Among the estimated 193,200 Aboriginal and Torres Strait Islander children aged 0–14 years in 2008, the majority (79%) were reported to be in excellent or very good health, 18% in good health, and 4% in fair or poor health. The proportions of Aboriginal and Torres Strait Islander children with excellent or very good health did not vary significantly between non-remote and remote areas, nor between boys and girls.
Oral health
In 2008, three in ten Aboriginal and Torres Strait Islander children with teeth were reported to have teeth or gum problems, most commonly fillings and/or cavities due to tooth decay (15% each) (graph 3.15). Just over two-thirds of Aboriginal and Torres Strait Islander children (67%) had visited a dentist at some stage in their life, with 47% having seen a dentist in the previous year. A further 14,800 Aboriginal and Torres Strait Islander children (8%) needed dental care in the previous year, but had not been to a dentist. The most commonly reported reason(s) for children not having seen a dentist were that the waiting time was too long or the service was not available at the time required (32%) and/or that cost was a barrier (21%). Three-quarters of Aboriginal and Torres Strait Islander children (75%) were reported to be brushing their teeth at least once a day, with higher rates of daily brushing in non-remote areas than in remote areas (80% compared with 60%).
Ear and hearing problems
Nationally, ear or hearing problems were experienced by 16,500 Aboriginal and Torres Strait Islander children (9%) in 2008, with similar rates reported in non-remote and remote areas. Among Aboriginal and Torres Strait Islander children with ear or hearing problems, just over one-third (35%) had runny ears or glue ear (caused by middle ear infections) and 28% had hearing loss or partial deafness. In non-remote areas, more than half (55%) of children had experienced ear or hearing problems for more than two years, compared with 40% of those who were living in remote areas.
Sight problems
In 2008, an estimated 13,800 Aboriginal and Torres Strait Islander children (7%) had eye or sight problems. Among children with eye or sight problems, 37% were long-sighted, 28% were short-sighted, and 61% wore glasses or contact lenses to correct their sight problems.
Nutrition
Among the estimated 53,900 Aboriginal and Torres Strait Islander children aged 0–3 years in 2008, one in five (20%) were currently being breast-fed and 55% had previously been breast-fed. Overall rates of breast-feeding (current and previous, combined) were higher in remote areas than in non-remote areas (85% compared with 73%). In remote areas, the proportion of Aboriginal and Torres Strait Islander infants aged less than six months who were currently being breast-fed was more than one-and-a-half times the corresponding rate in non-remote areas (77% compared with 45%).
As well as having higher rates of breast-feeding, Aboriginal and Torres Strait Islander children in remote areas also tended to be breast-fed for longer than children in non-remote areas. Among children who had previously been breast-fed, the median age at which breast-feeding stopped was 36 weeks (or 8–9 months) for those in remote areas, compared with 17 weeks (around 4 months) for children in non-remote areas. Similarly, children living in remote areas were almost twice as likely as those in non-remote areas to have been breast-fed for the first 1–2 years of life (24% compared with 13%).
The National Health and Medical Research Council (NHMRC) Dietary Guidelines recommend that people eat a wide variety of nutritious foods, including a high intake of plant food, such as fruit and vegetables. In 2008, more than half (59%) of the 179,300 Aboriginal and Torres Strait Islander children aged 1–14 years were reported to eat fruit every day, while 53% ate vegetables daily.
The number of serves of fruit and vegetables usually eaten was only collected for Aboriginal and Torres Strait Islander children in non-remote areas. Among the 106,000 children aged 4–14 years in non-remote areas, younger children were more likely than older children to meet the NHMRC guidelines for daily intake of fruit and vegetables. Around six in ten children aged 4–7 years (62%) exceeded the recommended daily single serve of fruit and 60% met or exceeded the recommended two serves of vegetables. In comparison, an estimated one in five Aboriginal and Torres Strait Islander children aged 12–14 years (21%) ate the recommended three serves of fruit and 19% ate the recommended four serves of vegetables.
Physical activity and inactivity
In 2008, almost three-quarters (74%) of the 139,400 Aboriginal and Torres Strait Islander children aged 4–14 years were physically active for at least an hour every day in the week before the survey (84% in remote areas compared with 71% in non-remote areas) (graph 3.16). In addition, a higher proportion of boys, than girls, were physically active (78% compared with 70%). Almost half (47%) of Aboriginal and Torres Strait Islander children had played organised sport in the previous year, with participation rates higher in non-remote areas than in remote areas (49% compared with 40%).
