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INTRODUCTION

This snapshot provides an overview of the health and social circumstances of older Aboriginal and Torres Strait Islander Australians. Topics covered include family and community, culture and language, health status, long-term health conditions, disability, health risk factors, immunisation, service use, hospitalisation rates and mortality. Unless otherwise stated, ‘older Indigenous people’ in this article refers to those aged 55 years and over.

DATA SOURCES

Information for this article is drawn from a range of 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). Data has also been included from a variety of administrative sources including the National Mortality Database, collated by the Australian Institute of Health and Welfare (AIHW).

INQUIRIES

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


OLDER INDIGENOUS PEOPLE

POPULATION CONTEXT

• The Australian Indigenous population has a median age of 21 years which is relatively young compared with the median age of 37 years for the non-Indigenous population. The younger age structure of the Indigenous population is largely a product of both higher fertility rates and deaths occurring at younger ages (ABS & AIHW 2005, ABS 2006a).
• On 30 June 2001, there were an estimated 31,300 Aboriginal and Torres Strait Islander people (7%) and 4.2 million non-Indigenous people (22%) aged 55 years and over (ABS 2004).
• The relative difference in the proportion of older people in the Indigenous and non-Indigenous populations was even greater for those aged 65 years and over (3% compared with 13%) (ABS 2004).

Estimated Resident Population - 30 June 2001
	Indigenous				Non-Indigenous
	Males	Females	Persons	Percent	Males	Females	Persons	Percent
	'000	'000	'000	%	'000	'000	'000	%
55-64	8.7	9.5	18.3	4.0	918.2	894.4	1 812.6	9.6
65-74	4.0	4.8	8.8	1.9	635.2	676.9	1 312.1	6.9
75 and over	1.7	2.6	4.2	0.9	435.8	674.6	1 110.4	5.9
Total 55 and over	14.4	16.9	31.3	6.8	1 989.2	2 245.9	4 235.0	22.3
Total population	227.5	231.0	458.5	100.0	9 403.1	9 551.6	18 954.7	100.0
Source: Experimental Estimates and Projections, Aboriginal and Torres Strait Islander Australians, 30 June 1991 to 30 June 2009

• Among Indigenous people aged 55 years and over, 46% were men and 54% were women (ABS 2004).
• Indigenous people aged 55 years and over comprised 0.2% of the total Australian population in 2001.
• The Indigenous population aged 55 years and over was projected to have grown to between 36,800 (low series) and 39,800 (high series) by 30 June 2006 (footnote 1) (footnote 2) (ABS 2004).

• In the 2002 NATSISS, the majority of older Indigenous people (90%) said that they had support from someone outside their household in a time of crisis, most commonly from a family member (80%) (ABS 2004a).
• Eight out of ten older Indigenous people (81%) had been involved in social activities in the three months prior to the survey (footnote 3) (ABS 2004a).
• For older Indigenous people in remote areas (footnote 4), the most commonly reported social activities were church or religious activities (48%), funerals, ceremonies or festivals (48%) and recreation or cultural activities (43%).
• The most commonly reported social activities in non-remote areas were attendance at a café, restaurant or bar (52%), attendance at a park, botanical gardens or zoo (32%) and attendance at a sporting event as a spectator (28%).
• Among Australians aged 55 years and over, Indigenous people were around one-and-a-half times more likely than non-Indigenous people to have participated in recreational or cultural group activities (27% compared with 17%).
• Around one-quarter (26%) of older Indigenous people had been involved in voluntary work in the previous 12 months (ABS 2004a).

• In the 2002 NATSISS, Indigenous people aged 55 years and over were more likely than those in most other age groups to recognise homelands/traditional country (77%), to identify with a clan, tribal or language group (60%) and to speak an Indigenous language (26%) (ABS 2004a).

Selected indicators of culture and language - 2002
		15-24	25-34	35-44	45-54	15-54	55 years and over	Total 15 years and over
Speaks an Indigenous language	%	(a)18.2	(a)22.3	(a)21.8	(a)19.5	(a)20.4	26.1	21.1
Indigenous language is main language spoken at home	%	(a)11.1	13.0	11.7	(a)10.7	11.7	14.7	12.0
Recognises homelands	%	(a)61.6	(a)70.9	74.3	71.1	(a)68.6	76.9	69.6
Lives on homelands	%	(a)18.1	22.5	23.1	23.7	21.4	25.7	21.9
Identifies with clan, tribal or language group	%	(a)46.7	54.5	60.4	55.2	(a)53.4	60.0	54.1
Attended cultural event in the last 12 months	%	65.6	68.9	72.6	65.1	68.1	67.9	68.1
Indigenous persons	'000	82.7	71.1	57.8	38.4	250.0	32.2	282.2
(a) Difference between data for this age group and 55 and over age group is statistically significant.
Source: National Aboriginal and Torres Strait Islander Social Survey 2002

• In 2002, over two-thirds (68%) of older Indigenous people said they had attended an Aboriginal or Torres Strait Islander cultural event in the previous 12 months.
• A higher proportion of older Indigenous people in remote areas than non-remote areas reported one or more of the selected culture and language indicators.

