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Health and wellbeing are affected by a range of socio-economic, biomedical and environmental factors. They are also affected by lifestyle behaviours, known as risk factors, which increase the possibility of ill health, disability, disease or death(AIHW, 2011f). Where people have multiple risk factors, such as a combination of excessive alcohol intake, smoking and low exercise, their overall risk of disease and poor health increases even further.
Many chronic diseases can be prevented, delayed or improved by addressing lifestyle factors such as smoking, poor diet, insufficient exercise or obesity. As most risk behaviours are modifiable, health policy-makers can achieve population health benefits by targeting risk factors through legislation, education and incentive measures. They can monitor the progress of their efforts through use of population information, such as that presented below.
The ABS collects data on a number of lifestyle behaviours that are recognised as risks to health, including tobacco smoking, alcohol consumption, low exercise level, overweight and obesity, and low fruit and vegetable consumption. This section presents findings for these health risk factors.
SMOKING
Tobacco smoking is one of the more prominent lifestyle behaviours contributing to health risk in Australia. While rates in general are trending down, there is still some way to go, with around one in five people (20%) aged 15 years and over reporting being current smokers in 2007–08.
Of persons aged 15 years and over, 18% were daily smokers, 2% smoked less often than once a day, 29% were ex-smokers, and 52% reported that they had never smoked. Overall, more males than females were current smokers (22% and 18% respectively), although this is largely driven by higher rates for males in the younger adult age groups (15–44 years) (graph 11.20).
In 2007–08, smokers were more likely to report a combination of risk factors than non-smokers. Around half of current smokers aged 18 years and over led a sedentary lifestyle, doing very little or no exercise (51% compared with 38% of those who had never smoked). Current smokers were also more than three times as likely as people who had never smoked to drink alcohol at levels associated with a high risk of harm (23% compared with 8%).
In terms of associated health outcomes, 2007–08 data showed that people who had ever smoked were over six times more likely to have emphysema and one and a half times as likely to have bronchitis as people who had never smoked. Heart, stroke and vascular disease was also more prevalent in adults who had ever smoked (8%) than those who had never smoked (5%).
ALCOHOL CONSUMPTION
Alcohol is widely used and enjoyed in Australian society but the harmful use of alcohol is a problem that globally results in around 2.5 million deaths worldwide each year, and causes harm beyond the physical and psychological health of the drinker. An intoxicated person can harm others or put them at risk of traffic accidents or violent behaviour, and can negatively affect co-workers, relatives, friends or strangers. A significant proportion of the disease burden attributable to harmful drinking arises from injuries, including those due to road traffic accidents, violence, and suicides (WHO, 2011a).
Although low to moderate alcohol consumption may offer some protective health effects, high alcohol consumption is a major determinant of alcohol use disorders (such as alcoholic psychosis and alcohol dependence syndrome), epilepsy, cardiovascular diseases, cirrhosis of the liver and various cancers. As alcohol consumption weakens the immune system, the harmful use of alcohol is also associated with several infectious diseases like HIV/AIDS, tuberculosis and sexually transmitted infections (WHO, 2011a).
In the 2007–08 NHS, people were classified to a health risk level according to the 2001 NHMRC guidelines for alcohol consumption (low risk, risky, or high risk of long-term harm) based on their estimated average daily consumption of alcohol during the previous week. Survey results showed that three in five Australians aged 18 years and over (62%) drank alcohol in the previous week and of these, over one in five drank alcohol at risky or high risk levels for long-term harm (22%).
Rates of drinking at harmful levels were highest for men aged 25–34 years (17%), and for women aged 18–24 years or 45–54 years (both 14%).
EXERCISE
Physical activity is an important factor in maintaining good overall health and wellbeing. Being physically active has significant health benefits, including reducing the risk of some chronic conditions, helping to control weight and improving mental wellbeing. Some forms of physical activity may also help manage long-term conditions, such as arthritis and Type 2 diabetes, by reducing the effects of the conditions and improving people's quality of life.