As well as collecting information about physical activity, the 2008 NATSISS also measured the amount of time that Aboriginal and Torres Strait Islander children aged 5–14 years spent engaged in screen-based activities, such as watching television, videos or DVDs (as a proxy for time spent being inactive). Among the estimated 127,200 Aboriginal and Torres Strait Islander children aged 5–14 years in 2008, two-thirds (66%) spent more than two hours each day watching television, videos or DVDs, with higher rates reported for older children, than for younger children (71% of 10–14 year olds compared with 62% of 5–9 year olds).
Sleep
To decrease the risk of sudden infant death syndrome (SIDS), it is recommended that infants sleep on their backs. In 2008, this was the usual sleeping position for 61% (or 8,500) infants aged less than one year (66% in non-remote areas compared with 43% in remote areas). The proportion of children aged 1–3 years who usually slept on their back was considerably lower, at 40%.
According to the 2008 NATSISS, an estimated 43,800 Aboriginal and Torres Strait Islander children aged 0–14 years (23%) had experienced problems sleeping in the month before the survey (25% of those in non-remote areas compared with 13% in remote areas). Of these, 19% had difficulty sleeping due to over-excitement, 13% because of illness or pain, 12% due to nightmares and 12% due to fear of the dark.
Stressors and positive life events
In 2008, almost two-thirds (65%) of Aboriginal and Torres Strait Islander children aged 4–14 years had experienced at least one stressor in the previous year (66% in non-remote areas compared with 60% in remote areas). The stressors most commonly experienced by Aboriginal and Torres Strait Islander children were the death of a close family member/friend (22%), problems keeping up with school work (20%), being scared/upset by an argument or someone else's behaviour (19%), and having nothing fun to do (18%). Many Aboriginal and Torres Strait Islander children also experienced positive life events. More than half (62%) were reported to have been on a holiday or trip away in the previous year, and 58% had received an award, prize or some other form of positive recognition.
Passive smoking
Nationally in 2008, 63% of Aboriginal and Torres Strait Islander children aged 0–14 years were living in a household with one or more current daily smokers (72% in remote areas and 61% in non-remote areas). One in six (16%) Aboriginal and Torres Strait Islander infants and young children (aged 0–3 years) and 23% of children aged 4–14 years were exposed to cigarette smoking indoors. Reflecting higher rates of smoking among Aboriginal and Torres Strait Islander people than non-Indigenous people, Aboriginal and Torres Strait Islander children were exposed to passive smoking (indoors) at three times the rate of non-Indigenous children (21% compared with 7%).
MATERNAL HEALTH DURING PREGNANCY
In the 2008 NATSISS, information about the health of birth mothers was collected in relation to the estimated 53,900 Aboriginal and Torres Strait Islander children aged 0–3 years. For some topics, it was not possible to obtain information about all birth mothers. The proportions are therefore based on the fully responding population for each topic.
Health conditions
Two adverse conditions that can arise in pregnancy are gestational diabetes and high blood pressure. In 2008, a small proportion of birth mothers of Aboriginal and Torres Strait Islander children aged 0–3 years (8%), had diabetes or sugar problems, and 14% had high blood pressure during their pregnancy.
Risk factors
Insufficient folate intake during pregnancy can increase the risk of neural tube defects, such as spina bifida, in the unborn child. In 2008, around half (51%) of birth mothers of Aboriginal and Torres Strait Islander children aged 0–3 years took folate supplements before or during their pregnancy.
Tobacco, alcohol and illicit drug use during pregnancy pose significant risks to the health of the mother and unborn child. In 2008, one in five birth mothers of Aboriginal and Torres Strait Islander children aged 0–3 years (20%) were reported to have drunk alcohol during pregnancy and 42% had smoked or chewed tobacco (although more than half (57%) of these tobacco users reported using less tobacco while pregnant). A small proportion of Aboriginal and Torres Strait Islander children aged 0–3 years (5%) had birth mothers who had used illicit drugs during their pregnancy.
