Adelaide 5000. South Australia, Australia ...... The state can be divided into three regions representing metropolitan (capital city), rural, and remote areas.
South Australian Health & Wellbeing Survey DECEMBER 2000
Eleonora Dal Grande Anne Taylor David Wilson
Centre for Population Studies in Epidemiology South Australian Department of Human Services
ACKNOWLEDGMENTS We would like to acknowledge Edourad d’Espaignet, Alison Daly, Joy Eshpeter, Wilawan Kanjanapan, David Saunders and Gary Starr for their contributions toward the survey. Their direction and support were important in the design of this survey.
This work is copyright. It may be reproduced and CPSE welcomes requests for permission to reproduce in the whole or in part for work, study or training purposes subject to the inclusion of an acknowledgment of the source and no commercial use or sale. CPSE will only accept responsibility for data analyses conducted by CPSE staff or under CPSE supervision.
Published May 2002 by the South Australian Department of Human Services PO Box 6 Rundle Mall Adelaide 5000 South Australia, Australia
National Library of Australia Cataloguing-in-Publication: Dal Grande, E. South Australian health and wellbeing survey : December 2000.
ISBN 0 7308 9181 X. 1. Public health - South Australia. 2. Public welfare South Australia. 3. Health surveys - South Australia. 4. Medical care - South Australia. I. Wilson, David. II. Taylor, Anne, 1950- . III. South Australia. Dept. of Human Services. IV. Title.
362.1099423
In accordance with the Copyright Act 1968 a copy of each book published must be lodged with the National Library and respective deposit libraries in each state.
Further copies of this publication may be purchased from the Centre for Population Studies in Epidemiology (CPSE) or may be downloaded from the CPSE web site: http://www.health.sa.gov.au/pehs/cpse.html.
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TABLE OF CONTENTS EXECUTIVE SUMMARY .................................................................................5 CHAPTER 0: BACKGROUND AND METHODOLOGY ................................11 0.1 Introduction...................................................................................................................... 12 0.1 Survey design .................................................................................................................. 13 0.1 Data collection ................................................................................................................. 15 0.1 Data processing............................................................................................................... 17
CHAPTER 0: DEMOGRAPHIC PROFILE OF RESPONDENTS...................19 0.1 Demographic characteristics ......................................................................................... 20 0.1 ARIA (Accessibility/Remoteness Index of Australia) .................................................. 24
CHAPTER 0: MENTAL HEALTH ..................................................................27 0.1 Introduction...................................................................................................................... 28 0.1 Kessler psychological distress scale............................................................................ 29 0.1 SF-12 ................................................................................................................................. 39 0.4 Self-reported mental health condition........................................................................... 46
CHAPTER 1: HEALTH CONDITIONS ..........................................................53 1.1 Introduction...................................................................................................................... 54 1.2 Diabetes............................................................................................................................ 55 1.3 Arthritis............................................................................................................................. 57 1.4 Heart disease ................................................................................................................... 58 1.5 Stroke................................................................................................................................ 59 1.6 Cancer............................................................................................................................... 61 1.7 Osteoporosis.................................................................................................................... 63 1.8 Asthma.............................................................................................................................. 65 1.9 Other respiratory conditions .......................................................................................... 67 1.10 High cholesterol............................................................................................................. 69 1.11 High blood pressure...................................................................................................... 71 1.12 Injury requiring medical treatment .............................................................................. 73
CHAPTER 2: HEALTH CARE UTILISATION ...............................................75 2.1 Introduction...................................................................................................................... 76 2.2 Used a health service in the last 12 months................................................................. 76 2.3 Spent a night in hospital in the last 12 months............................................................ 80
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CHAPTER 3: HEALTH RISK FACTORS ......................................................83 3.1 Introduction...................................................................................................................... 84 3.2 Physical activity............................................................................................................... 84 3.3 Body Mass Index ............................................................................................................. 93 3.4 Alcohol risk ...................................................................................................................... 96 3.5 Smoking.......................................................................................................................... 101 3.6 Nutrition .......................................................................................................................... 106
CHAPTER 4: HEALTH RELATED ISSUES ................................................111 4.1 Perceived control of life events ................................................................................... 112 4.2 Psychosocial events ..................................................................................................... 116 4.3 Medication use............................................................................................................... 117 4.4 Days off from usual activities....................................................................................... 119 4.5 Limited amount of work done ...................................................................................... 121
REFERENCES ............................................................................................123 APPENDIX 1: STATE/TERRITORY SURVEY COMMITTEES...................125 APPENDIX 2: SERCIS ADVISORY COMMITTEE .....................................127 APPENDIX 3: SA REGION DEFINITIONS.................................................129 APPENDIX 4: LETTER INTRODUCING THE SURVEY ............................133 APPENDIX 5: WA, NT & SA CATI HEALTH AND WELLBEING QUESTIONNAIRE .......................................................................................135
4
EXECUTIVE SUMMARY
Executive summary
In November 2000 a three state population health survey assessing “Health and WellBeing” was conducted in South Australia as well as the Northern Territory and Western Australia. The overall aim of the survey was to demonstrate the capacity of a public health partnership and collaboration between the three participating states and territories and the Commonwealth. In addition, the survey aimed to assess the wellbeing of the populations using a set of standardised and validated instruments; benchmark results against participating states; and finally develop a process that could be used by States wanting to work in collaboration on similar projects. Approximately n=2500 interviews were undertaken in each of the states using the existing CATI (Computer-Assisted Telephone Interviewing) infrastructure in SA to collect the data. Rural and remote areas were over-sampled to provide reasonable estimates for these regions. Issues that were covered included: − Mental health (including the SF12 and Kessler 10), − Health conditions, − Health care utilisation, − Health risk factors (physical activity, BMI, alcohol, smoking, nutrition), − Perceived control of life events, and − Demographics and other social characteristics. In all, 2454 adults (18 years and over) in South Australia were interviewed and the overall response rate was 64%. Using the ARIA classification, 962 adults reside in metropolitan area (highly accessible,), 851 adults reside in rural areas of South Australia (accessible, moderately accessible) 732 adults reside in the remote areas of South Australia (remote, very remote). Reports highlighting state/territory or regional differences are being produced [1]. In addition, Western Australian and the Northern Territory have produced their independent state/territory reports [2,3]. This report summarises on the South Australian findings of the survey. In addition to the main results, analysis was done between metropolitan, rural and remote areas using ARIA classifications. Where possible, trend analysis were made with data from SERCIS surveys conducted between 1997 to 1999 where identical questions were asked. The following dot points highlight the main results.
