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 >> Self-Assessed Health

Self-assessed health status provides an indicator of overall health; it reflects an individual’s perception of his or her own health. As this measure is dependent on an individual’s awareness and expectations regarding their health, it may be influenced by factors such as access to health services and health information. Cunningham and colleagues (1997) examined the robustness of this measure and found that factors such as language spoken and employment status can have an effect on how individuals describe their health.


In the 2002 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) around 42% of Indigenous people aged 18 years or over reported their health as very good or excellent, 33% reported their health as good and 25% reported their health as fair or poor. After adjusting for differences in age structure, Indigenous Australians were twice as likely to report their health as fair or poor than non-Indigenous Australians (graph 7.1) (ABS 2004f). This was similar to estimates from the 2001 National Health Survey (NHS) which showed that, after adjusting for different age structures in the Indigenous and non-Indigenous populations, Indigenous Australians aged 15 years or over were almost twice as likely to report fair or poor health as non-Indigenous Australians (ABS 2002b).

7.1 Self-assessed health status(a), Persons aged 18 years or over - 2002
Graph: Self-assessed health status(a), Persons aged 18 years or over—2002



Indigenous people were more likely to report fair or poor health than non-Indigenous people at all ages, with the exception of those aged 18-24 years (graph 7.2). The proportion of Indigenous people reporting fair or poor health increased with age, from 8% of people aged 18-24 years to 56% of people aged 65 years or over. Indigenous Australians living in remote areas were less likely to report fair or poor health (22%) than those in non-remote areas (27%).

7.2 Persons(a) with fair or poor self-assessed health, by Indigenous status - 2002
Graph: Persons(a) with fair or poor self-assessed health, by Indigenous status—2002



Changes in self-assessed health status between 1994 and 2002

There has been no significant change between 1994 and 2002 in the proportion of Indigenous Australians who reported their health as excellent or very good. There has, however, been a decrease in reported good health overall, and an increase in reported fair or poor health between 1994 and 2002 for both males and females (table 7.3).

7.3 Self-assessed health status, Indigenous persons aged 15 years or over - 1994 and 2002

1994
2002
Males
Females
Persons
Males
Females
Persons

Excellent/very good %
(a)48.8
(a)42.1
(a)45.3
(a)47.1
(a)41.3
(a)44.1
Good %
(a)32.8
40.9
37.1
(a)30.1
34.6
32.4
Fair/poor %
18.1
16.8
17.5
22.5
24.0
23.3
Total(b) no.
102 200
112 400
214 600
135 200
147 000
282 200

(a) Differences between 1994 and 2002 are not statistically significant.
(b) Includes persons who did not report their health status.
ABS, 1994 NATSIS and 2002 NATSISS


The proportion of Indigenous Australians who reported fair or poor health was higher in 2002 (23%) than in 1994 (18%). The Australian Capital Territory had the largest increase in the proportion of people reporting fair or poor health between 1994 and 2002 (6% to 18%), followed by Western Australia (16% to 24%) and Queensland (17% to 24%).


Self-assessed health and socioeconomic factors

Indigenous Australians living in the poorest households (those in the lowest quintile for mean equivalised gross household income per week) were more likely to report fair or poor health than those in households receiving the highest incomes. Indigenous males and females who had completed Year 12 were less likely to report fair or poor health (15% of males and 14% of females) than those who had only completed Year 9 or below (36% of males and 37% of females).


Indigenous males and females who had completed Year 12 or equivalent were twice as likely to report fair or poor health as their non-Indigenous counterparts. However, Indigenous males and females who had only completed Year 9 or below and those in the poorest households (lowest quintile of equivalised gross household income per week) reported only slightly higher levels of fair or poor health than non-Indigenous males and females (table 7.4).

