Aboriginal and Torres Strait Islander Health Performance Framework (HPF) 2012

Tier 2—Health behaviours—2.18 Physical activity

The HPF was designed to measure the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH) and will be an important tool for developing the new National Aboriginal and Torres Strait Islander Health Plan (NATSIHP).

Page last updated: 15 November 2012

Why is it important?:

Physical inactivity is an important modifiable risk factor associated with several potentially preventable chronic diseases that are prevalent in the Aboriginal and Torres Strait Islander population. These include cardiovascular disease, hypertension and diabetes. Physical inactivity is also related to overweight and obesity, another important risk factor for multiple diseases. Physical inactivity accounted for approximately 6.7% of the total burden of disease in the Australian population and 8% for the Indigenous population (Vos et al. 2007; Begg et al. 2007).

Physical inactivity is the third leading risk factor in the Indigenous population, after tobacco use and high body mass. Its effect is manifested through a range of diseases, most notably ischaemic heart disease (55% of the burden attributed to physical inactivity) and diabetes (33%).

Current guidelines recommend that adults do at least 30 minutes of moderate intensity physical activity on most, preferably all, days; and that children aged 5–18 years do at least 60 minutes per day of moderate to vigorous physical activity (Commonwealth Department of Health and Ageing, n.d). Research has established inverse associations between physical activity with fat mass and biomedical risk factors for chronic disease (Ness et al. 2007; Steele et al. 2009). Studies of the relationship between physical activity and the presence of disease have confirmed that activity reduces the risk for heart disease (Stephenson et al. 2000; Bull et al. 2004), high blood pressure (Kokkinos et al. 2001), diabetes and the symptoms of depression, anxiety and stress (WHO 2008). In the case of diabetes, large scale trials in China, Finland and the United States have shown that a combination of modest weight loss, diet and moderate physical activity can reduce the risk of developing Type 2 diabetes by 50–60% in those at high risk (Bull et al. 2004). Research has established inverse associations between physical activity with fat mass and biomedical risk factors for chronic disease (Ness et al. 2007; Steele et al. 2009). Studies of the relationship between physical activity and the presence of disease have confirmed that activity reduces the risk for heart disease (Stephenson et al. 2000; Bull et al. 2004), high blood pressure (Kokkinos et al. 2001), diabetes and the symptoms of depression, anxiety and stress (WHO 2008). In the case of diabetes, large scale trials in China, Finland and the United States have shown that a combination of modest weight loss, diet and moderate physical activity can reduce the risk of developing Type 2 diabetes by 50–60% in those at high risk (Bull et al. 2004).

Findings:

Between 2001 and 2004–05 there was a noticeable shift towards lower levels of physical activity among Aboriginal and Torres Strait Islander peoples in non-remote areas. The proportion of sedentary Aboriginal and Torres Strait Islander peoples aged 15 years and over increased between those years from 37% to 47%. The proportion reporting a high level of physical activity remained unchanged over this period at 7%.

After adjusting for differences in the age structure of the two populations, Aboriginal and Torres Strait Islander peoples aged 15 years and over in non-remote areas were one and a half times as likely as non-Indigenous Australians to be classified as sedentary in 2004–05. A higher proportion of Indigenous females than Indigenous males were sedentary (51% compared with 42%). The proportion of Indigenous Australians who were sedentary ranged from 37% in Tasmania and the ACT to 51% in NSW.

Sedentary or low levels of physical activity were highest among those aged 45 years and over, while moderate or high levels of physical activity were highest among those aged 15–24 and 25–34 years (32% and 27% respectively). Over three-quarters (78%) of Indigenous people aged 15 years and over who were overweight or obese reported exercising at low or sedentary levels. Most Indigenous current smokers aged 18 years and over (83%) reported low or sedentary exercise levels.

There is a positive association between level of physical activity and self-assessed health status. For Aboriginal and Torres Strait Islander peoples in non-remote areas, the proportion reporting excellent, very good or good health status was 94% for those who engaged in high levels of physical activity and 71% for those who were sedentary.

In the 2008 NATSISS, 74% of Indigenous children aged 4–14 years were physically active for at least 60 minutes every day in the week before the survey. This varied by jurisdiction, with WA and Tasmania having the highest proportion (80%) and the ACT having the lowest (59%).

Implications:

Improving levels of physical activity levels presents a significant opportunity for closing the gap in Indigenous disadvantage, particularly a reduction in deaths from ischaemic heart disease and diabetes. However, individual health behaviours should be interpreted with an understanding of the social and structural factors that put the population at increased risk (OATSIH 2004).

To increase opportunities for physical activity, funding agreements are in place to provide access to a range of sport and physical recreation activities across Australia. These agreements include weekly sports competitions, sports carnivals, small sporting grants, sports equipment, sport and recreation officers and access to sport-specific accreditation (e.g., sports administration, umpiring, coaching). Community-based health promotion initiatives that incorporate traditional games are also being analysed for holistic benefits including cultural connectedness and improved wellbeing (Parker et al. 2006).

The Indigenous Sport and Active Recreation Program supports community participation in sport and active recreation activities that help to improve the health and physical wellbeing of Indigenous Australians and those activities that contribute to broader social benefits for participants and their communities. The program's objectives are to increase the active participation of able and disabled Indigenous Australians in sport and active recreation; encourage and increase community ownership and management of sport and active recreation activities, including through skills development; and provide employment opportunities for people to support or assist in the provision of sport and active recreation activities.

Preventative health is also a key priority area of the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. Under the Agreement, governments are implementing initiatives to help reduce the lifestyle risk factors that contribute to preventable chronic disease. This includes a network of healthy lifestyle workers to promote increased physical activity.

In March 2011, the Swap It Don't Stop It campaign was launched. The campaign has a dedicated page on its website where print advertising relating to swapping sitting for walking more may be downloaded and a radio advertisement may be heard. The webpage also outlines the LiveLonger campaign which delivers physical activity messages specifically for Aboriginal and Torres Strait Islander peoples.Top of Page
Figure 128—Indigenous persons aged 15 years and over, level of physical activity, non-remote areas, 2001 and 2004–05
Figure 128—Indigenous persons aged 15 years and over, level of physical activity, non-remote areas, 2001 and 2004–05
Source: ABS & AIHW analysis of 2004–05 NHS (Indigenous supplement) and 2004–05 NATSIHS
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Figure 129—Persons aged 15 years and over reporting a sedentary level of physical activity, by Indigenous status, sex and age group, non-remote areas, 2004–05
Figure 129—Persons aged 15 years and over reporting a sedentary level of physical activity, by Indigenous status, sex and age group, non-remote areas, 2004–05—Males
Top of PageFigure 129—Persons aged 15 years and over reporting a sedentary level of physical activity, by Indigenous status, sex and age group, non-remote areas, 2004–05—Females
Source: ABS & AIHW analysis of 2004–05 NATSIHS and 2004–05 NHS
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Figure 130—Persons aged 15 years and over, level of physical activity, by Indigenous status, non-remote areas, 2004–05
Figure 130—Persons aged 15 years and over, level of physical activity, by Indigenous status, non-remote areas, 2004–05
Source: ABS & AIHW analysis of 2004–05 NATSIHS and 2004–05 NHS
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Figure 131—Persons aged 15 years and over reporting excellent, very good or good health status, by Indigenous status and level of physical activity, non-remote areas, age-standardised, 2004–05
Figure 131—Persons aged 15 years and over reporting excellent, very good or good health status, by Indigenous status and level of physical activity, non-remote areas, age-standardised, 2004–05
Source: ABS & AIHW analysis of 2004–05 NATSIHS and 2004–05 NHS
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