Better health and ageing for all Australians

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

Tier 2—Person-related factors—2.22 Overweight and obesity

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Why is it important?:

Overweight and obesity is a global health problem. Being overweight or obese increases the risk of suffering from a range of health conditions, including coronary heart disease, Type 2 diabetes, some cancers, knee and hip problems, and sleep apnoea. High body mass accounted for approximately 7.5% of the total burden of disease in the Australian population and 11% for the Indigenous population (Vos et al. 2007; Begg et al. 2007).

Obesity is closely associated with risk factors for the main causes of morbidity and mortality among Aboriginal and Torres Strait Islander peoples (NHMRC 2000). It impacts largely through diabetes, which is responsible for 49% of the burden attributed to high body mass, and ischemic heart disease (40%). Obesity is estimated to contribute 16% of the health gap between Aboriginal and Torres Strait Islander peoples and the total Australian population (Vos et al. 2007).

Findings:

The proportion of Aboriginal and Torres Strait Islander peoples aged 18 years and over living in non-remote areas with a Body Mass Index (BMI, see glossary) score in the overweight or obese range increased from 51% in 1995 to 60% in 2004–05. There was little change between 2001 and 2004–05 in remote areas and for the total Indigenous population.

Indigenous women had higher rates of obesity (34%) and lower rates of overweight (24%) compared to men (28% and 34% respectively). For both Aboriginal and Torres Strait Islander males and females, the rates for overweight/obesity were higher in older age groups, with nearly three quarters of the population aged 55 years and over being overweight or obese.

After adjusting for differences in the age structure of the two populations, Indigenous Australian adults were twice as likely to be obese as non-Indigenous Australian adults.

There are no current data on the prevalence of overweight and obesity among Aboriginal and Torres Strait Islander children. The Australian Aboriginal and Torres Strait Islander Health Survey, to be conducted as part of the Australian Health Survey 2012–13, will collect information on the physical measures of height and weight that will be used to calculate the body mass of children.

Results from the 2004–05 NATSIHS show higher proportions of Torres Strait Islanders in the overweight or obese categories than in the Aboriginal population (61% versus 56%) (ABS 2006b).

Implications:

Given the health risks associated with being obese or overweight, the situation for Aboriginal and Torres Strait Islander peoples requires urgent attention. It is second only to tobacco consumption in terms of contribution of modifiable risk factors to the health gap experienced by Aboriginal and Torres Strait Islander peoples.

In the first instance, arresting the increase in proportions of people who are overweight or obese is a reasonable target. As Australia is ranked as one of the 'fattest developed nations' (DoHA 2008a), this is one measure where it may be unwise to benchmark targets against the non-Indigenous population for the longer term.

Poor eating patterns and lack of physical activity are regarded as the main causes of overweight and obesity (AMA 2005a). Nutrition and physical activity are therefore the areas on which policies should focus.

Reversal of obesity is difficult even in the absence of environmental and social barriers. Therefore, early intervention to prevent the onset of excessive weight gain is likely to be the most effective strategy (McDermott et al. 2000). Clifford et al. (2011) highlighted the poor quality and general lack of intervention studies focusing on healthy lifestyles among Aboriginal and Torres Strait Islander peoples. From the wider literature, studies reporting success in reducing obesity have a number of common characteristics, including: a focus on physical activity and diet opposed to diet alone; the ability to accommodate the preferences of participants; a group focus; and choice between a number of physical activities. Programs must also be culturally acceptable, conveniently located, easily incorporated into the daily schedule and show goal attainment which is realistic and appropriate (Canuto et al. 2011).

The NSFATSIH proposes partnerships with (a) food wholesalers, retailers and Aboriginal and Torres Strait Islander communities to ensure accessibility and affordability of healthy food choices; (b) media, health and education sectors to encourage understanding of nutrition and healthy food choices; and (c) state and territory governments, local councils, private sponsors and sports and recreation bodies to encourage the involvement of Aboriginal and Torres Strait Islander peoples in sport and recreational activities. Partnerships are a key component of the Noongar Healthy Lifestyle Program, which was established by the WA Department of Health in partnership with the WA Police Service, the City of Fremantle, the Department for Communities, local Aboriginal community groups and the local Primary School. The program aims to increase physical activity, healthy eating and intergenerational sharing and includes the creation of new basketball teams and a program of nutrition workshops. A specific focus is also needed for Torres Strait Islander peoples, particularly those living in the Torres Strait Islands area.

Taking Preventative Action, the Australian Government's response to the 2009 National Preventative Health Strategy, committed to ensuring that actions taken to address Australia's obesity problem include specific initiatives to address obesity in the Aboriginal and Torres Strait Islander population. Actions will include whole of community education and social marketing and communication strategies for nutrition. Monitoring of this measure should be in conjunction with measures 2.18 and 2.19.

The National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes comprises a package of health reforms that include a focus on preventive health and primary health care. For example, it includes community education activities to increase awareness of the risk factors for chronic disease, such as poor nutrition and lack of physical activity, as well as improving awareness of, and access to, health care services and programs.Top of Page
Figure 140—Proportion of Aboriginal and Torres Strait Islander adults who were overweight or obese, 1995, 2001 and 2004–05
Figure 140—Proportion of Aboriginal and Torres Strait Islander adults who were overweight or obese, 1995, 2001 and 2004–05

Source: ABS and AIHW analysis 1995 and 2004–05 NATSIHS and 2001 NHS (Indigenous supplement)

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Figure 141—Proportion of adults who were overweight or obese, by Indigenous status and age, 2004–05
Figure 141—Proportion of adults who were overweight or obese, by Indigenous status and age, 2004–05

Source: ABS & AIHW analysis of 2004–05 NATSIHS and 2004–05 NHS

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Figure 142—Proportion of adults (age-standardised) by BMI category and Indigenous status, 2004–05
Figure 142—Proportion of adults (age-standardised) by BMI category and Indigenous status, 2004–05

Source: ABS and AIHW analysis of 2004–05 NATSIHS and 2004–05 N

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Figure 143—Proportion of Indigenous adults by BMI category, by sex, 2004–05
Figure 143—Proportion of Indigenous adults by BMI category, by sex, 2004–05

Source: ABS & AIHW analysis of 2004–05 NATSIHS and 2004–05 NHS

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