7.4 Socioeconomic characteristics, Indigenous persons aged 18 years or over - 2002

Proportion with fair/poor health
Rate Ratio(a)
Males
Females
Persons
Males
Females
Persons
%
%
%
rate
rate
rate

Equivalised gross household income(b)
Lowest quintile
31.4
32.9
32.3
1.0
1.3
1.2
Second quintile
26.1
24.6
25.3
1.4
1.5
1.5
Third quintile
12.4
22.7
17.7
1.4
2.7
2.1
Fourth quintile
*15.1
10.0
12.8
2.1
1.6
1.9
Fifth quintile
*9.9
*15.9
*13.1
1.8
3.3
2.5
Highest year of school completed(c)
Year 9 or below(d)
35.7
37.3
36.5
1.3
1.4
1.3
Year 10 or 11
17.4
20.3
19.0
1.3
1.7
1.5
Year 12 or equivalent
14.5
13.7
14.1
2.0
1.8
1.9

* estimate has a relative standard error of 25% to 50% and should be used with caution
(a) Rate ratios are the age-standardised rates for Indigenous persons divided by the age-standardised rates for non-Indigenous persons. Rates are directly age-standardised to the 2001 Australian population.
(b) The equivalised gross household weekly income quintile boundaries are based on the equivalised gross household income per week for the total population of Australia (see Glossary).
(c) Excludes persons still at school.
(d) Includes persons who never attended school.
ABS, 2002 NATSISS and 2002 GSS


In 2002, Indigenous males and females who were not in the labour force were more likely to report fair or poor health (48% and 32% respectively) than those who were unemployed (20% of males and 25% of females) or employed (15% of males and 14% of females).


Indigenous people who were unemployed were almost twice as likely to report fair or poor health as non-Indigenous people who were unemployed, while Indigenous people who were employed were more than twice as likely to do so (table 7.5).

7.5 Labour force status, Indigenous persons aged 18-64 years - 2002

Proportion with fair/poor health
Rate Ratio(a)
Males
Females
Persons
Males
Females
Persons
Labour force status
%
%
%
rate
rate
rate

Employed
*14.9
14.2
14.6
2.3
2.6
2.4
Unemployed
20.4
24.6
22.2
1.5
1.9
1.7
Not in the labour force
47.5
31.7
36.7
1.2
1.6
1.4

* estimate has a relative standard error of 25% to 50% and should be used with caution
(a) Rate ratios are the age-standardised rates for Indigenous persons divided by the age-standardised rates for non-Indigenous persons. Rates are directly age-standardised to the 2001 Australian population.
ABS, 2002 NATSISS


Self-assessed health status and family and cultural factors

Indigenous males and females who said they had been removed, as children, from their natural families were more likely to report fair or poor health (39% of males and 41% of females) than those who had not been removed (21% of males and 22% of females). Males and females who said they spoke English as their main language at home were more likely to report fair or poor health (24% of males and 25% of females) than those who spoke an Aboriginal or Torres Strait Islander language at home (13% and 15% of males and females respectively; table 7.6).

7.6 Family and cultural characteristics, Indigenous persons aged 15 years or over - 2002

Proportion with fair or poor health
Males
Females
Persons

NUMBER (no.)

Removal of person from natural family
Has been removed from natural family
4 200
5 300
9 500
Has not been removed from natural family
25 400
28 100
53 600
Recognition of homelands
Recognises homelands
22 400
25 500
47 900
Does not recognise homelands
8 100
9 800
17 900
Identification with clan, tribal or language group
Identifies with clan, tribal/language group
16 900
18 500
35 400
Does not identify with clan, tribal/language group
12 800
16 200
29 000
Main language spoken at home
English
27 900
32 000
59 800
Indigenous language
2 100
2 700
4 800

PROPORTION (%)

Removal of person from natural family
Has been removed from natural family
38.6
41.1
40.0
Has not been removed from natural family
21.4
22.1
21.8
Recognition of homelands
Recognises homelands
23.8
25.0
24.4
Does not recognise homelands
19.7
21.9
20.8
Identification with clan, tribal or language group
Identifies with clan, tribal/language group
22.0
24.3
23.2
Does not identify with clan, tribal/language group
22.9
24.0
23.5
Main language spoken at home
English
23.9
25.4
24.7
Indigenous language
13.4
14.7
14.1

ABS, 2002 NATSISS




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