Selected indicators of culture and language(a) - 2002

General health

• In the 2004-05 NATSIHS, 18% of Indigenous people aged 55 years and over reported their health as either very good or excellent, 32% reported their health as good and 50% reported their health as fair or poor (footnote 5) (ABS 2006).
• Older Indigenous people were almost three times as likely as Indigenous people aged 15-54 years to report their health as fair or poor (50% compared with 18%).
• The proportion of Indigenous people reporting fair or poor health increased with age, from 9% of people aged 15-24 years to 50% of people aged 55 years and over (ABS 2006).
• Older Indigenous people who reported their health as excellent or very good were around three times as likely as those who reported fair/poor health to be employed (34% compared with 12%) and to have access to higher household incomes (27% compared with 9%) (footnote 6).
• Older Indigenous people with excellent or very good health were less likely than those who with fair/poor health to report high/very high levels of psychological distress (12% compared with 36%) (footnote 7).
• In all age groups, Indigenous people were more likely than non-Indigenous people to report their health as fair or poor. Among Australians aged 55 years and over, Indigenous people were more than one-and-a-half times as likely as non-Indigenous people to report their health as fair or poor (50% compared with 29%) (ABS 2006).

Fair or poor self-assessed health, by Indigenous status - 2004-05

• In 2004-05, 97% of Indigenous people aged 55 years and over reported having at least one long-term condition, with 5% reporting one long-term condition, 13% reporting two long-term conditions and 79% reporting three or more long-term conditions (footnote 8) (ABS 2006).
• Older Indigenous people were almost one-and-a-half times as likely as those aged 15-54 years to have a long-term health condition (97% compared with 75%).
• The proportion of Indigenous people reporting one or more long-term conditions increased with age, ranging from 59% of people aged 15-24 years to 97% of people aged 55 years and over (ABS 2006).

Number of long-term health conditions, Indigenous persons - 2004-05

• In 2004-05, the most commonly reported long-term health conditions among older Indigenous people were arthritis (44%), high blood pressure (42%) and diabetes/high sugar levels (32%) (ABS 2006).
• Indigenous women aged 55 years and over were more likely than Indigenous men in the same age group to report eye/sight problems (94% compared with 87%).
• While the proportions of people with at least one long-term condition were similar for Indigenous and non-Indigenous Australians aged 55 years and over, Indigenous people were more than twice as likely as non-Indigenous people to report diabetes/high sugar levels (32% compared with 12%) and asthma (19% compared with 9%) (ABS 2006).
• In the 2004-05 NATSIHS, 7% of Indigenous people aged 55 years and over reported having kidney disease, a markedly higher rate than the rate for non-Indigenous people in this age group (less than 1%) (footnote 9) (ABS 2006).

Prevalence of Kidney Disease, by Indigenous status - 2004-05

• In the 2002 NATSISS, 70% of older Indigenous people reported a disability or long-term health condition, more than double the rate for Indigenous people aged 15-54 years (32%).
• The proportion of Indigenous people reporting a disability or long-term health condition increased with age, ranging from 23% of people aged 15-24 years to 70% of people aged 55 years and over.
• Among Australians aged 55 years and over in non-remote areas, Indigenous people were significantly more likely than non-Indigenous people to have a disability or long-term health condition (77% compared with 63%).
• One in six older Indigenous people (18%) had a profound or severe core activity limitation, meaning that they always or sometimes needed assistance with at least one activity of everyday living (self care, mobility or communication). This compares with a rate of 6% for Indigenous people aged 15-54 years (ABS & AIHW 2005).
• The proportion of Indigenous people who reported a profound or severe core activity limitation increased with age, ranging from 4% of people aged 15-24 years to 18% of people aged 55 years and over (ABS & AIHW 2005).
• Among Australians aged 55 years and over in non-remote areas, Indigenous people were one-and-a-half times as likely as non-Indigenous people to report a profound or severe core activity limitation (15% compared with 10%).

