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	ADULT HEALTH: SELF-ASSESSED HEALTH
	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 Aboriginal and Torres Strait Islander Australians have poorer self-assessed health than non-Indigenous Australians: In 2008, 44% of Aboriginal and Torres Strait Islander people aged 15 years and over reported excellent/very good health and 22% reported fair/poor health. Aboriginal and Torres Strait Islander people were twice as likely as non-Indigenous people to report fair/poor health. This gap has remained unchanged since 2002.

Self-assessed health is a commonly used measure of health status. While it may not always be equivalent to that 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 smokers, high risk drinkers or engaging in other health risk behaviours. Research has also shown that self-assessed health is a predictor of mortality and morbidity (Endnote 1).

This topic presents results from the 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) which provides the most recent data for self-assessed health.

In 2008, 44% of Aboriginal and Torres Strait Islander people aged 15 years and over rated their health as excellent or very good; one-third (34%) rated their health as good; and just over one in five (22%) rated their health as fair or poor. Between 2002 and 2008, there was no change in the proportion of people who reported excellent/very good health (both 44%) or fair/poor health (23% in 2002; 22% in 2008).

Overall, Aboriginal and Torres Strait Islander men were more likely than women to report excellent/very good health in 2008 (46% compared with 41%). Rates of excellent/very good health decreased with age, ranging from 58% of those aged 15–24 years to 22% of those aged 55 years and over (graph 1.3). There was no difference in prevalence of excellent/very good health between people living in remote and non-remote areas (both 44%), however, people in remote areas were less likely than those in non-remote areas to to report fair/poor health (19% compared with 23%).

It is generally accepted that people with higher socioeconomic status enjoy better health than those with lower socioeconomic status. In 2008, Aboriginal and Torres Strait Islander people who had completed Year 12 were more likely than those who had left school at Year 9 or below to report excellent/very good health (53% compared with 33%) and were half as likely to report fair/poor health (14% compared with 35%). Rates of fair/poor health were also lower among people who were employed (15%) compared with those who were unemployed (21%). These patterns were evident for both young people aged 15–34 years and people aged 35 years and over. Previous analysis also shows a similar relationship between self-assessed health and income - for more information see the discussion on Self-assessed health in the 2008 edition of this report.

		Highest year of school completed(a)			Labour force status
			Year 9 or
		Year 12	below(b)		Employed	Unemployed
15–34 years
Excellent/Very Good	%	58.7	49.2		58.9	51.4
Good	%	(c)32.3	(c)34.6		(d)31.6	(d)33.2
Fair/poor	%	8.9	16.2		9.5	15.4
Total	%	100.0	100.0		100.0	100.0
35 years and over
Excellent/Very Good	%	42.9	24.8		41.2	29.7
Good	%	(c)34.6	(c)31.8		(d)38.3	(d)34.6
Fair/poor	%	22.6	43.4		20.5	35.7
Total	%	100.0	100.0		100.0	100.0
All persons
Excellent/Very Good	%	53.1	32.6		(d)50.4	(d)45.7
Good	%	(c)33.1	(c)32.7		(d)34.8	(d)33.6
Fair/poor	%	13.8	34.7		14.8	20.7
Total	%	100.0	100.0		100.0	100.0

(a) Excludes persons still attending secondary school.
(b) Includes persons who never attended school.
(c) Difference between Year 12 and Year 9 or below is not statistically significant.
(d) Difference between Employed and Unemployed is not statistically significant.
Source: 2008 National Aboriginal and Torres Strait Islander Social Survey. These estimates are also available for download in the Adult Health datacube.

Self-assessed health is also strongly linked with other health and wellbeing characteristics. In 2008, Aboriginal and Torres Strait Islander people aged 15 years and over with excellent/very good health were less likely than those with fair/poor health to be current daily smokers (39% compared with 52%), to drink at chronic risky/high risk levels (14% compared with 19%) and to have high/very high levels of psychological distress (20% compared with 52%). For young people aged 15-34 years, those with excellent/very good health were also less likely to have been a victim of physical or threatened violence (25% compared with 39% of those with fair/poor health), to have engaged in binge drinking (36% compared with 47%) and to have used illicit substances in the last 12 months (21% compared with 35%).

The most recent data on self-assessed health status for the non-Indigenous population is available from the 2007–08 National Health Survey. In 2008, rates of fair/poor health were higher for Aboriginal and Torres Strait Islander people than non-Indigenous people in every age group, with the largest gaps occurring amongst those aged over 45 years and the smallest gaps among those aged 15–24 years. After adjusting for age differences, Aboriginal and Torres Strait Islander people aged 15 years and over were twice as likely as non-Indigenous people to report fair/poor health overall. They were also less likely to report excellent/very good health (rate ratio of 0.7). The gap in fair/poor health between Aboriginal and Torres Strait Islander people and non-Indigenous Australians has remained unchanged since 2002.


ENDNOTES

1. Australian Bureau of Statistics 2007, 'Self-assessed Health in Australia: A Snapshot, 2004–05', cat. no. 4838.0.55.001, ABS, Canberra. <www.abs.gov.au>.

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