6
Executive summary
Mental Health • The prevalence of psychological distress determined by the Kessler 10 for South Australia was 12.8%. • Using the SF12, the mean scores for the Physical Component Summary (PCS) and Mental Component Summary (MCS) has remained constant between 1997 and 2000. • Using the self-report measure of mental health condition, (that is, a mental condition confirmed by a medical practitioner in the twelve months prior to the survey, or those who were currently receiving treatment for a mental condition), 12.9% of adults were identified as suffering a mental health condition. People living in rural (10.3%) and remote (9.6%) areas of South Australia had a lower prevalence of a current self-reported diagnosed mental health condition than people living in the metropolitan area (13.5%). There were no difference in the prevalence of current self-reported diagnosed mental health condition between the surveys conducted in 1997 and 2000. Health conditions • 6.2% of respondents in South Australia reported having medically confirmed diabetes. This prevalence rate has been rising since 1997. • 20.5% of South Australians have been told by a doctor that they have arthritis. The prevalence of arthritis has remain constant over the 1997 to 2000 period. The prevalence in remote South Australia (15.5%) was lower than metropolitan (20.6%) and rural (21.1%) South Australia. • The prevalence of adults ever having heart disease was 6.2%, having a stroke was 2.0%, and ever having cancer was 4.8%. • The prevalence of osteoporosis in South Australia was 4.2%. Adults living in rural South Australia (2.4%) had lower rates of osteoporosis (metropolitan was 4.6% and remote SA was 2.8%). The prevalence of osteoporosis has remain constant over the 1997 to 2000 period. • 12.7% of South Australians have been told by a doctor that they have current asthma. The prevalence of current confirmed asthma has been rising since 1997. • 2.6% of South Australia have been told by a doctor they have other respiratory problems such as bronchitis, emphysema, chronic lung diseases, that has lasted six months or more. • The prevalence of ever having high cholesterol was 19.7% and the prevalence of those who still have high cholesterol was 7.5%. The rate of ever having high cholesterol has been rising since 1997.
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Executive summary
•
•
The prevalence of ever having high blood pressure was 22.7% and the prevalence of those who still have high blood pressure was 11.0%. The rate of ever having high blood pressure has been decreasing since 1997. 17.2% of South Australians had an injury in the last 12 months that required medical treatment. There were no differences between rural/remote areas and metropolitan area.
Health care utilisation • 90.6% of South Australians had used a health service in South Australia in the previous 12 months. People living in rural (87.7%) and remote (82.3%) South Australia had a lower proportion of health service use in the previous 12 months than people living in metropolitan areas (91.3%). • 84.6% of South Australians used primary health care services, 6.2% used mental health services, 26.9% used hospital based services and 35.3% used allied health services in the previous 12 months. People living in rural (80.7%) and remote (78.0%) areas of South Australia had a lower proportion of using primary health care services (metropolitan areas was 85.6%). People living in remote South Australia (32.7%) had a higher proportion of using hospital based services in the previous 12 months (metropolitan areas was 26.4%). • The proportion of South Australians who had spent at least one night in a hospital in the previous 12 months was 12.6%: 6.0% spent the night in a private hospital and 6.9% spent the night in a public hospital. People living in remote South Australia (15.9%) had a higher proportion of spending at least one night in a hospital in the previous 12 months. Health risk factors • People who work full time or part time were asked to described the main type of physical activity they do at work. 56.8% mostly sat, 18.3% mostly walked and 21.4% mostly did heavy labour or physically demanding work. People living in the rural (31.1%) and remote (29.7%) areas were more likely to do physically demanding work (metropolitan areas was 19.4%). • In a usual week, 85.2% of South Australians walked for at least 10 minutes at a time, while at work, for recreation, exercise, to get to and from places, or for any other reason, on at least one day in the week. • In a usual week, 87.1 % of South Australians had done moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that caused some increases in breathing or heart rate, on at least one day in the week.
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Executive summary
•
•
•
•
•
•
In a usual week, 33.0% of South Australians had done activities designed to increase muscle strength or tone for at least 10 minutes at a time, such as lifting weights, pull-ups, push-ups or sit ups, on at least one day in the week. In a usual week, 48.2% of South Australians had done vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that caused large increases in breathing or heart rate, on at least one day in the week. The prevalence of people classified as underweight was 9.5%, overweight was 40.9%, and obese was 15.5%. The prevalence of adults who were classified as underweight was lower in the rural (6.5%) and remote areas (6.5%) than metropolitan areas (10.1%). The prevalence of underweight, overweight and obese has remain constant in the 1997 and 2000 period. 3.3% of South Australians were determined to be intermediate to high alcohol risk drinkers. This rate has decreased over the last four years. Rural (5.9%) and remote (6.9%) South Australians had higher proportions of intermediate to high risk alcohol drinkers than people living in metropolitan areas (2.7%). The proportion of household members that smoke inside the home was found to be 12.4%. This rate was higher for people living in rural (15.5%) and remote (15.5%) areas of South Australian (metropolitan areas was 11.7%). 19.9% of adults in South Australia reported that they were current smokers. Remote (26.5%) South Australians had higher proportions of current smokers than people living in metropolitan areas (19.2%).
Perceived control of life events • There were a higher proportion of people living in the remote areas of South Australia who often or always felt a lack of control with their financial situation and their personal life.