Health care
In 2008, almost half (45%) of birth mothers had sought advice or information about aspects of pregnancy or childbirth before the birth of their child. Information has the potential to influence the behaviours of prospective mothers in a positive way. For example, birth mothers who had sought advice or information about aspects of pregnancy or childbirth were more likely to have taken folate than those who had not sought advice (63% compared with 45%), and were less likely to have smoked or chewed tobacco during pregnancy (36% compared with 47%). An expectant mother’s health status and associated behaviours may also influence whether or not she seeks advice. Birth mothers with high blood pressure were more likely to have sought advice (57%) than those without high blood pressure (43%). Similarly, birth mothers who had used tobacco during pregnancy were less likely to have sought advice about aspects of pregnancy or childbirth (38%) than those who had not used tobacco during pregnancy (49%).
A majority (91%) of birth mothers of Aboriginal and Torres Strait Islander children aged 0–3 years in 2008 had regular checkups while pregnant with a doctor (63%), midwife or nurse (43%) and/or an Aboriginal or Torres Strait Islander health worker (8%). Reflecting differential access to various health professionals in non-remote and remote areas, regular pregnancy checkups with a doctor were more common in non-remote areas than in remote areas (68% compared with 46%), whereas checkups with an Aboriginal and Torres Strait Islander health worker were more common among birth mothers living in remote areas (16% compared with 6% in non-remote areas).
Most (98%) Aboriginal and Torres Strait Islander children aged 0–3 years in 2008, had been born in a hospital. For many birth mothers of Aboriginal and Torres Strait Islander children in remote areas, this meant travelling a considerable distance from home to give birth. While more than half (59%) of Aboriginal and Torres Strait Islander children in remote areas were born in a hospital at least 100 kilometres from their home, a similar proportion (52%) of children in non-remote areas were born less than 10 kilometres from their home.
HEALTH OF YOUNG PEOPLE AND ADULTS
Among the estimated 327,100 Aboriginal and Torres Strait Islander people aged 15 years and over in 2008, 44% rated their health as excellent or very good; just over one-third (34%) rated their health as good; and almost one-quarter (22%) rated their health as fair or poor. The proportions of Aboriginal and Torres Strait Islander people with excellent or very good health did not vary significantly between non-remote and remote areas. Males were more likely than females to report excellent/very good health (46% compared with 41%) and rates of excellent/very good health decreased with age, from 58% of those aged 15–24 years to 22% of those aged 55 years and over.
The most recent information on self-assessed health for non-Indigenous people is from the 2007–08 National Health Survey. After adjusting for differences in the age structures of the two populations, Aboriginal and Torres Strait Islander people were twice as likely as non-Indigenous people to have reported fair/poor health.
Disability and long-term health conditions
Nationally, 50% of Aboriginal and Torres Strait Islander people aged 15 years and over had a disability or long-term health condition, including one in twelve (8%) with a profound or severe core activity limitation, meaning that they needed help with one or more activities of daily living some or all of the time. The proportions of Aboriginal and Torres Strait Islander people with a disability or long-term health condition were similar for males and females, and for those living in remote and non-remote areas. Rates of disability and profound/severe core activity limitation steadily increased with age (graph 3.17).
Psychological distress and stressors
Using a modified version of the Kessler Psychological Distress Scale (the K5+), the 2008 NATSISS collected information on the levels of psychological distress experienced by Aboriginal and Torres Strait Islander people aged 15 years and over in the four weeks before the survey. Results showed that almost one-third (31%) of Aboriginal and Torres Strait Islander people had experienced high/very high levels of psychological distress during this period, with the overall rate for females (34%) higher than the rate for males (27%).
These data are consistent with the high proportion (58%) of Aboriginal and Torres Strait Islander people who reported having personally experienced one or more life stressors in the previous year. The most commonly reported stressors were Death of a family member or close friend (26%), Serious illness (13%), Inability to get a job (11%), Overcrowding at home (7%), Mental illness (7%) and Alcohol-related problems (7%). Apart from alcohol-related problems, the proportions of people reporting each of these stressors were significantly different in non-remote and remote areas (graph 3.18).
Risk factors
A person's health can be enhanced and improved by, for example, maintaining a healthy weight and participating in physical activity. Conversely, health may be adversely affected by behaviours such as risky levels of alcohol consumption, drug-taking and tobacco use. These can increase the likelihood of accidents and injuries occurring in the short term, and contribute to the development of chronic diseases over the life course.
Weight
According to the 2004–05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), more than half (57%) of Aboriginal and Torres Strait Islander people aged 15 years and over were either overweight or obese (58% of males and 55% of females). A further 38% of people were in the healthy weight range and 6% were underweight. While the proportion of Aboriginal and Torres Strait Islander males and females within the healthy weight range was the same (38%), females were more likely than males, to be underweight (7% compared with 4%) or obese (31% compared with 26%), while males were more likely than females to be overweight (32% compared with 23%).