In recent decades, there has been a decline in physical activity due to the increasingly sedentary nature of many forms of work, activities such as watching television or using a computer, and changes in transportation. Sedentary behaviour is believed to be associated with the rise in overweight and obesity, which increases the risk of cardiovascular disease, colon and breast cancers, Type 2 diabetes and osteoporosis (AIHW, 2011g). In 2006–07, the direct health care costs due to physical inactivity in Australia were estimated to be $1.5 billion, including $469 million attributable to falls and $372 million attributable to coronary heart disease (Econtech, 2007).
Worldwide, physical inactivity is the fourth leading risk factor for mortality, contributing to 6% of deaths (WHO, 2010), and is a leading modifiable health risk factor contributing to the burden of disease and injury in Australia (Begg et al. 2007).
In 2007–08, 60% of Australians adults (18 years and over) had done some exercise for fitness, recreation or sport in the week prior to interview, with:
44% walking for exercise
31% doing moderate exercise (i.e. exercise that caused a moderate increase in heart rate or breathing) and
6% doing vigorous exercise (i.e. exercise that caused a large increase in heart rate or breathing).
Women were more likely to walk for exercise than men (46% compared with 41%), and men were more likely to do moderate exercise (34% compared with 29%) or vigorous exercise (16% compared with 10%). Moderate and vigorous exercise were most common among younger age groups, while older people tended to walk for exercise. (Note that people could report more than one type of exercise.)
However, only 38% of Australians aged 18 years and over met the recommended physical activity guidelines of at least 30 minutes of exercise on most days of the week, with each session lasting 10 minutes or more. This was more common for men than women (40% and 36% respectively) and for younger people.
Even when people were exercising, the health benefits accruing from the exercise may have been jeopardised by their work and leisure habits. Prolonged periods of sitting may not only be detrimental to people's health but may also counteract the benefits of regular moderate to vigorous physical activity (Healy et al. 2008). More than three out of four Australians aged 18 years and over spent between two and six hours a day sitting at leisure activities such as watching television, reading or playing computer games (78%), and almost half (45%) spent most of their time sitting at work.
Almost 40% of Australians aged 18 years and over did no exercise at all in the week prior to the survey.
OVERWEIGHT AND OBESITY
The health consequences of overweight and obesity are many and varied, ranging from an increased risk of premature death to several non-fatal but debilitating complaints that have an adverse effect on people's quality of life (WHO, 1999). Around 44% of the diabetes burden, 23% of the ischaemic heart disease burden and between 7% and 41% of selected cancer burdens are attributable to overweight and obesity (WHO, 2011b).
Overweight and obesity can affect a person's ability to work or participate in family and community activities, and can have serious implications for the health sector in terms of cost and burden on services. In 2008, it was estimated that the overall cost of obesity to Australian society and governments was $58 billion (Access Economics, 2008).
Using measured height and weight data to calculate a person's body mass index (BMI), ABS data showed that in Australia in 2007–08, around 25% of people aged 18 years and over were obese, 37% were overweight, a further 37% were in the normal weight range and 2% were underweight. More men (68%) were overweight or obese than women (55%). Rates of overweight and obesity generally increased with age, peaking at 65–74 years for both men and women (graph 11.21). (BMI is a simple index of weight for height that is commonly used in classifying people into the following ranges: underweight, normal weight, overweight and obese. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2).)
After adjusting for age, rates of overweight and obesity in Australian adults increased from 57% in 1995 (65% of men and 50% of women) to 61% in 2007–08 (68% of men and 55% of women).
Overweight and obesity in children is a major health concern. Studies have shown that once children become obese they are more likely to stay obese into adulthood and have an increased risk of developing both short and long-term health conditions, such as Type 2 diabetes and cardiovascular disease (Australian Social Trends, September 2009, 4102.0). In 2007–08, one in four children aged 5–17 years (25%) were classified as overweight or obese.
HIGH BLOOD PRESSURE AND HIGH CHOLESTEROL
High blood pressure, or hypertension, is a major risk factor for a range of health problems, including bleeding from the aorta, chronic kidney disease, heart attack and heart failure, poor blood supply to the legs, stroke and vision problems (PubMed Health, 2011). Along with obesity, other major causes of hypertension are diets that are high in salt, excessive alcohol consumption and insufficient physical activity.