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Executive summary
10
CHAPTER 1: BACKGROUND AND METHODOLOGY
Background and methodology
1.1 Introduction Following discussions at National CATI (Computer Assisted Telephone Interviewing) Technical Reference Group meetings, a joint submission from Western Australian (WA), Northern Territory (NT) and South Australia (SA) was submitted to the Commonwealth Department of Health and Aged Care. The proposal was to undertake a three state/territory CATI health and wellbeing survey utilising the already established SA infrastructure. The overall aim of the collaboration was to demonstrate the capacity for a public health survey partnership between the three participating states and territory and the Commonwealth. In particular, the project (nominally called the WANTS survey), aimed to: • Demonstrate a partnership between WA/NT/SA CATI TRG members and the Commonwealth; • Assess the wellbeing of the WA, NT and SA population using a set of standardised and validated instruments; • Benchmark results against participating states; and overall • Develop a process that could be used by States wanting to work in collaboration on similar projects. A management group, comprising Alison Daly (WA), Edouard D’Espaignet (NT), David Wilson and Anne Taylor (SA) and Joy Eshpeter (Commonwealth) was established to oversee the survey process. Each individual state/territory also brought their own research teams and local experts to assist in the design of the questionnaire. The names of those involved are included in Appendix 1. SA conducted the telephone interviewing on behalf of the other states using SERCIS (Social, Environmental and Risk Context Information System) which is a telephone monitoring system designed to provide high quality data on large samples of the South Australian/Australian population. SERCIS is managed within the Centre for Population Studies in Epidemiology Unit of the South Australian Department of Human Services and overseen by an Advisory Committee (Appendix 2). This report summarises the main South Australian findings of the survey.
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Background and methodology
1.2 Survey design 1.2.1 Sample selection All households in SA with a telephone connected and the telephone number listed in the latest version of the EWP (Electronic White Pages) were eligible for selection in the sample. The target number of interviews for South Australia was 2500. In this study, the total number of interviews for South Australia were determined to be distributed as 900 interviews in the metropolitan area, 800 interviews in rural areas, and 800 interviews in remote areas. These geographic regions are defined in Section 1.2.2. The minimum sample size of 800 was necessary to enable populations estimates of health conditions and behaviours to be made with a reasonable confidence intervals. A random sample of the whole state would be representative of the population structure, but health estimates for rural and remote areas would have wide confidence intervals. Such estimates would do little to describe health in the less populated areas of the state. A stratified sample was therefore determined to be the best use of survey resources. As a consequence of the need to over-sample non-metropolitan areas, separate samples were drawn for each of the three geographic regions (metro/rural/remote). These samples represented increasing proportions of the population as remoteness increased. A summary of the target number of interviews as a proportion of the estimated residential population in each region in 1999 is shown in Table 1.1. The estimated residential population figures supplied by the Australian Bureau of Statistics were the most up-to-date available at the time of sampling and were used for these purposes. The initial sample sizes drawn from the EWP were based on the best recent estimates of response rates available to the survey team. Table 1.1 Target interviews by region as a proportion of population size Region
Target interviews
Residential population 18+ *
900
933,554
Rural
800
169,374
0.5%
Remote
800
34,801
2.3%
Metropolitan
sample proportion 0.1%
* Estimated Residential Population – ABS 1999
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Background and methodology
Within each household, the person who had their birthday last was selected for interview. There was no replacement for non-contactable persons. 1.2.2 Definition of geographic regions The state can be divided into three regions representing metropolitan (capital city), rural, and remote areas. The rural and remote areas were substantially less populated than the metropolitan region. Rural and remote areas were a particular focus of the survey in terms of assessing health status and health service planning requirements. Defining remoteness of population locations from health and other services has been an issue of considerable discussion in recent years and has resulted in two classifications: Rural, Remote and Metropolitan Area (RRMA) [4] and the Accessibility/Remoteness Index of Australia (ARIA) [5]. Regions were defined as aggregations of postcode areas in the state. Postcodes were taken as the geographic reference as this was the only reliable location data available in the telephone listing database that could be extrapolated to larger regions. Postcodes are readily translated to SLA's (Statistical Local Areas) in which estimated population numbers are published. This connection between address and ABS data was necessary for weighting of the data to reflect population proportions by age and gender (see Section 1.4.2). Postcode to region lists for South Australia are detailed in Appendix 3. The definitions of regions in South Australia were based on ARIA (Accessibility/Remoteness Index of Australia) codes [5]. ARIA seeks to define remoteness from services in terms of distance by road. All populated locations in Australia are given an ARIA value ranging from 0 for high accessibility to 12 for high remoteness. This index is also available as five categories, which are better suited to classifications such as required by the present study. ARIA categories were used to define regions in SA in the following way: • Highly Accessible (ARIA score 0-1.84) defined metropolitan; • Accessible (ARIA score 1.84-3.51) and Moderately Accessible (ARIA score 3.51-5.80) together defined rural; and • Remote (ARIA score 5.80-9.08) and Very Remote (ARIA score 9.08-12) together defined remote regions. The postcode to region list for SA in Appendix 3 was derived from the postcode to ARIA category specification [6].
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Background and methodology
1.2.3 Introductory letter A letter introducing the health survey (Appendix 4) was sent to the household of each selected telephone number. The letter informed people of the purpose of the survey and indicated that they could expect to be contacted by telephone within the time frame of the survey. 1.2.4 Questions Initial questionnaire design was based on a previous SERCIS survey - the 1997 Mental Health Survey [7]. Modifications were made based on management group discussions and individual state/territory sub-committee recommendations. The full list of questions asked in this survey is contained in Appendix 5. 1.2.5 Pilot testing Before the conduct of the main survey, the questionnaire was pilot tested (n=50). Pilot testing took place from Tuesday 17th October 2000 to Thursday 19 October 2000. Modifications were made to the questionnaire following the debrief on Friday 20th October.
1.3 Data collection Data collection was undertaken by the contacted agency, Harrison Health Research. The survey commenced on 1st November 2000 and concluded on Thursday 21st December. Telephone calls were made between 9:30 am and 9.00 pm, seven days a week. Professional interviewers conducted the interviews and were supervised by Harrison Health Research and SERCIS personnel. Disposition codes were supplied to SERCIS staff daily, or as required, to ensure careful monitoring of survey activities. On contacting the household, the interviewer initially identified themselves and the purpose of the survey.