Participation in sport or physical activity
The 2008 NATSISS collected information about participation in a range of sporting activities and social activities in the three months before the survey. One-quarter (25%) of Aboriginal and Torres Strait Islander people aged 15 years and over had taken part in sporting or physical activities, with participation rates higher for males than for females (32% compared with 19%).
Tobacco smoking
In 2008, just under half (45%) of Aboriginal and Torres Strait Islander people aged 15 years and over were current daily smokers, 20% were ex-smokers, and around one-third (33%) had never smoked. Smoking rates were similar for males and females in all age groups, apart from those aged 35–44 years, among whom the smoking rates were significantly higher for males than for females (56% compared with 47%) (graph 3.19). Overall smoking rates were also higher in remote areas than in non-remote areas (49% compared with 43%).
The most recent information on smoking for non-Indigenous people is from the 2007–08 National Health Survey. For both males and females, smoking was more prevalent among Aboriginal and Torres Strait Islander people than non-Indigenous people in every age group. After adjusting for differences in the age structure of the two populations, Aboriginal and Torres Strait Islander people aged 15 years and over were twice as likely as non-Indigenous people to be current daily smokers.
Illicit substance use
Illicit substance use refers to the use of substances that are either illegal to possess (e.g. heroin) or legally available but used inappropriately (e.g. misuse of prescription medication). According to the 2008 NATSISS, one in five Aboriginal and Torres Strait Islander people aged 15 years and over (20%) reported having recently used an illicit substance (i.e. in the 12 months before the survey), most commonly marijuana (16%). Recent illicit substance use was reported by a higher proportion of males than females (25% compared with 16%) and by young people (25% of those aged 15–34 years compared with 15% of people aged 35 years and over). Overall rates of recent substance use were also higher among Aboriginal and Torres Strait Islander people living in non-remote areas than in remote areas (22% compared with 16%).
Harmful drinking
Based on the 2001 National Health and Medical Research Council Australian Drinking Guidelines (NHMRC, 2001), two measures of risky drinking of alcohol were collected in the 2008 NATSISS. The first measure was designed to identify long-term or chronic risk and the second measure was designed to identify acute risk (or binge) drinking.
In 2008, an estimated 13% of Aboriginal and Torres Strait Islander people aged 15 years and over reported drinking at chronic risky/high risk levels in the 12 months before the survey. A further 50% were low risk drinkers and just over one-third (35%) reported that they had not drunk alcohol in the last 12 months (or had never consumed alcohol). While rates of risky/high risk drinking were similar for Aboriginal and Torres Strait Islander people in non-remote and remote areas, abstinence was more common in remote areas (46%) than in non-remote areas (31%). A higher proportion of males than females reported drinking at chronic risky/high risk levels (16% compared with 10%) and this difference was evident in every age group (graph 3.20).
Just over one-third (34%) 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 before the survey. Overall, 41% of males drank at acute risky/high risk levels compared with 27% of females, and rates of binge drinking were higher in non-remote than in remote areas (35% compared with 30%).
Use of health services
The 2008 NATSISS collected information about problems experienced in accessing health services such as those provided by Aboriginal and Torres Strait Islander health workers, dentists, doctors, other health workers, hospitals, mental health services and Medicare.
Nationally, an estimated 86,200 Aboriginal and Torres Strait Islander people aged 15 years and over (or 26%) reported problems accessing one or more health services. Problems most commonly experienced were in relation to accessing dentists (20%), doctors (10%) and hospitals (7%). People living in remote areas were more likely than those in non-remote areas to have encountered problems accessing one or more health services (36% compared with 23%). The types of problems experienced also varied by remoteness. Aboriginal and Torres Strait Islander people in non-remote areas were more likely than those in remote areas to have reported that waiting times were too long or that a service was not available when needed (55% compared with 33%) or that the cost of the service was a barrier (38% compared with 16%) (graph 3.21). In contrast, Aboriginal and Torres Strait Islander people in remote areas were more likely than those in non-remote areas to have reported no services in their area (51% compared with 27%), insufficient services in their area (47% compared with 34%) or transport/distance (46% compared with 25%) as barriers.
More information on the health of Aboriginal and Torres Strait Islander people can be found in chapter 11 HEALTH.