In 2007–08, just over 9% of Australians had hypertension or a hypertensive disease. People who were obese had a greater likelihood of having hypertension or a hypertensive disease than those in other weight ranges (16% compared with 11% of overweight people and 8% of people in the normal weight range).
High cholesterol is also considered a risk factor for a number of circulatory conditions. High cholesterol levels were reported by 6% of the population in 2007–08, with the prevalence highest for those in the 65–74 year and 75 years and over age groups (19% and 16% respectively). Around 27% of people with high cholesterol had a heart, stroke or vascular disease, compared with 4% of people who did not report high cholesterol. Over half of all people reporting high cholesterol also reported having hypertension or a hypertensive disease (55% compared with 7% of people without high cholesterol levels). Almost one in five people with high cholesterol had been diagnosed with diabetes (18%, compared with 3% of those who did not report high cholesterol).
FRUIT AND VEGETABLE INTAKE
Fruit and vegetables contain essential vitamins, minerals and fibre that help reduce the risk of chronic diseases. Regular consumption of fruit and vegetables is associated with reduced risks of cancer, cardiovascular disease, stroke, Alzheimer's disease, cataracts, and some of the functional declines associated with ageing (Liu, 2003). In 2007–08, just over half of children aged 5–7 years (57%), a third of children aged 8–11 years (33%), 5% of people aged 12–18 years, and 6% of people aged 19 years and over ate the recommended daily serves of fruit and vegetables for their age group.
New Australian Health Survey to provide fresh insights
The ABS is currently conducting the 2011–13 Australian Health Survey (AHS). The AHS builds on previous health surveys and will allow comparisons of health information over time on topics such as obesity, smoking, health conditions and how people manage their health.
The AHS will also collect new information about food and nutrient consumption, detailed physical activity and, for the first time, biomedical measures. These biomedical measures will reveal new insights into heart and kidney disease, diabetes and other chronic conditions by enabling examination of health factors such as cholesterol, glucose and sodium levels. The survey will also allow analysis of the relationship between biomedical measures, lifestyle factors and health outcomes. First results will be available from late 2013.
Statistics contained in the Year Book are the most recent available at the time of preparation. In many cases, the ABS website and the websites of other organisations provide access to more recent data. Each Year Book table or graph and the bibliography at the end of each chapter provides hyperlinks to the most up to date data release where available.
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This page first published 24 May 2012, last updated 11 November 2015
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HEALTH RISK FACTORS
Health and wellbeing are affected by a range of socio-economic, biomedical and environmental factors. They are also affected by lifestyle behaviours, known as risk factors, which increase the possibility of ill health, disability, disease or death (AIHW, 2011f). Where people have multiple risk factors, such as a combination of excessive alcohol intake, smoking and low exercise, their overall risk of disease and poor health increases even further.
Many chronic diseases can be prevented, delayed or improved by addressing lifestyle factors such as smoking, poor diet, insufficient exercise or obesity. As most risk behaviours are modifiable, health policy-makers can achieve population health benefits by targeting risk factors through legislation, education and incentive measures. They can monitor the progress of their efforts through use of population information, such as that presented below.
The ABS collects data on a number of lifestyle behaviours that are recognised as risks to health, including tobacco smoking, alcohol consumption, low exercise level, overweight and obesity, and low fruit and vegetable consumption. This section presents findings for these health risk factors.
SMOKING
Tobacco smoking is one of the more prominent lifestyle behaviours contributing to health risk in Australia. While rates in general are trending down, there is still some way to go, with around one in five people (20%) aged 15 years and over reporting being current smokers in 2007–08.
Of persons aged 15 years and over, 18% were daily smokers, 2% smoked less often than once a day, 29% were ex-smokers, and 52% reported that they had never smoked. Overall, more males than females were current smokers (22% and 18% respectively), although this is largely driven by higher rates for males in the younger adult age groups (15–44 years) (graph 11.20).
In 2007–08, smokers were more likely to report a combination of risk factors than non-smokers. Around half of current smokers aged 18 years and over led a sedentary lifestyle, doing very little or no exercise (51% compared with 38% of those who had never smoked). Current smokers were also more than three times as likely as people who had never smoked to drink alcohol at levels associated with a high risk of harm (23% compared with 8%).