15
Background and methodology
1.3.1 CATI The CATI III (Computer Assisted Telephone Interview) system was used to conduct the interviews. This system allows immediate entry of data from the interviewer’s questionnaire screen to the computer database. The main advantages of this system are the precise ordering and timing of call backs and correct sequencing of questions as specific answers are given. The CATI system enforces a range of checks on each response with most questions having a set of pre-determined response categories. In addition, CATI automatically rotates response categories, when required, to minimise bias. When open-ended responses were required, these were transcribed exactly by the interviewer. 1.3.2 Call backs At least six call-backs were made to the telephone number selected to interview household members. Different times of the day or evening were scheduled for each call-back. If a person could not be interviewed immediately they were re-scheduled for interview at a time suitable to them. Where a refusal was encountered, another interviewer generally (at the discretion of the supervisor) called later, in an endeavour to obtain the interview(s). Replacement interviews for persons who could not be contacted or interviewed were not permitted. 1.3.3 Validation Of each interviewer’s work, 10% was selected at random for validation by the supervisor. In addition, Harrison Health Research is a member of Interviewer Quality Control Australia (IQCA), a national quality control assurance initiative of the Market Research Society of Australia. Accredited organisations must strictly adhere to rigorous quality assurance requirements and are subject to regular audits by IQCA auditors.
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Background and methodology
1.3.4 Response rate The overall response rate was 63.8%. Initially a sample of 5170 was drawn. Sample loss of 1181 occurred due to non-connected numbers (844), non-residential numbers (153), respondent unavailable (145) and fax/modem connections (39). From the eligible sample of 3989, the response rate and participation rate were calculated as shown in Table 1.2.
Table 1.2: Response rates SA n
%
3989
100.0
Refusals
737
18.5
Non-contact after six attempts
542
13.6
Respondent unable to speak English, Italian, Greek, Croatian, Chinese (traditional and simplified) or Vietnamese
41
1.0
Incapacitated and unable to be interviewed
98
2.5
Terminated interviews
12
0.3
Hearing impaired
14
0.4
Response rate
2545
63.8
Participation rate
2545
73.8
Initial eligible sample
Completed interviews
Response rate = completed interviews / initial eligible sample Participation rate = completed interviews / (initial eligible sample - non-contact after six attempts)
1.4 Data processing 1.4.1 Analysis Raw data from the CATI system were analysed using SPSS Version 10.0. 1.4.2 Weighting The data presented in this report were weighted by age, gender, and probability of selection in the household. Weighting was used to correct for the disproportionality of the sample with respect to the populations of interest. The weights reflect unequal sample inclusion probabilities and compensate for differential non-response. The
17
Background and methodology
adult populations, aged 18 years or over, of South Australia were obtained from the Australian Bureau of Statistics. The most recently available population estimates, being the estimated residential population for 1999, were used. The data were weighted using the ABS data so that the health estimates calculated would be representative of the adult populations of those three states. Probability of selection of the adult in the household was calculated from the number of adults in the household and the number of telephone listings in the EWP that reach the household. As each region involved a discrete sample, these were weighted separately. The estimated residential populations in regions were aggregated from SLA's using the geographic information used to define the regions (see Section 1.2.2). Combined weights to enable state level analyses were constructed from the region weights by applying the sampling proportions in each region. In this way, metropolitan responses, for example, were weighted up slightly and remote responses were weighted down substantially. 1.4.3 Data interpretation The weighting of the data results in occasional rounding effects for the numbers. In all instances the percentages should be the point of reference rather than the actual numbers of respondents. The percentages presented in this report have been processed on the figures pre-rounding. 1.4.4 Comparisons Where possible, comparisons were made between the results of this survey and data obtained in previous SERCIS surveys where identical questions were asked. The χ2 test was used to detect significant differences in the proportion between two SERCIS surveys when the question was only included in two SERCIS surveys. The χ2 for trend test was used to test for significant changes in the proportions over time when the question was included in three or more SERCIS surveys.
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CHAPTER 2: DEMOGRAPHIC PROFILE OF RESPONDENTS
Demographic profile
2.1 Demographic characteristics The primary demographic descriptions of the South Australian sample showing gender, age, and household compositions, are presented in Table 2.1 Table 2.1: Demographic profile - sex, age, household size SA n
%
Gender Male
1244
48.9
Female
1301
51.1
18 to 25 years
312
12.3
25 to 34 years
478
18.8
35 to 44 years
510
20.0
45 to 54 years
457
17.9
55 to 64 years
309
12.1
65 to 74 years
261
10.2
75 years and over
219
8.6
1
363
14.3
2
1521
59.8
3
404
15.9
4 or more
257
10.1
1596
62.7
1
377
14.8
2
394
15.5
3 or more
176
6.9
Not stated
1
0.1
2545
100.0
Age groups
Household size (18 years and over)
Number of children in the household None
Total
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Demographic profile
The demographic descriptions of the samples are continued in Table 2.2. This presents marital status and educational attainment. For those respondents born in Australia, Aboriginal and Torres Strait Islander status is shown. Table 2.2: Demographic profile - marital status, educational attainment, country of birth, Aboriginal or Torres Strait Islander SA n
%
Never married
569
22.3
De facto
134
5.3
Married
Marital status
1526
60.0
Separated
50
2.0
Divorced
107
4.2
Widowed
157
6.2
Not stated
1
0.1
2
0.1
Educational attainment Never attended school Some primary school
35
1.4
Completed primary school
137
5.4
Some high school
948
37.3
Completed high school ie year 12, form 6, HSC
538
21.1
TAFE or Trade Certificate or Diploma
423
16.6
University, CAE or some other tertiary institute degree
452
17.7
11
0.4
Yes
1930
75.9
No
615
24.1
2545
100.0
12
0.6
1918
99.3
1
0.1
1930
100.0
Other Born in Australia
Total Aboriginal or Torres Strait Islander Yes No Refused Total
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Demographic profile
The demographic descriptions continues in Table 2.3, showing work status and occupation. Table 2.3: Demographic profile - work status, lifetime occupation, pension or benefit from DSS SA n
%
Work status Full time employed
1026
40.3
Part time employed
504
19.8
Unemployed
43
1.7
Home duties
286
11.2
Retired
491
19.3
Student
136
5.3
59
2.3
1
0.1
Manager or administrator
306
12.0
Professional
229
9.0
Para-professional
185
7.3
Trades person
233
9.1
Clerk
368
14.4
Sales person or personal service worker
355
13.9
92
3.6
Labourer or related worked
497
19.5
Home duties
181
7.1
Never worked
100
3.9
2545
100.0
Yes
781
51.4
No
726
47.8
12
0.8
1519
100.0
Other Refused Lifetime occupation
Plant or machine operator or driver
Total Received pension or benefit from the Department of Social Security #
Don’t know Total
Note: The ‘other’ category for lifetime occupation has not been re-coded into the existing categories. # Only asked of those who do not work full time.