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
CHILDREN'S HEALTH
Among the estimated 193,200 Aboriginal and Torres Strait Islander children aged 0–14 years in 2008, the majority (79%) were reported to be in excellent or very good health, 18% in good health, and 4% in fair or poor health. The proportions of Aboriginal and Torres Strait Islander children with excellent or very good health did not vary significantly between non-remote and remote areas, nor between boys and girls.
Oral health
In 2008, three in ten Aboriginal and Torres Strait Islander children with teeth were reported to have teeth or gum problems, most commonly fillings and/or cavities due to tooth decay (15% each) (graph 3.15). Just over two-thirds of Aboriginal and Torres Strait Islander children (67%) had visited a dentist at some stage in their life, with 47% having seen a dentist in the previous year. A further 14,800 Aboriginal and Torres Strait Islander children (8%) needed dental care in the previous year, but had not been to a dentist. The most commonly reported reason(s) for children not having seen a dentist were that the waiting time was too long or the service was not available at the time required (32%) and/or that cost was a barrier (21%). Three-quarters of Aboriginal and Torres Strait Islander children (75%) were reported to be brushing their teeth at least once a day, with higher rates of daily brushing in non-remote areas than in remote areas (80% compared with 60%).
Ear and hearing problems
Nationally, ear or hearing problems were experienced by 16,500 Aboriginal and Torres Strait Islander children (9%) in 2008, with similar rates reported in non-remote and remote areas. Among Aboriginal and Torres Strait Islander children with ear or hearing problems, just over one-third (35%) had runny ears or glue ear (caused by middle ear infections) and 28% had hearing loss or partial deafness. In non-remote areas, more than half (55%) of children had experienced ear or hearing problems for more than two years, compared with 40% of those who were living in remote areas.
Sight problems
In 2008, an estimated 13,800 Aboriginal and Torres Strait Islander children (7%) had eye or sight problems. Among children with eye or sight problems, 37% were long-sighted, 28% were short-sighted, and 61% wore glasses or contact lenses to correct their sight problems.
Nutrition
Among the estimated 53,900 Aboriginal and Torres Strait Islander children aged 0–3 years in 2008, one in five (20%) were currently being breast-fed and 55% had previously been breast-fed. Overall rates of breast-feeding (current and previous, combined) were higher in remote areas than in non-remote areas (85% compared with 73%). In remote areas, the proportion of Aboriginal and Torres Strait Islander infants aged less than six months who were currently being breast-fed was more than one-and-a-half times the corresponding rate in non-remote areas (77% compared with 45%).
As well as having higher rates of breast-feeding, Aboriginal and Torres Strait Islander children in remote areas also tended to be breast-fed for longer than children in non-remote areas. Among children who had previously been breast-fed, the median age at which breast-feeding stopped was 36 weeks (or 8–9 months) for those in remote areas, compared with 17 weeks (around 4 months) for children in non-remote areas. Similarly, children living in remote areas were almost twice as likely as those in non-remote areas to have been breast-fed for the first 1–2 years of life (24% compared with 13%).
The National Health and Medical Research Council (NHMRC) Dietary Guidelines recommend that people eat a wide variety of nutritious foods, including a high intake of plant food, such as fruit and vegetables. In 2008, more than half (59%) of the 179,300 Aboriginal and Torres Strait Islander children aged 1–14 years were reported to eat fruit every day, while 53% ate vegetables daily.
The number of serves of fruit and vegetables usually eaten was only collected for Aboriginal and Torres Strait Islander children in non-remote areas. Among the 106,000 children aged 4–14 years in non-remote areas, younger children were more likely than older children to meet the NHMRC guidelines for daily intake of fruit and vegetables. Around six in ten children aged 4–7 years (62%) exceeded the recommended daily single serve of fruit and 60% met or exceeded the recommended two serves of vegetables. In comparison, an estimated one in five Aboriginal and Torres Strait Islander children aged 12–14 years (21%) ate the recommended three serves of fruit and 19% ate the recommended four serves of vegetables.
Physical activity and inactivity
In 2008, almost three-quarters (74%) of the 139,400 Aboriginal and Torres Strait Islander children aged 4–14 years were physically active for at least an hour every day in the week before the survey (84% in remote areas compared with 71% in non-remote areas) (graph 3.16). In addition, a higher proportion of boys, than girls, were physically active (78% compared with 70%). Almost half (47%) of Aboriginal and Torres Strait Islander children had played organised sport in the previous year, with participation rates higher in non-remote areas than in remote areas (49% compared with 40%).
