Better health and ageing for all Australians

Aboriginal and Torres Strait Islander Health Performance Framework - 2010

1.15 Perceived health status

Up to OATSIH Publications

prev pageTOC |next page

Table of contents

Why is it important?:

Self-assessed health status provides a measure of the overall level of a population’s health based on individuals’ personal perceptions of their own health. Health is recognised as having physical, mental, social and spiritual components. Therefore, the measurement of health must go beyond quantifying levels of morbidity and mortality. Part of this broader approach to measuring health is to ask people to assess the state of their own health.

Self-assessed health status is dependent on an individual’s awareness and expectations regarding their health. Self-assessed health status is influenced by various factors, including access to health services and health information, the extent to which health conditions have been diagnosed, and level of education (Delpierre et al. 2009). Social constructs of health also influence this assessment, such as the culturally distinct view of health and wellbeing held by Aboriginal and Torres Strait Islander peoples, the existing level of health within a community and judgments concerning the person’s own health compared with others in their community.

Self-assessed health status correlates with objective health measures, such as reported long-term health conditions, recent health-related actions, and the presence of a disability. However, there are some inconsistencies in how Aboriginal and Torres Strait Islander peoples report their health status, particularly those for whom English is not their main language. Many Aboriginal and Torres Strait Islander peoples have rated their health as good or excellent despite significant health problems. Self-assessed health status is a useful measure of overall health status, but needs to be interpreted with some caution.

Findings:

In the 2008 NATSISS, 44% of Aboriginal and Torres Strait Islander people aged 15 years and over reported their health as being very good or excellent, 34% reported their health as being good, and 22% reported their health as being poor or fair. These proportions have remained fairly stable since 2002. Older people were less likely than younger people to report very good or excellent health: 58% in the 15–24 years age group compared with 22% in the 55 and over age group. Indigenous females were less likely than Indigenous males to report their health as being very good or excellent (41% compared with 47%).

Aboriginal and Torres Strait Islander people were less likely than non-Indigenous Australians to report very good or excellent health, and the difference between the two populations was greatest in the older age groups. After adjusting for differences in age structure, Aboriginal and Torres Strait Islander people were twice as likely as non-Indigenous Australians to report their health as fair or poor.

The proportion of Aboriginal and Torres Strait Islander people reporting fair or poor health was highest in South Australia and New South Wales (27% and 26% respectively), and lowest in the Northern Territory, Australian Capital Territory and Queensland (18%, 20% and 20% respectively).

Aboriginal and Torres Strait Islander people reporting the presence of long-term health conditions are more likely to report their health as fair or poor. The proportion of Indigenous Australians reporting fair or poor health increases with the number of health conditions reported. A similar pattern can be observed for non-Indigenous Australians.

Poorer perceived health status is associated with a range of determinants of health (see discussion in Key Messages). For example, of Indigenous Australians reporting fair or poor health status, 62% were in the lowest income quintile compared with 3% in the highest quintile, 10% were unemployed compared with 35% who were employed and 47% had completed year 9 or below compared with 14% who had completed Year 12.

Implications:

Aboriginal and Torres Strait Islander people rate their own general health as poorer than that of other Australians across all adult age groups, although the disparities are narrower in the younger age groups. The differences between the two populations are large, which is consistent with other measures of overall health status.

Self-assessed health is one of very few measures of overall health status that are currently available for Aboriginal and Torres Strait Islander peoples throughout the country. The relative consistency of self-assessed health across all jurisdictions and across urban, rural and remote areas suggests that there may not be large variations in overall health status for Indigenous Australians across the country. This would be consistent with some other measures for which national data are available, such as low birthweight (see measure 1.01), for which there is also minimal variation between jurisdictions. However, other measures such as the prevalence of end stage renal disease indicate that there are very large differences in disease incidence between jurisdictions and across remoteness categories (see measure 1.09).

How an individual Aboriginal or Torres Strait Islander person assesses their own health status may also be influenced by how they perceive their health relative to other people, including other Aboriginal and Torres Strait Islander people, around them. There is a similar challenge to develop valid measures for comparing international variations in perceptions of health and health-related experiences (Murray et al. 2003; Salomon et al. 2003). Further research would be valuable to identify the specific issues impacting on perceived health for Indigenous Australians.

Figure 39 – Self-assessed health status (age-standardised percentage) by Indigenous status, persons aged 15 years and over, Australia 2008


Figure 39 – Self-assessed health status (age-standardised percentage) by Indigenous status, persons aged 15 years and over, Australia 2008
Source: ABS and AIHW analysis of 2008 National Aboriginal and Torres Strait Islander Social Survey
Text description of figure 39 (TXT 1KB)

Figure 40 – Self-assessed health status by Indigenous status and age group, persons aged 15 years and over, Australia 2008


Figure 40 – Self-assessed health status by Indigenous status and age group, persons aged 15 years and over, Australia 2008
Source: ABS and AIHW analysis of 2008 National Aboriginal and Torres Strait Islander Social Survey
Text description of figure 40 (TXT 1KB)

Figure 41 – Self-assessed health status, Indigenous Australians aged 15 years and over, by remoteness, Australia 2008


Figure 41 – Self-assessed health status, Indigenous Australians aged 15 years and over, by remoteness, Australia 2008
Source: ABS and AIHW analysis of 2008 National Aboriginal and Torres Strait Islander Social Survey
Text description of figure 41 (TXT 1KB)

Figure 42 – Self-assessed health status by Indigenous status and number of long-term health conditions, age-standardised, Australia 2004–05


Figure 42 – Self-assessed health status by Indigenous status and number of long-term health conditions, age-standardised, Australia 2004–05
Source: ABS and AIHW analysis of 2004–05 National Aboriginal and Torres Strait Islander Health Survey Survey and 2004–05 National Health Survey
Text description of figure 42 (TXT 1KB)

prev pageTOC |next page