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Demographic profile
Household financial status is shown in Table 2.4. The questions asked of respondents related to their views on excess discretionary income, and the gross annual income of the household. Table 2.4: Demographic profile - money situation, gross annual household income SA n
%
98
3.8
Have just enough money to get through to the next pay
481
18.9
There is some money left over each week but just spent it
165
6.5
1324
52.0
396
15.5
Don’t know
56
2.2
Refused
27
1.1
Up to $12,000
248
9.8
$12,001 to $20,000
365
14.3
$20,001 to $40,000
454
17.8
$40,001 to $60,000
472
18.5
$60,001 to $80,000
329
12.9
More than $80,000
312
12.3
Not stated / refused
127
5.0
Don’t know
240
9.4
2545
100.0
Money situation Spending more money than getting
Can save a bit every now and then Can save a lot
Gross annual household income
Total
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Demographic profile
2.2 ARIA (Accessibility/Remoteness Index of Australia) The report will highlight analysis by metropolitan, rural and remote using Accessibility/Remoteness Index of Australia (ARIA). This index was developed to define remoteness for rural and remote Australia. ARIA was developed by the Information and Research Branch, Department of health and Aged Care, and the National Key Centre for Social Applications of Geographic Information Systems (GISCA) at the University of Adelaide in 1999 [5,6]. This index of remoteness was to overcome the problems of the Rural, Remote and Metropolitan Area (RRMA) classification which was developed in 1994 [4]. The RRMA was based on statistical local areas (SLAs) as classified in the 1991 Census and population density, distances to large population centres. ARIA was to overcome the limitations of RRMA [6]; 1) the classifications are available only at the SLA level and 2) the boundaries are based on 1991 Census. The ARIA was developed using the methodology underlying the RRMA and Geographical Information Systems (GISCA). The GIS database contained road, locality and service information to “calculate a remoteness index” and “GIS methodology was used to measure remoteness”. Remoteness was defined as assessibility to the four categories of the 201 service centres across Australia and road distances of 11,340 population localities to these service centres. Socio-economic, urban/rural and population size factors were not included in the definition. For each localities, a continuous value was given where 0 means highly accessible and 12 mean highly remote. ARIA values are available at population localities (towns or cities), Censuses Collection Districts (CD), postcode and statistical local area. ARIA can be grouped into five categories: • • •
•
24
Highly Accessible (ARIA score 0-1.84) - locality has “unrestricted access to a wide range of goods, services and opportunities for social interaction”. Accessible (ARIA score 1.84-3.51) - locality has “some restrictions to accessibility of some goods, services and opportunities for social interaction”. Moderately Accessible (ARIA score 3.51-5.80) - locality has “significantly restricted accessibility of goods, services and opportunities for social interaction”. Remote (ARIA score 5.80-9.08) - locality has “very restricted accessibility of goods, services and opportunities for social interaction”.
Demographic profile
•
Very Remote (ARIA score 9.08-12) - locality has “very little accessibility of goods, services and opportunities for social interaction”.
For this survey, the postcode was used to determine the ARIA value. Some postcodes did not have an ARIA value, so the nearest postcode or locality was used (see Appendix 3). In this report, all analyses will be conducted by three ARIA categories: • Metropolitan - highly accessible (ARIA score 0-1.84), • Rural - accessible and moderately Accessible (ARIA score 1.84-5.80), and • Remote - remote and very remote (ARIA score 5.80-12).
The number of adults interviewed for each ARIA category is shown in Table 2.5. Table 2.5: ARIA categories n Metropolitan Adelaide
962
Rural areas of South Australia
851
Remote areas of South Australia
732
Total
2545
25
Demographic profile
26
CHAPTER 3: MENTAL HEALTH
Mental health
3.1 Introduction In this report, the mental health status of respondents is reported using four different methods, namely; • • •
Kessler psychological distress scale; SF-12; and Self-reported mental health condition;
These next sections contain the following for each method: • The description of the method and background explanation for use; • Scoring rational; • Prevalence of having a mental health condition in South Australia using the nominated method; and • Demographic profile of adults with a mental health condition as determined by the nominated method.
28
Mental health
3.2 Kessler psychological distress scale 3.2.1 Description The Kessler psychological distress 10 item scale or K10 was developed to measure anxiety and depressive disorders on a general population [8,9]. The scale has five response categories intended to “yield a global measure of ‘psychosocial distress’ based on questions about the level of anxiety and depressive symptoms in the most recent four-week period” [10]. The answers to each of the individual questions of the Kessler psychological distress scale are listed in Table 3.1. Table 3.1: Kessler psychological distress scale - questions and categories n
%
In the past four weeks, about how often did you feel tired out for no good reason? All of the time
52
2.1
Most of the time
150
5.9
Some of the time
519
20.4
A little of the time
737
29.0
1087
42.7
All of the time
16
0.6
Most of the time
62
2.4
Some of the time
275
10.8
None of the time In the past four weeks, about how often did you feel nervous?
A little of the time
692
27.2
None of the time
1500
58.9
Total
2545
100.0
All of the time
7
0.6
Most of the time
6
0.6
Some of the time
43
4.1
A little of the time
139
13.3
None of the time
851
81.4
1045
100.0
In the past four weeks, about how often did you feel so nervous that nothing could calm you down?
