4704.0 - The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, 2005  
ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 14/10/2005   
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Contents >> Chapter 7: Health Status >> Causes of Ill-Health

This section provides an overview of Indigenous people's experience of various illnesses and health conditions using prevalence data, visits to general practitioners (GPs) and admissions to hospitals. Specific causes of ill-health are then discussed in more detail in the following section. Information on prevalence of disability is presented in Chapter 5.


Prevalence

Information about the self-reported prevalence of various conditions is available from the 2001NHS. In 2001, eye/sight problems, musculoskeletal problems, diseases of the respiratory and circulatory systems, and ear/hearing problems were the most commonly reported conditions among Indigenous people. After adjusting for age, Indigenous people had a higher prevalence of most types of health conditions than non-Indigenous people (table 7.7).

7.7 Age-standardised prevalence of selected conditions(a)(b)(c) - 2001

Indigenous
Non-Indigenous
Condition
%
%

Eye/sight problems
46
51
Musculoskeletal diseases
35
32
Arthritis
16
7
Diseases of the respiratory system
33
30
Asthma
17
12
Circulatory problems/diseases
19
17
Ear/hearing problems
18
14
Endocrine, nutritional and metabolic diseases
15
9
Diabetes mellitus
11
3
Diseases of the nervous system
10
8
Digestive diseases
7
7

(a) Proportions have been age standardised using the 2001 estimated resident population of Australia.
(b) Total numbers have been weighted using ABS population estimates.
(c) Sum of components may exceed 100% as persons may have reported more than one type of condition.
ABS, 2001 National Health Survey


Consultations with General Practitioners

Information about GP consultations is available from the ‘Bettering the Evaluation and Care of Health’ (BEACH) survey. Information is collected from a random sample of approximately 1,000 GPs from across Australia each year. A sample of 100 consecutive consultations is collected from each GP. Over the period 1998-99 to 2002-03, there were 5,476 GP consultations with Aboriginal and Torres Strait Islander patients recorded in the survey, representing 1.1% of total GP consultations. Respiratory conditions (mainly upper respiratory tract infections and asthma) were the problems most commonly managed at consultations with Indigenous patients (23 per 100 consultations), followed by skin problems (16 per 100), musculoskeletal conditions (14 per 100), psychological problems (13 per 100), circulatory problems (mainly hypertension) and endocrine and metabolic diseases (mainly diabetes) (both at a rate of 13 per 100) (table 7.8).


The number of Indigenous patients in the BEACH survey is likely to be underestimated. This is because some GPs do not ask about Indigenous status, or the patient may choose not to identify (AIHW 2002b). Therefore, the rate of GP consultations for Indigenous Australians presented in table 7.8. is likely to be an underestimate of the true level of consultation with GPs. It should also be noted that the estimates are derived from a relatively small sample of GP consultations involving Indigenous Australians.

7.8 General practitioner consultations, selected problems managed - 1998-99 to 2002-03

Number
Rate per 100 consultations
Type of problem
Indigenous
Total
Indigenous
Total

Respiratory
1 235
108 865
22.5
21.7
Skin
891
83 469
16.3
16.6
Musculoskeletal
747
87 092
13.6
17.4
Psychological
734
56 950
13.4
11.3
Circulatory
712
83 461
13.0
16.6
Endocrine and metabolic
712
49 906
13.0
9.9
Diabetes
389
14 019
7.1
2.8
Digestive
571
50 412
10.4
10.0
Pregnancy, family planning
359
21 757
6.6
4.3
Ear
325
21 611
5.9
4.3
Other
1 411
166 083
25.9
33.2
Total problems(a)
8 086
743 625
147.7
148.1

(a) Components may not add to total as more than one problem can be managed at each consultation.
Britt et al. 2003


Hospitalisations

Hospitalisation statistics are not a measure of prevalence or incidence of a disease, but can provide insights into the health of the population who use hospitals. A number of qualifications need to be made about hospitalisations data with regard to Indigenous identification (box 7.9). The identification of Aboriginal and Torres Strait Islander patients in hospital records is incomplete and is considered to be in need of improvement in some jurisdictions (New South Wales, Victoria, Queensland, Tasmania and the Australian Capital Territory) (AIHW 2005b). Therefore, true hospitalisation rates for Aboriginal and Torres Strait Islander people are likely to be higher than those reported in this chapter.


Ratios have been used in this chapter as a measure of hospitalisation in the Indigenous population relative to other Australians. Ratios of this type illustrate differences between the rates of hospital admissions among Indigenous people and those of other Australians, taking into account differences in age distributions. They reflect differences between observed hospitalisations of Aboriginal and Torres Strait Islander people and those expected if they had the same hospitalisation rate as other Australians.

7.9 Identification of Indigenous people in hospital records
Diagram: Identification of Indigenous people in hospital records



In 2003-04, the most common diagnosis for Indigenous Australians was 'care involving dialysis' which is used in the treatment of kidney failure. Indigenous Australians were also commonly hospitalised for injury (e.g. assault and suicide), pregnancy and childbirth (e.g. complications associated with labour and delivery), respiratory diseases (e.g. influenza and pneumonia), digestive diseases (e.g. diseases of the liver, intestines and oral cavity), and mental and behavioural disorders (e.g. schizophrenia and psychoactive substance use). ‘Symptoms, signs and abnormal clinical and laboratory findings' was also a common diagnosis for Indigenous Australians and includes conditions such as convulsions, fever of unknown origin, pain in throat and chest and abdominal and pelvic pain.


Hospitalisation rates for Indigenous Australians were higher than for other Australians for many diagnoses (table 7.10). Indigenous Australians were hospitalised for care involving dialysis at 12 times the rate, and for endocrine, nutritional and metabolic diseases (including diabetes), at three times the rate for other Australians.

7.10 Hospitalisations of Indigenous persons, by principal diagnosis - 2003-04

Principal diagnosis (ICD-10-AM chapter)
Observed hospitalisations
Expected hospitalisations
Ratio(a)

Factors influencing health status and contact with health services
89 710
17 828
5.0
Care involving dialysis (Z49)
81 983
6 816
12.0
Other (Z00-Z99)(b)
7 727
11 012
0.7
Injury, poisoning and certain other consequences of external causes (S00-T98)
17 318
9 234
1.9
Complications of pregnancy, childbirth and the puerperium (O00-O99)
16 783
11 535
1.5
Diseases of the respiratory system (J00-J99)
16 041
7 218
2.2
Diseases of the digestive system (K00-K93)
11 604
13 236
0.9
Mental and behavioural disorders (F00-F99)
9 558
5 475
1.7
Symptoms, signs and abnormal clinical and laboratory findings, n.e.c. (R00-R99)
9 317
6 380
1.5
Diseases of the circulatory system (I00-I99)
7 260
3 864
1.9
Diseases of the genitourinary system (N00-N99)
5 949
5 724
1.0
Diseases of the skin and subcutaneous tissue (L00-L99)
5 230
2 103
2.5
Certain infectious and parasitic diseases (A00-B99)
5 069
2 633
1.9
Endocrine, nutritional and metabolic diseases (E00-E90)
4 291
1 455
2.9
Other
27 129
27 839
0.8
Total
216 142
108 206
2.0

(a) Ratio is observed hospitalisations divided by expected hospitalisations. Expected hospitalisations are based on the age, sex and cause-specific rates for 'Other' Australians.
(b) Excludes care involving dialysis.
AIHW, National Hospital Morbidity Database.



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