As well as collecting information about physical activity, the 2008 NATSISS also measured the amount of time that Aboriginal and Torres Strait Islander children aged 5–14 years spent engaged in screen-based activities, such as watching television, videos or DVDs (as a proxy for time spent being inactive). Among the estimated 127,200 Aboriginal and Torres Strait Islander children aged 5–14 years in 2008, two-thirds (66%) spent more than two hours each day watching television, videos or DVDs, with higher rates reported for older children, than for younger children (71% of 10–14 year olds compared with 62% of 5–9 year olds).
Sleep
To decrease the risk of sudden infant death syndrome (SIDS), it is recommended that infants sleep on their backs. In 2008, this was the usual sleeping position for 61% (or 8,500) infants aged less than one year (66% in non-remote areas compared with 43% in remote areas). The proportion of children aged 1–3 years who usually slept on their back was considerably lower, at 40%.
According to the 2008 NATSISS, an estimated 43,800 Aboriginal and Torres Strait Islander children aged 0–14 years (23%) had experienced problems sleeping in the month before the survey (25% of those in non-remote areas compared with 13% in remote areas). Of these, 19% had difficulty sleeping due to over-excitement, 13% because of illness or pain, 12% due to nightmares and 12% due to fear of the dark.
Stressors and positive life events
In 2008, almost two-thirds (65%) of Aboriginal and Torres Strait Islander children aged 4–14 years had experienced at least one stressor in the previous year (66% in non-remote areas compared with 60% in remote areas). The stressors most commonly experienced by Aboriginal and Torres Strait Islander children were the death of a close family member/friend (22%), problems keeping up with school work (20%), being scared/upset by an argument or someone else's behaviour (19%), and having nothing fun to do (18%). Many Aboriginal and Torres Strait Islander children also experienced positive life events. More than half (62%) were reported to have been on a holiday or trip away in the previous year, and 58% had received an award, prize or some other form of positive recognition.
Passive smoking
Nationally in 2008, 63% of Aboriginal and Torres Strait Islander children aged 0–14 years were living in a household with one or more current daily smokers (72% in remote areas and 61% in non-remote areas). One in six (16%) Aboriginal and Torres Strait Islander infants and young children (aged 0–3 years) and 23% of children aged 4–14 years were exposed to cigarette smoking indoors. Reflecting higher rates of smoking among Aboriginal and Torres Strait Islander people than non-Indigenous people, Aboriginal and Torres Strait Islander children were exposed to passive smoking (indoors) at three times the rate of non-Indigenous children (21% compared with 7%).
MATERNAL HEALTH DURING PREGNANCY
In the 2008 NATSISS, information about the health of birth mothers was collected in relation to the estimated 53,900 Aboriginal and Torres Strait Islander children aged 0–3 years. For some topics, it was not possible to obtain information about all birth mothers. The proportions are therefore based on the fully responding population for each topic.
Health conditions
Two adverse conditions that can arise in pregnancy are gestational diabetes and high blood pressure. In 2008, a small proportion of birth mothers of Aboriginal and Torres Strait Islander children aged 0–3 years (8%), had diabetes or sugar problems, and 14% had high blood pressure during their pregnancy.
Risk factors
Insufficient folate intake during pregnancy can increase the risk of neural tube defects, such as spina bifida, in the unborn child. In 2008, around half (51%) of birth mothers of Aboriginal and Torres Strait Islander children aged 0–3 years took folate supplements before or during their pregnancy.
Tobacco, alcohol and illicit drug use during pregnancy pose significant risks to the health of the mother and unborn child. In 2008, one in five birth mothers of Aboriginal and Torres Strait Islander children aged 0–3 years (20%) were reported to have drunk alcohol during pregnancy and 42% had smoked or chewed tobacco (although more than half (57%) of these tobacco users reported using less tobacco while pregnant). A small proportion of Aboriginal and Torres Strait Islander children aged 0–3 years (5%) had birth mothers who had used illicit drugs during their pregnancy.