Total
29
Mental health
Table 3.1: Kessler psychological distress scale - questions and categories (cont) n
%
All of the time
32
1.3
Most of the time
25
1.0
Some of the time
114
4.5
A little of the time
332
13.1
2041
80.2
All of the time
31
1.2
Most of the time
69
2.7
Some of the time
392
15.4
A little of the time
846
33.3
None of the time
1207
47.4
Total
2545
100.0
All of the time
20
1.5
Most of the time
29
2.2
Some of the time
168
12.6
A little of the time
378
28.3
None of the time
742
55.5
1338
100.0
All of the time
12
0.5
Most of the time
52
2.0
Some of the time
256
10.1
A little of the time
608
23.9
1617
63.5
66
2.6
In the past four weeks, about how often did you feel hopeless?
None of the time In the past four weeks, about how often did you feel restless or fidgety?
In the past four weeks, about how often did you feel so restless you could not sit still?
Total In the past four weeks, about how often did you feel depressed?
None of the time In the past four weeks, about how often did you feel everything was an effort? All of the time Most of the time
111
4.4
Some of the time
366
14.4
A little of the time
688
27.0
None of the time
1313
51.6
Total
2545
100.0
30
Mental health
Table 3.1: Kessler psychological distress scale - questions and categories (cont) n
%
All of the time
16
0.6
Most of the time
28
1.1
Some of the time
103
4.0
A little of the time
275
10.8
2123
83.4
13
0.5
In the past four weeks, about how often did you feel so sad that nothing could cheer you up?
None of the time In the past four weeks, about how often did you feel worthless? All of the time Most of the time
35
1.4
Some of the time
117
4.6
A little of the time
216
8.5
None of the time
2164
85.0
Total
2545
100.0
3.2.2 Scoring of the Kessler 10 to determine psychological distress The creators of the Kessler 10 have not developed or published details on the scoring of the scale. However, various scoring of Kessler 10 have been developed and are described below. 3.2.3 Kessler scoring method A - anxiety or depressive disorder A scoring of the Kessler 10 have been described by the Clinical Research Unit for Anxiety & Depression (CRUFAD), School of Psychiatry, University of NSW [8]. The response categories are converted to Likert scales but reversed ie value of 1 for “none of the time” to 5 for “all of the time”. These 10 items are summed to give scores ranging between 10 and 50. CRUFAD developed cutoff scores for the Kessler 10 by comparing the score against the CIDI instrument [11]. Both instruments were included in the Australian Survey of Mental Health and Well-being [8,11]. Table 3.2 shows the proportion of respondents in South Australia who were determined to be low or no risk of having anxiety or depressive disorder, medium risk and high risk according to the Kessler 10.
31
Mental health
Overall, 2.2% (95% CI 1.7 - 2.8, n=57) of respondents in South Australia were determined to have a high risk of having anxiety or depressive disorder (Table 3.2). Table 3.2: Anxiety or depressive disorder according to the Kessler 10 n Low or no risk (score of 12 to 15) Medium risk (score of 16 to 29)
1757
69.0 (67.2 - 70.8)
731
28.7 (27.0 - 30.5)
57
2.2 (1.7 - 2.8)
High risk (score of 30 to 50) Total
% (95% CI)
2545
100.0
Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
Table 3.3 contains the three risk levels of anxiety or depressive disorder according to the Kessler 10 for each of South Australian regions. There were no statistically significant differences in the proportion of respondents with high risk of anxiety or depressive disorder between the regions. Table 3.3: Anxiety or depressive disorder according to the Kessler 10 Metropolitan
Rural
Remote
n
% (95% CI)
n
% (95% CI)
n
% (95% CI)
Low or no risk
660
68.6 (65.7 - 71.5)
607
71.4 (68.3 - 74.4)
505
69.0 (65.7 - 72.4)
Medium risk
280
29.1 (26.3 - 32)
228
26.8 (23.8 - 29.7)
204
27.8 (24.6 - 31.1)
22
2.3 (1.3 - 3.2)
16
1.9 (1.0 - 2.8)
23
3.2 (1.9 - 4.4)
High risk Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ2 test, p < 0.05) than state overall figure Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
The following table (Table 3.4) shows the demographic profile of people with high risk of anxiety or depressive disorder for South Australia. The demographic profile of people with high risk of anxiety or depressive disorder was not undertaken for each of the South Australian regions because of insufficient numbers.
32
Mental health
Table 3.4: High risk of anxiety or depressive disorder according to the Kessler 10 by demographic variables Variable
South Australia n
%
Gender Male Female
29 27
2.3 2.1
Age group (years) 18 to 34 years 35 to 44 years 45 to 54 years 55 to 64 years 65 or more years
6 15 16 10 10
0.7 ⇓ 2.9 3.5 3.2 2.1
Household size (18 years and over) 1 adult 2 adults 3 or more adults
15 30 12
4.2 ⇑ 1.9 1.8
Number of children (less than 18 years) No children 1 or more children
43 13
2.7 1.4
Marital Status Married/De Facto Separated/Divorced Widowed Never Married
35 6 16
2.1 3.9 2.8
Highest educational qualification obtained Secondary Trade/Apprenticeship/Certificate/ Diploma Degree or higher
37 13 6
2.2 3.1 1.4
Country of birth Australia Overseas
41 15
2.1 2.5
Region overall
57
2.2
⇑ ⇓ Statistically significantly higher or lower (χ2 test, p < 0.05) than overall region figure # Insufficient numbers for statistical test Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
33
Mental health
Table 3.4: High risk of anxiety or depressive disorder according to the Kessler 10 by demographic variables (cont) Variable
South Australia n
%
Work status Employed full time Employed part time Unemployed Home duties, student, retired or other
9 8 2 38
0.9 ⇓ 1.5 4.2 # 3.9
Lifetime occupation Manager, professional, para-professional Trades person, clerk, sales person or personal service worker Plant or machine operator or driver, labourer or related worker Home duties, never worked
16 18 13 9
2.2 1.9 2.3 3.3
Money situation Spending more money than getting Have just enough money to get through to next pay There is some money left over each week but just spent it Can save a bit every now and then Can save a lot Don’t know / not stated
5 23 4 17 4 4
4.7 4.8 2.4 1.3 1.0 4.8
Gross annual household income Less than $20,000 $20,000 to < $40,000 $40,001 to < $80,000 $80,001 or more Not stated
29 6 9 4 10
4.7 ⇑ 1.3 1.1 1.2 # 2.6
Region overall
57
2.2
Receive Pension or Benefit (if not employed) Yes No
26 22
3.3 2.9
⇑ ⇓ Statistically significantly higher or lower (χ2 test, p < 0.05) than overall region figure # Insufficient numbers for statistical test Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
34
⇑ # # #
Mental health
3.2.4 Kessler scoring method B - psychological distress An alternative scoring of the Kessler 10 have been used in the NSW Health 1997 and 1998 Survey reports [10]. Similar to the previous method, the response categories are converted to Likert scales but reversed ie value of 1 for “none of the time” to 5 for “all of the time”. These 10 items are summed to give scores ranging between 10 and 50 and are then converted to a ‘T-score’ by subtracting the mean of the score and dividing by the standard deviation of the score. These scores were then standardised with a mean of 50 and standard deviation of 10.