In terms of associated health outcomes, 2007–08 data showed that people who had ever smoked were over six times more likely to have emphysema and one and a half times as likely to have bronchitis as people who had never smoked. Heart, stroke and vascular disease was also more prevalent in adults who had ever smoked (8%) than those who had never smoked (5%).
ALCOHOL CONSUMPTION
Alcohol is widely used and enjoyed in Australian society but the harmful use of alcohol is a problem that globally results in around 2.5 million deaths worldwide each year, and causes harm beyond the physical and psychological health of the drinker. An intoxicated person can harm others or put them at risk of traffic accidents or violent behaviour, and can negatively affect co-workers, relatives, friends or strangers. A significant proportion of the disease burden attributable to harmful drinking arises from injuries, including those due to road traffic accidents, violence, and suicides (WHO, 2011a).
Although low to moderate alcohol consumption may offer some protective health effects, high alcohol consumption is a major determinant of alcohol use disorders (such as alcoholic psychosis and alcohol dependence syndrome), epilepsy, cardiovascular diseases, cirrhosis of the liver and various cancers. As alcohol consumption weakens the immune system, the harmful use of alcohol is also associated with several infectious diseases like HIV/AIDS, tuberculosis and sexually transmitted infections (WHO, 2011a).
In the 2007–08 NHS, people were classified to a health risk level according to the 2001 NHMRC guidelines for alcohol consumption (low risk, risky, or high risk of long-term harm) based on their estimated average daily consumption of alcohol during the previous week. Survey results showed that three in five Australians aged 18 years and over (62%) drank alcohol in the previous week and of these, over one in five drank alcohol at risky or high risk levels for long-term harm (22%).
Rates of drinking at harmful levels were highest for men aged 25–34 years (17%), and for women aged 18–24 years or 45–54 years (both 14%).
EXERCISE
Physical activity is an important factor in maintaining good overall health and wellbeing. Being physically active has significant health benefits, including reducing the risk of some chronic conditions, helping to control weight and improving mental wellbeing. Some forms of physical activity may also help manage long-term conditions, such as arthritis and Type 2 diabetes, by reducing the effects of the conditions and improving people's quality of life.
In recent decades, there has been a decline in physical activity due to the increasingly sedentary nature of many forms of work, activities such as watching television or using a computer, and changes in transportation. Sedentary behaviour is believed to be associated with the rise in overweight and obesity, which increases the risk of cardiovascular disease, colon and breast cancers, Type 2 diabetes and osteoporosis (AIHW, 2011g). In 2006–07, the direct health care costs due to physical inactivity in Australia were estimated to be $1.5 billion, including $469 million attributable to falls and $372 million attributable to coronary heart disease (Econtech, 2007).
Worldwide, physical inactivity is the fourth leading risk factor for mortality, contributing to 6% of deaths (WHO, 2010), and is a leading modifiable health risk factor contributing to the burden of disease and injury in Australia (Begg et al. 2007).
In 2007–08, 60% of Australians adults (18 years and over) had done some exercise for fitness, recreation or sport in the week prior to interview, with:
Women were more likely to walk for exercise than men (46% compared with 41%), and men were more likely to do moderate exercise (34% compared with 29%) or vigorous exercise (16% compared with 10%). Moderate and vigorous exercise were most common among younger age groups, while older people tended to walk for exercise. (Note that people could report more than one type of exercise.)
However, only 38% of Australians aged 18 years and over met the recommended physical activity guidelines of at least 30 minutes of exercise on most days of the week, with each session lasting 10 minutes or more. This was more common for men than women (40% and 36% respectively) and for younger people.
Even when people were exercising, the health benefits accruing from the exercise may have been jeopardised by their work and leisure habits. Prolonged periods of sitting may not only be detrimental to people's health but may also counteract the benefits of regular moderate to vigorous physical activity (Healy et al. 2008). More than three out of four Australians aged 18 years and over spent between two and six hours a day sitting at leisure activities such as watching television, reading or playing computer games (78%), and almost half (45%) spent most of their time sitting at work.
Almost 40% of Australians aged 18 years and over did no exercise at all in the week prior to the survey.