Health care
In 2008, almost half (45%) of birth mothers had sought advice or information about aspects of pregnancy or childbirth before the birth of their child. Information has the potential to influence the behaviours of prospective mothers in a positive way. For example, birth mothers who had sought advice or information about aspects of pregnancy or childbirth were more likely to have taken folate than those who had not sought advice (63% compared with 45%), and were less likely to have smoked or chewed tobacco during pregnancy (36% compared with 47%). An expectant mother’s health status and associated behaviours may also influence whether or not she seeks advice. Birth mothers with high blood pressure were more likely to have sought advice (57%) than those without high blood pressure (43%). Similarly, birth mothers who had used tobacco during pregnancy were less likely to have sought advice about aspects of pregnancy or childbirth (38%) than those who had not used tobacco during pregnancy (49%).
A majority (91%) of birth mothers of Aboriginal and Torres Strait Islander children aged 0–3 years in 2008 had regular checkups while pregnant with a doctor (63%), midwife or nurse (43%) and/or an Aboriginal or Torres Strait Islander health worker (8%). Reflecting differential access to various health professionals in non-remote and remote areas, regular pregnancy checkups with a doctor were more common in non-remote areas than in remote areas (68% compared with 46%), whereas checkups with an Aboriginal and Torres Strait Islander health worker were more common among birth mothers living in remote areas (16% compared with 6% in non-remote areas).
Most (98%) Aboriginal and Torres Strait Islander children aged 0–3 years in 2008, had been born in a hospital. For many birth mothers of Aboriginal and Torres Strait Islander children in remote areas, this meant travelling a considerable distance from home to give birth. While more than half (59%) of Aboriginal and Torres Strait Islander children in remote areas were born in a hospital at least 100 kilometres from their home, a similar proportion (52%) of children in non-remote areas were born less than 10 kilometres from their home.
HEALTH OF YOUNG PEOPLE AND ADULTS
Among the estimated 327,100 Aboriginal and Torres Strait Islander people aged 15 years and over in 2008, 44% rated their health as excellent or very good; just over one-third (34%) rated their health as good; and almost one-quarter (22%) rated their health as fair or poor. The proportions of Aboriginal and Torres Strait Islander people with excellent or very good health did not vary significantly between non-remote and remote areas. Males were more likely than females to report excellent/very good health (46% compared with 41%) and rates of excellent/very good health decreased with age, from 58% of those aged 15–24 years to 22% of those aged 55 years and over.
The most recent information on self-assessed health for non-Indigenous people is from the 2007–08 National Health Survey. After adjusting for differences in the age structures of the two populations, Aboriginal and Torres Strait Islander people were twice as likely as non-Indigenous people to have reported fair/poor health.
Disability and long-term health conditions
Nationally, 50% of Aboriginal and Torres Strait Islander people aged 15 years and over had a disability or long-term health condition, including one in twelve (8%) with a profound or severe core activity limitation, meaning that they needed help with one or more activities of daily living some or all of the time. The proportions of Aboriginal and Torres Strait Islander people with a disability or long-term health condition were similar for males and females, and for those living in remote and non-remote areas. Rates of disability and profound/severe core activity limitation steadily increased with age (graph 3.17).
Psychological distress and stressors
Using a modified version of the Kessler Psychological Distress Scale (the K5+), the 2008 NATSISS collected information on the levels of psychological distress experienced by Aboriginal and Torres Strait Islander people aged 15 years and over in the four weeks before the survey. Results showed that almost one-third (31%) of Aboriginal and Torres Strait Islander people had experienced high/very high levels of psychological distress during this period, with the overall rate for females (34%) higher than the rate for males (27%).
These data are consistent with the high proportion (58%) of Aboriginal and Torres Strait Islander people who reported having personally experienced one or more life stressors in the previous year. The most commonly reported stressors were Death of a family member or close friend (26%), Serious illness (13%), Inability to get a job (11%), Overcrowding at home (7%), Mental illness (7%) and Alcohol-related problems (7%). Apart from alcohol-related problems, the proportions of people reporting each of these stressors were significantly different in non-remote and remote areas (graph 3.18).
Risk factors
A person's health can be enhanced and improved by, for example, maintaining a healthy weight and participating in physical activity. Conversely, health may be adversely affected by behaviours such as risky levels of alcohol consumption, drug-taking and tobacco use. These can increase the likelihood of accidents and injuries occurring in the short term, and contribute to the development of chronic diseases over the life course.
Weight
According to the 2004–05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), more than half (57%) of Aboriginal and Torres Strait Islander people aged 15 years and over were either overweight or obese (58% of males and 55% of females). A further 38% of people were in the healthy weight range and 6% were underweight. While the proportion of Aboriginal and Torres Strait Islander males and females within the healthy weight range was the same (38%), females were more likely than males, to be underweight (7% compared with 4%) or obese (31% compared with 26%), while males were more likely than females to be overweight (32% compared with 23%).