K10 standardised =
(K10 summed items - mean (K10 summed items))
x 10 - 50
Standard deviation (K10 summed items)
The cutoff was determined by taking one standard deviation above the mean, value of 60 to determine a high level of psychological distress. Overall, 12.8% (95% CI 11.514.2, n=326) of respondents reported having psychological distress according to the Kessler 10 (Table 3.5). Table 3.5: Psychological distress according to the Kessler 10 n
%
No
2219
87.2
Yes
326
12.8
Total
2545
100.0
Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
3.2.5 Kessler 10 by demographic variables and region The prevalence of psychological distress determined by the Kessler 10 for each of the South Australian regions is shown in Table 3.6. There were no statistically significantly differences in the proportion of respondents with psychological distress between the regions.
35
Mental health
Table 3.6: Prevalence of psychological distress in South Australia by region Metropolitan n
Rural
% (95% CI)
n
% (95% CI)
Remote n
% (95% CI)
Yes
127
13.2 (11.2 - 15.5)
92
10.8 (8.8 - 13.3)
97
13.2 (10.9 - 16.0)
No
835
86.8 (84.4 - 88.8)
759
89.2 (86.9 - 91.2)
635
86.8 (84.0 - 89.1)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ2 test, p < 0.05) than state overall figure Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
Figure 3.1: Proportion of people with psychological distress in South Australia by region 18 16 Proportion
14 12 10 8 6 4 2 0 SA State
36
Metropolitan
Rural
Remote
Mental health
Table 3.7: Psychological distress in South Australia by demographic variables and region Variable
Metropolitan n
%
Rural n
Remote %
n
%
Gender Male Female
60 66
12.9 13.4
42 50
9.8 11.9
36 61
9.3 17.7
Age group (years) 18 to 24 years 25 to 34 years 35 to 44 years 45 to 54 years 55 to 64 years 65 to 74 years 75 or more years
15 22 21 23 17 14 14
12.5 12.1 11.1 13.4 14.6 14.2 17.3
5 12 24 22 16 7 6
6.1 8.2 13.6 14.4 13.4 7.1 8.0
17 27 20 16 7 9 1
20.7 17.3 11.9 12.4 7.3 15.2 2.4 #
Household size (18 years and over) 1 adult 2 adults 3 adults 4 or more adults
27 64 28 8
19.6 ⇑ 11.5 17.2 7.3 ⇓
16 58 15 3
13.2 9.9 14.8 7.9 #
11 68 17 1
11.4 14.0 14.5 1.6 #
Number of children (less than 18 years) No children 1 or more children
85 41
13.9 11.8
48 45
9.5 12.8
56 41
14.0 12.3
Marital Status Married/De Facto Separated/Divorced Widowed Never Married
75 12 9 31
12.2 19.2 14.7 13.8
69 9 4 11
11.1 17.8 8.2 # 7.9
59 12 2 24
11.2 27.7 ⇑ 6.8 # 18.0
89
14.5
74
11.7
70
13.6
15 22
9.3 12.0
12 7
8.8 7.6
23 4
16.7 4.8 #
89
12.8
78
10.5
87
13.4
37
14.4
5 9
127
13.2
92
Highest educational qualification obtained Secondary Trade/Apprenticeship/Certificate/ Diploma Degree or higher Country of birth Australia - non-Aboriginal & Torres Strait Islander Australia - Aboriginal & Torres Strait Islander Overseas Region overall
42.1 ⇑ 9.3 10.8
1 9 97
13.5 # 11.9 13.2
⇑ ⇓ Statistically significantly higher or lower (χ2 test, p < 0.05) than overall region figure # Insufficient numbers for statistical test Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
37
Mental health
Table 3.7: Psychological distress in South Australia by demographic variables and region (cont) Variable
Metropolitan n
Work status Employed full time Employed part time Unemployed Home duties, student, retired or other Lifetime occupation Manager, professional, paraprofessional Trades person, clerk, sales person or personal service worker Plant or machine operator or driver, labourer or related worker Home duties, never worked Money situation Spending more money than getting Have just enough money to get through to next pay There is some money left over each week but just spent it Can save a bit every now and then Can save a lot Don’t know / not stated Gross annual household income Less than $20,000 $20,000 to < $40,000 $40,001 to < $80,000 $80,001 or more Not stated Region overall Receive Pension or Benefit (if not employed) Yes No
%
Rural n
Remote %
%
28 25 4 69
7.3 ⇓ 13.2 37.3 # 18.5 ⇑
19 17 4 51
5.7 ⇓ 10.8 15.5 # 15.7 ⇑
23 19 12 42
7.8 ⇓ 12.4 33.6 ⇑ 17.5
25
10.8
13
7.9
16
12.4
47
11.5
31
10.2
28
10.5
34 21
15.8 19.9 ⇑
32 17
11.4 15.0
38 14
15.6 16.3
10
29.3 ⇑
8
20.0
17
34.0
41
22.5 ⇑
37
23.2 ⇑
24
16.9
8 51 8 8
12.6 10.1 5.8 ⇓ 28.0
6 32 9 -
12.5 7.8 5.7 ⇓ -
8 35 7 6
21.8 9.7 6.0 ⇓ 24.6
44 22 33 6 21
19.7 ⇑ 13.1 10.7 5.1 ⇓ 15.1
42 21 12 8 9
17.8 ⇑ 13.0 4.9 9.2 7.5
33 20 19 8 18
18.6 ⇑ 14.1 9.4 6.6 18.2
127
13.2
92
10.8
97
13.2
48 50
16.6 17.7
46 27
16.0 ⇑ 11.8
41 32
19.3 ⇑ 14.9