• In the 2004-05 NATSIHS, 30% of older Indigenous people were current daily smokers. This rate is much lower than the daily smoking rate for those aged 18-54 years (53%) (footnote 10).
• Among Australians aged 55 years and over, Indigenous people were two-and-a-half times as likely as non-Indigenous people to be current daily smokers (30% compared with 12%) (ABS 2006).

• In 2004-05, 10% of older Indigenous men and 11% of older Indigenous women said they had consumed alcohol at long-term risky/high risk levels in the seven days prior to interview. These rates were lower than the long-term risky/high risk levels for Indigenous men and women aged 18-54 years (21% and 14%, respectively) (footnote 11).
• Among Australians aged 55 years and over, the rates of long-term risky/high risk alcohol consumption were similar for Indigenous and non-Indigenous people.
• Eleven percent of older Indigenous men and 8% of older Indigenous women said they drank at short-term risky/high risk levels at least once a week in the last 12 months. These rates were lower than the short-term risky/high risk levels for Indigenous men and women aged 18-54 years (26% and 16%, respectively) (footnote 12).
• Among Australians aged 55 years and over, Indigenous people were more than twice as likely as non-Indigenous people to have consumed alcohol at short-term risky/high risk levels (9% compared with 4%). However, older Indigenous people were also more likely than non-Indigenous people to have never consumed alcohol (17% compared with 12%) (ABS 2006).

• Among Indigenous people who reported their height and weight in 2004-05, 24% of people aged 55 years and over were in the normal/healthy weight range, 34% were overweight and 39% were obese (footnote 13).
• Older Indigenous people were less likely than Indigenous people aged 15-54 years to be in the normal/healthy weight range (24% compared with 40%) and more likely to be in the overweight or obese weight range (74% compared with 54%).
• Among Australians aged 55 years and over, Indigenous people were more likely than non-Indigenous people to be overweight or obese (74% compared with 59%).

• In 2004-05, 91% of Indigenous people aged 55 years and over reported eating fruit every day and 95% reported eating vegetables every day. These rates are slightly lower than those for older people in the non-Indigenous population (97% and 100%, respectively).

• In 2004-05, among older Indigenous people living in non-remote areas, 85% were sedentary or engaged in low levels of exercise and 14% exercised at moderate or high levels (footnote 14).
• In non-remote areas, being sedentary or engaging in low levels of exercise increased with age, ranging from 67% of Indigenous people aged 15-24 years to 85% of those aged 55 years and over.
• Among Australians aged 55 years and over in non-remote areas, Indigenous people were more likely than non-Indigenous people to be sedentary or engaged in low levels of exercise (85% compared with 72%).

• In the two weeks prior to interview, 43% of older Indigenous people reported visiting a doctor (including GP and specialist) - twice the rate for those aged 15-54 years (20%).
• One-quarter of older Indigenous people (25%) said they had consulted other health care professionals in the two weeks prior to interview, compared with 19% of people aged 15-54 years.
• In 2004-05, the proportion of Indigenous people that had consulted a doctor in the two weeks prior to interview increased with age, from 15% of those aged 15-24 years to 43% of those aged 55 years and over (ABS 2006).
• Among Australians aged 55 years and over, Indigenous people were more likely than non-Indigenous people to have visited a doctor in the two weeks prior to interview (43% compared with 37%) (ABS 2006).

• In the 2004-05 NATSIHS, two-thirds (67%) of Indigenous people aged 55 years and over reported that they had been vaccinated for influenza in the previous 12 months and 40% for pneumonia in the last five years.
• Indigenous people aged 55 years and over in remote areas (86%) were more likely than those in non-remote areas (60%) to have been recently vaccinated for influenza, and were more than twice as likely to have received a vaccination against pneumonia in the last five years (64% compared with 31%).

Residential care

• Among Australians admitted to permanent or respite residential aged care facilities in 2004-05, 800 were of Aboriginal or Torres Strait Islander origin (0.8%).
• One in seven Indigenous people admitted to permanent or respite residential care were under the age of 55 years (14%), compared with less than 2% of non-Indigenous people.

• Among Australians who had received Community Aged Care packages at 30 June 2005, 1,100 were Indigenous (4%).
• Around 12% of Indigenous people who received Community Aged Care packages were under the age of 55 years, compared with 1% of non-Indigenous recipients.

• Among Australians who received Home and Community Care packages in 2004-05, 17,300 were Indigenous (2%).
• Around 37% of Indigenous people who received Home and Community Care packages were under the age of 55 years, compared with 14% of non-Indigenous recipients.

• In June 2005, there were 1,200 recipients of Extended Aged Care at Home packages. Nineteen packages were for Indigenous people, of whom five were under 55 years of age.
• Indigenous recipients of Extended Aged Care at Home packages were more likely than non-Indigenous recipients to be under 55 years of age (26% compared with less than 1%).