Participation in sport or physical activity
The 2008 NATSISS collected information about participation in a range of sporting activities and social activities in the three months before the survey. One-quarter (25%) of Aboriginal and Torres Strait Islander people aged 15 years and over had taken part in sporting or physical activities, with participation rates higher for males than for females (32% compared with 19%).
Tobacco smoking
In 2008, just under half (45%) of Aboriginal and Torres Strait Islander people aged 15 years and over were current daily smokers, 20% were ex-smokers, and around one-third (33%) had never smoked. Smoking rates were similar for males and females in all age groups, apart from those aged 35–44 years, among whom the smoking rates were significantly higher for males than for females (56% compared with 47%) (graph 3.19). Overall smoking rates were also higher in remote areas than in non-remote areas (49% compared with 43%).
The most recent information on smoking for non-Indigenous people is from the 2007–08 National Health Survey. For both males and females, smoking was more prevalent among Aboriginal and Torres Strait Islander people than non-Indigenous people in every age group. After adjusting for differences in the age structure of the two populations, Aboriginal and Torres Strait Islander people aged 15 years and over were twice as likely as non-Indigenous people to be current daily smokers.
Illicit substance use
Illicit substance use refers to the use of substances that are either illegal to possess (e.g. heroin) or legally available but used inappropriately (e.g. misuse of prescription medication). According to the 2008 NATSISS, one in five Aboriginal and Torres Strait Islander people aged 15 years and over (20%) reported having recently used an illicit substance (i.e. in the 12 months before the survey), most commonly marijuana (16%). Recent illicit substance use was reported by a higher proportion of males than females (25% compared with 16%) and by young people (25% of those aged 15–34 years compared with 15% of people aged 35 years and over). Overall rates of recent substance use were also higher among Aboriginal and Torres Strait Islander people living in non-remote areas than in remote areas (22% compared with 16%).
Harmful drinking
Based on the 2001 National Health and Medical Research Council Australian Drinking Guidelines (NHMRC, 2001), two measures of risky drinking of alcohol were collected in the 2008 NATSISS. The first measure was designed to identify long-term or chronic risk and the second measure was designed to identify acute risk (or binge) drinking.
In 2008, an estimated 13% of Aboriginal and Torres Strait Islander people aged 15 years and over reported drinking at chronic risky/high risk levels in the 12 months before the survey. A further 50% were low risk drinkers and just over one-third (35%) reported that they had not drunk alcohol in the last 12 months (or had never consumed alcohol). While rates of risky/high risk drinking were similar for Aboriginal and Torres Strait Islander people in non-remote and remote areas, abstinence was more common in remote areas (46%) than in non-remote areas (31%). A higher proportion of males than females reported drinking at chronic risky/high risk levels (16% compared with 10%) and this difference was evident in every age group (graph 3.20).
Just over one-third (34%) 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 before the survey. Overall, 41% of males drank at acute risky/high risk levels compared with 27% of females, and rates of binge drinking were higher in non-remote than in remote areas (35% compared with 30%).
Use of health services
The 2008 NATSISS collected information about problems experienced in accessing health services such as those provided by Aboriginal and Torres Strait Islander health workers, dentists, doctors, other health workers, hospitals, mental health services and Medicare.
Nationally, an estimated 86,200 Aboriginal and Torres Strait Islander people aged 15 years and over (or 26%) reported problems accessing one or more health services. Problems most commonly experienced were in relation to accessing dentists (20%), doctors (10%) and hospitals (7%). People living in remote areas were more likely than those in non-remote areas to have encountered problems accessing one or more health services (36% compared with 23%). The types of problems experienced also varied by remoteness. Aboriginal and Torres Strait Islander people in non-remote areas were more likely than those in remote areas to have reported that waiting times were too long or that a service was not available when needed (55% compared with 33%) or that the cost of the service was a barrier (38% compared with 16%) (graph 3.21). In contrast, Aboriginal and Torres Strait Islander people in remote areas were more likely than those in non-remote areas to have reported no services in their area (51% compared with 27%), insufficient services in their area (47% compared with 34%) or transport/distance (46% compared with 25%) as barriers.
More information on the health of Aboriginal and Torres Strait Islander people can be found in chapter 11 HEALTH.