more likely than low risk drinkers to regularly smoke (63% compared with 46% were current daily smokers) and to use illicit substances (37% compared with 22%). Moreover, a very high proportion of chronic risky/high risk drinkers (88%) had engaged in binge drinking in the two weeks prior to interview - more than twice the rate of low-risk drinkers (46%).

Among the Aboriginal and Torres Strait Islander population, there is a strong link between alcohol consumption and representation in the criminal justice system, particularly for men (Endnote 4). The 2008 NATSISS shows that chronic risky/high risk drinkers were more likely than low risk drinkers to have been arrested in the last five years (29% compared with 15%), to have been formally charged by police (55% compared with 36%) and to have been incarcerated at some point in their lifetime (18% compared with 7%). They were also more likely to have been a victim of violence in the last 12 months (35% compared with 25%). Aboriginal and Torres Strait Islander men who were chronic risky/high risk drinkers were two and a half times as likely as women drinkers to be arrested; twice as likely to be charged by police and nearly five times as likely to have been incarcerated.

	Males				Females				Persons
	Risky/	Low	Abstain-		Risky/	Low	Abstain-		Risky/	Low	Abstain-
	high risk	risk	ers(b)		high risk	risk	ers(b)		high risk	risk	ers(b)
	%	%	%		%	%	%		%	%	%
Victim of physical or threatened violence	34.3	23.5	15.0		34.8	25.6	16.6		34.5	24.5	16.0
Has ever been formally charged by police	69.7	46.6	32.2		37.1	23.2	12.8		55.5	35.5	19.8
Has been arrested in last 5 years	39.5	19.6	13.3		15.7	10.3	4.3		29.1	15.2	7.6
Has ever been incarcerated	27.5	11.5	14.3		*6.0	2.5	2.2		18.1	7.2	6.5

*Estimate has a relative standard error of 25% to 50% and should be used with caution. 
(a) Based on the amount of alcohol (mls) consumed on an average drinking day.
(b) Includes persons who did not consume alcohol in the last 12 months/never consumed alcohol.
Source: 2008 National Aboriginal and Torres Strait Islander Social Survey. These estimates are also available for download in the Adult Health datacube.


Non-Indigenous comparisons for chronic risky/high risk drinking are not available for 2008, as no comparable question was asked in the 2007–08 National Health Survey or 2006 General Social Survey. The most recent comparable non-Indigenous/Aboriginal and Torres Strait Islander data are available from the the 2004-05 NHS and 2004–05 NATSIHS. After adjusting for age differences between the two populations, the rates of chronic risky/high risk drinking were similar for both non-Indigenous and Aboriginal and Torres Strait Islander Australians aged 18 years and over (Endnote 5).
BINGE DRINKING

In 2008, 37% of Aboriginal and Torres Strait Islander people aged 15 years and over reported drinking at acute risky/high risk levels (commonly referred to as binge drinking) in the two weeks prior to interview, similar to the rate reported in 2002 (35%). Binge drinking was more common among males than females in all broad age groups, with men aged 25-34 years reporting the highest rates (graph 5.3). Overall, 46% of men drank at acute risky/high risk levels compared with 28% of women and rates of binge drinking were higher in non-remote than remote areas (38% compared with 33%).



Like chronic alcohol consumption, those who had consumed acute risky/high risk amounts of alcohol reported lower rates of excellent/very good health than those who had drank at low risk levels (43% compared with 52%) They were also more likely to regularly smoke (59% compared with 33%), to drink at long-term risky/high risk levels (41% compared with 6%), to use illicit substances (32% compared with 18%) and to have been a victim of physical or threatened violence (32% compared with 16%).

Non-Indigenous comparisons for rates of binge drinking are not available for 2008, as no comparable question was asked in the 2008 National Health Survey or 2006 General Social Survey. The most recent comparable non-Indigenous/Aboriginal and Torres Strait Islander data are available from the the 2004-05 NHS and 2004–05 NATSIHS. After adjusting for age differences between the two populations, Aboriginal and Torres Strait Islander Australians were twice as likely as non-Indigenous Australians aged 18 years and over to drink at short-term risky/high risky levels at least once a week (Endnote 5).

ENDNOTES:

1. NHMRC (National Health and Medical Research Council) 2009, 'Australian Guidelines to Reduce Health Risks from Drinking Alcohol', Commonwealth of Australia, <www.nhmrc.gov.au>.

2. Vos, T., Barker, B., Stanley, L. and Lopez, A. 2007, 'The Burden of Disease and Injury in Aboriginal and Torres Strait Islander Peoples, 2003', School of Population Health, Brisbane, <www.uq.edu.au>.

3. Measures of alcohol consumption collected in the NATSIHS and NHS differ from those collected in the NATSISS for both long-term (chronic) and short-term (binge) drinking. These differences are outlined in the discussion on alcohol consumption in the 2008 edition of this report.

4. SCRGSP (Steering Committee for the review of Government Service Provision) 2009, 'Overcoming Indigenous Disadvantage: Key Indicators 2009', Productivity Commission, Canberra <www.pc.gov.au>.

5. ABS and AIHW 2008, 'The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples 2008', ABS cat. no. 4714.0, AIHW cat. no. IHW 14, ABS and AIHW, p142, Canberra.

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