• In 2004-05, one-quarter (26%) of hospitalisations of Indigenous people in Queensland, South Australia, Western Australia and the Northern Territory combined were for people aged 55 years and over (footnote 15) (AIHW 2006).
• Older Indigenous people were more likely than those in younger age groups to be hospitalised, regardless of sex.

Hospitalisations, by Indigenous status - 2004-05 (a)

• In 2004-05, the hospitalisation rate was almost three times greater for Indigenous people than non-Indigenous people (971 per 1,000 compared with 348 per 1,000) (AIHW 2006).

• In the period 1996-2001, life expectancy at birth was estimated at 59 years for Indigenous males and 65 years for Indigenous females. These are around 17 years below the life expectancies of 77 years for all Australian males and 82 years for all Australian females in 1998-2000 (ABS & AIHW 2005).
• For the period 2000-2004, there were 7,500 deaths registered as deaths of Indigenous people in Queensland, South Australia, Western Australia and the Northern Territory combined. Of these, 3,400 (46%) were deaths of Indigenous people aged 55 years and over (footnote 16) (AHMAC 2006).
• In comparison, there were 225,300 deaths of non-Indigenous Australians in the same four jurisdictions combined for the period 2000-2004. Of these, 198,000 (88%) were deaths of people aged 55 years and over.

• Between 2000-2004, the leading causes of death for Indigenous men and women aged 55 years and over were cancer, diseases of the circulatory system, respiratory diseases and diabetes.
• Mortality rates for cancer were similar in older Indigenous and non-Indigenous populations but one-and-a-half times higher for men than women in both populations.

Death rates for Cancer by Indigenous status, Persons aged 55 years and over - 2000-2004(a)

• Among Australians aged 55 years and over, mortality rates for diseases of the circulatory system were almost one-and-a-half times higher for Indigenous than non-Indigenous men (1,448 per 100,000 compared with 1,006 per 100,000), and were similar between Indigenous and non-Indigenous women (1,035 per 100,000 compared with 1,016 per 100,000).
• Among Australians aged 55 years and over, mortality rates for diseases of the respiratory system were twice as high for Indigenous than non-Indigenous men (542 per 100,000 compared with 268 per 100,000), and were also higher for Indigenous than non-Indigenous women (349 per 100,000 compared with 212 per 100,000).
• Among Australians aged 55 years and over, death rates for diabetes were six times higher for Indigenous than non-Indigenous men (406 per 100,000 compared with 68 per 100,000), and almost nine times higher for Indigenous than non-Indigenous women (492 per 100,000 compared with 57 per 100,000).
• Among Australians aged 55 years and over, death rates for chronic kidney disease were almost two-and-a-half times higher for Indigenous than non-Indigenous men (97 per 100,000 compared with 41 per 100,000) and more than three times higher for Indigenous than non-Indigenous women (133 per 100,000 compared with 42 per 100,000).

Male death rates for selected conditions, Men aged 55 years and over - 2000-2004(a)



Female death rates for selected conditions, Women aged 55 years and over - 2000-2004(a)

2. Population estimates for 2006 based on the 2006 Census will be available in Population Distribution, Aboriginal and Torres Strait Islander Australians (ABS, cat. no. 4705.0), due for release in August 2007. Back

3. In the 2002 NATSISS, Indigenous people were asked about their involvement in a range of social activities in the three months prior to interview. Due to differences in the types of activities for which information was collected in remote areas and non-remote areas, comparable data by remoteness is only available for the categories: recreational or cultural group activities, community or special interest group activities, church or religious activities, café, restaurant or bar (including pubs and canteens), involvement in sport or physical recreation activities and attendance at a sporting event as a spectator. All other activities are either specific to remote areas or non-remote areas. Back

4. 'Non-remote' is comprised of Major Cities of Australia, Inner Regional Australia and Outer Regional Australia, while 'Remote' is comprised of Remote Australia and Very Remote Australia. For more information, refer to Statistical Geography Volume 1, Australian Standard Geographical Classification (ASGC), 2006 (ABS cat no. 1216.0). Back

5. Data from the 2004-05 NATSIHS and 2004-05 NHS relate only to persons in private dwellings and exclude persons in hospitals, nursing and convalescent homes and hospices. Therefore the data may not fully represent the health of the older population. Back

6. 'High household income' is defined in this article as a gross weekly equivalised household cash income in the third quintile or above. For further information see Appendix 7 in the National Aboriginal and Torres Strait Islander Health Survey: Users' Guide 2004-05 (cat. no. 4715.0.55.004). Back