OVERWEIGHT AND OBESITY
The health consequences of overweight and obesity are many and varied, ranging from an increased risk of premature death to several non-fatal but debilitating complaints that have an adverse effect on people's quality of life (WHO, 1999). Around 44% of the diabetes burden, 23% of the ischaemic heart disease burden and between 7% and 41% of selected cancer burdens are attributable to overweight and obesity (WHO, 2011b).
Overweight and obesity can affect a person's ability to work or participate in family and community activities, and can have serious implications for the health sector in terms of cost and burden on services. In 2008, it was estimated that the overall cost of obesity to Australian society and governments was $58 billion (Access Economics, 2008).
Using measured height and weight data to calculate a person's body mass index (BMI), ABS data showed that in Australia in 2007–08, around 25% of people aged 18 years and over were obese, 37% were overweight, a further 37% were in the normal weight range and 2% were underweight. More men (68%) were overweight or obese than women (55%). Rates of overweight and obesity generally increased with age, peaking at 65–74 years for both men and women (graph 11.21). (BMI is a simple index of weight for height that is commonly used in classifying people into the following ranges: underweight, normal weight, overweight and obese. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2).)
After adjusting for age, rates of overweight and obesity in Australian adults increased from 57% in 1995 (65% of men and 50% of women) to 61% in 2007–08 (68% of men and 55% of women).
Overweight and obesity in children is a major health concern. Studies have shown that once children become obese they are more likely to stay obese into adulthood and have an increased risk of developing both short and long-term health conditions, such as Type 2 diabetes and cardiovascular disease (Australian Social Trends, September 2009, 4102.0). In 2007–08, one in four children aged 5–17 years (25%) were classified as overweight or obese.
HIGH BLOOD PRESSURE AND HIGH CHOLESTEROL
High blood pressure, or hypertension, is a major risk factor for a range of health problems, including bleeding from the aorta, chronic kidney disease, heart attack and heart failure, poor blood supply to the legs, stroke and vision problems (PubMed Health, 2011). Along with obesity, other major causes of hypertension are diets that are high in salt, excessive alcohol consumption and insufficient physical activity.
In 2007–08, just over 9% of Australians had hypertension or a hypertensive disease. People who were obese had a greater likelihood of having hypertension or a hypertensive disease than those in other weight ranges (16% compared with 11% of overweight people and 8% of people in the normal weight range).
High cholesterol is also considered a risk factor for a number of circulatory conditions. High cholesterol levels were reported by 6% of the population in 2007–08, with the prevalence highest for those in the 65–74 year and 75 years and over age groups (19% and 16% respectively). Around 27% of people with high cholesterol had a heart, stroke or vascular disease, compared with 4% of people who did not report high cholesterol. Over half of all people reporting high cholesterol also reported having hypertension or a hypertensive disease (55% compared with 7% of people without high cholesterol levels). Almost one in five people with high cholesterol had been diagnosed with diabetes (18%, compared with 3% of those who did not report high cholesterol).
FRUIT AND VEGETABLE INTAKE
Fruit and vegetables contain essential vitamins, minerals and fibre that help reduce the risk of chronic diseases. Regular consumption of fruit and vegetables is associated with reduced risks of cancer, cardiovascular disease, stroke, Alzheimer's disease, cataracts, and some of the functional declines associated with ageing (Liu, 2003). In 2007–08, just over half of children aged 5–7 years (57%), a third of children aged 8–11 years (33%), 5% of people aged 12–18 years, and 6% of people aged 19 years and over ate the recommended daily serves of fruit and vegetables for their age group.
For more information on the consumption of fruit and vegetables in Australia, see the special article In pursuit of 2 & 5 – fruit and vegetable consumption in Australia in this chapter.
The ABS is currently conducting the 2011–13 Australian Health Survey (AHS). The AHS builds on previous health surveys and will allow comparisons of health information over time on topics such as obesity, smoking, health conditions and how people manage their health.
The AHS will also collect new information about food and nutrient consumption, detailed physical activity and, for the first time, biomedical measures. These biomedical measures will reveal new insights into heart and kidney disease, diabetes and other chronic conditions by enabling examination of health factors such as cholesterol, glucose and sodium levels. The survey will also allow analysis of the relationship between biomedical measures, lifestyle factors and health outcomes. First results will be available from late 2013.