7. The 2004-05 NATSIHS used a modified five-item version of the Kessler Psychological Distress Scale (known as the K5) to measure non-specific psychological distress. Low/moderate distress represents a K5 score of 5-11 and high/very high distress represents a score of 12-25. Further information on the social and emotional well-being module can be found in the National Health Survey and National Aboriginal and Torres Strait Islander Health Survey 2004-05: Data Reference Package (cat. no. 4363.0.55.002). Back

8. In the 2004-05 NATSIHS, a long-term condition was defined as a medical condition (illness, injury or disability) which had lasted at least six months, or which the respondent expected to last for six months or more. Back

9. The treatment for chronic kidney disease accounts for around one-third of all hospital admissions for Indigenous people (see The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples 2005 ABS cat. no. 4704.0). As persons in hospitals are not included in the scope of the NATSIHS, results from this survey may underestimate the prevalence of kidney disease in the Indigenous population. Back

10. In the 2004-05 NATSIHS, a current daily smoker was defined as a person who was smoking one or more cigarettes (or cigars or pipes) per day, on average, at the time of the interview. Back

11. Long-term alcohol risk levels for the 2004-05 NATSIHS were derived from the daily consumption of alcohol in the seven days prior to interview. Risk levels were based on the National Health and Medical Research Council (NHMRC) guidelines for risk of harm in the long-term. Risky/high risk equates to 50ml or more of alcohol per day for men and 25ml or more per day for women. Back

12. Short-term alcohol risk levels were derived from questions on the frequency of consuming five (for females) or seven (for males) or more standard drinks on any one occasion in the last 12 months. These risk levels equate to the National Health and Medical Research Council (NHMRC) guidelines for risk of harm in the short-term. For further information, see the National Health Survey and National Aboriginal and Torres Strait Islander Health Survey 2004-05: Data Reference Package (ABS cat. no. 4363.0.55.002). Back

13. Body Mass Index was calculated from reported height and weight information, using the formula weight (kilograms) divided by the square of the height (metres). For further information, see the Glossary of National Aboriginal and Torres Strait Islander Health Survey 2004-05 (ABS cat. no. 4715.0). Back

14. In the 2004-05 NATSIHS, levels of exercise were based on frequency, intensity (i.e. walking, moderate exercise and vigorous exercise) and duration of exercise (for recreation, sport or fitness) in the two weeks prior to the interview. For further information, see the Glossary of National Aboriginal and Torres Strait Islander Health Survey 2004-05 (ABS cat. no. 4715.0). Back

15. Hospitalisations data are derived from information collected in Australian hospitals by the Australian Institute of Health and Welfare (AIHW). Data are collected for each 'separation', which begins when a patient is admitted to hospital and ends when the total hospital stay ends, or where there is a change in the type of care provided (for example, from acute care to rehabilitation). The same patient may therefore be counted more than once. For further information, see the Glossary of National Australian Hospital Statistics 2004-05. (AIHW cat. no. HSE 41). Back

16. Due to incomplete recording of Aboriginal and Torres Strait Islander status on death records, the mortality data presented in this article are restricted to Queensland, South Australia, Western Australia and the Northern Territory as these jurisdictions are considered to have the most complete coverage of Indigenous deaths for the period 2000-2004. Indigenous mortality data is based on an aggregate of these jurisdictions and therefore the exact magnitude of difference between the Indigenous and non-Indigenous population may underestimate Indigenous mortality rates. Back

REFERENCES

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

ABS 2006a, Population by age and sex, Australian states and territories, June 2006, cat. no. 3201.0, ABS, Canberra.

ABS 2004, Experimental Estimates and Projections, Aboriginal and Torres Strait Islander Australians, 30 June 1991 to 30 June 2009, cat. no. 3238.0, ABS, Canberra.

ABS 2004a, National Aboriginal and Torres Strait Islander Social Survey 2002, cat. no. 4714.0, ABS, Canberra.

Australian Bureau of Statistics & Australian Institute of Health and Welfare 2005, The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples 2005, ABS cat. no. 4704.0, AIHW cat. no. 4430.0, ABS, Canberra.

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

Australian Institute of Health and Welfare (AIHW) 2006. Australian Hospital Statistics 2004-05. AIHW cat. no. HSE 41. AIHW, Canberra: AIHW

AIHW 2002. Older Australia at a glance 2002 (3rd edition). AIHW cat. no. AGE 25. Canberra: AIHW & DoHA.

Warburton, J & Chambers, B 2007, Older Indigenous Australians: their integral role in culture and community. Australian Journal on Ageing, 26, 1, pg 3-7.