⇑ ⇓ Statistically significantly higher or lower (χ2 test, p < 0.05) than overall region figure # Insufficient numbers for statistical test Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
38
n
Mental health
3.3 SF-12 3.3.1 Description The Short Form 12 (SF-12) health status measure was developed in the United States by the Medical Outcomes Study. It is a subset of the SF-36 and is a valid measure of health status in Australia [12]. The scoring of the SF-12 was done as specified in the SF-12 scoring manual [13]. The SF-12 consists of 12 questions addressing quality of life issues, which were aggregated into two summary scales: • the physical component summary scale (PCS), in which a higher score indicates better physical health; and • the mental component summary scale (MCS), in which a higher score indicates better mental health; and The two scores range between 0 and 100. The two summary scales (physical and mental) can be used to compare respondents with and without conditions or experiences. The summary scales of the SF-12 are based on fewer items than the same scales determined by the SF-36. The literature shows some loss of precision when using the shorter version, but this is offset by considerable saving in survey time and costs. The SF-12 was therefore considered a good alternative instrument for this survey. 3.3.2 PCS and MCS summary statistic All respondents were asked the SF-12 questions. Table 3.8 shows the mean scores, with 95% confidence intervals, for the two summary scales of the SF-12. The mean scores of the PCS and MCS has remained constant over the last four years. Table 3.8: Mean scores for the SF-12 summary scales by year of survey Physical component summary (PCS)
Mental component summary (MCS)
n
Mean (95% CI)
Mean (95% CI)
1997 July [7]
2501
49.8 (49.4 - 50.2)
52.1 (51.8 - 52.4)
Year of survey 1998 May [14]
3001
48.8 (48.4 - 49.2)
52.3 (52.0 - 52.6)
1998 October [15]
3003
49.4 (49.0 - 49.7)
52.2 (51.9 - 52.5)
2000 December
2545
49.2 (48.9 - 49.6)
52.3 (51.9 - 52.6)
39
Mental health
Figure 3.2: Mean scores for the SF-12 summary scales by year of survey 53
Mean score
52 51
PCS
50
MCS
49 48 47 46 1997
1998
1999
2000
Year
Note: 1998 figure is the average of the two surveys conducted in 1998.
3.3.3 PCS score by demographic variables and region Table 3.9 shows the mean scores, 95% confidence interval of the mean, standard deviation of the mean, and standard error of the mean for the physical summary scale of the SF-12 by various demographic variables. Higher mean scores indicate better overall physical health.
40
Mental health
Table 3.9: PCS score by demographic variables and region Variable Gender Male Female Age group (years) 18 to 24 years 25 to 34 years 35 to 44 years 45 to 54 years 55 to 64 years 65 to 74 years 75 or more years Household size (18 years and over) 1 adult 2 adults 3 adults 4 or more adults Number of children (less than 18 years) No children 1 or more children Marital Status Married/De Facto Separated/Divorced Widowed Never Married Highest educational qualification obtained Secondary Trade/Apprenticeship/ Certificate/ Diploma Degree or higher Country of birth Australia - non-Aboriginal & Torres Strait Islander Australia - Aboriginal & Torres Strait Islander Overseas Total
Metropolitan
Rural
Remote
n
Mean (95% CI)
n
Mean (95% CI)
n
Mean (95% CI)
466
49.3 (48.5 - 50.2)
429
48.5 (47.6 - 49.5)
388
49.8 (48.8 - 50.7)
496
49.3 (48.4 - 50.2)
422
49.0 (48.1 - 50.0)
344
49.3 (48.3 - 50.3)
123 181
53.7 (52.5 - 55.0) ⇑ 52.7 (51.6 - 53.8) ⇑
84 151
54.3 (53.5 - 55.1) ⇑ 53.0 (52.0 - 54.0) ⇑
81 159
52.1 (50.6 - 53.6) ⇑ 52.4 (51.4 - 53.5) ⇑
191 172
51.1 (49.9 - 52.4) ⇑ 49.3 (47.8 - 50.7)
175 156
50.6 (49.2 - 51.9) ⇑ 49.2 (47.7 - 50.7)
164 130
50.7 (49.4 - 51.9) 49.6 (47.9 - 51.3)
114 98
46.7 (44.9 - 48.6) ⇓ 44.5 (42.3 - 46.6) ⇓
116 95
44.4 (42.4 - 46.4) ⇓ 45.6 (43.4 - 47.7) ⇓
89 61
48.2 (45.9 - 50.5) 43.6 (40.7 - 46.5) ⇓
83
40.6 (38.2 - 43.1) ⇓
74
39.7 (37.1 - 42.2) ⇓
48
41.9 (38.9 - 44.9) ⇓
138
45.3 (43.3 - 47.3) ⇓
118
45.0 (42.9 - 47.0) ⇓
100
47.0 (44.8 - 49.2) ⇓
555 160
49.6 (48.8 - 50.4) 50.5 (49.0 - 52.0)
591 101
48.9 (48.1 - 49.7) 51.3 (49.8 - 52.9) ⇑
488 114
49.4 (48.6 - 50.3) 51.2 (49.6 - 52.8)
108
51.2 (49.6 - 52.9)
41
52.0 (50.1 - 53.9) ⇑
29
54.2 (53.3 - 55.2) ⇑
613 349
48.0 (47.2 - 48.9) ⇓ 51.7 (50.8 - 52.5) ⇑
502 349
46.7 (45.7 - 47.6) ⇓ 51.8 (51.0 - 52.6) ⇑
400 332
47.8 (46.8 - 48.8) ⇓ 51.7 (50.9 - 52.5) ⇑
613
49.4 (48.7 - 50.2)
618
48.9 (48.1 - 49.6)
521
49.6 (48.8 - 50.4)
60 31
45.6 (42.6 - 48.6) ⇓ 40.4 (37.4 - 43.3) ⇓
48 48
47.4 (44.2 - 50.7) 40.9 (37.6 - 44.3) ⇓
44 35
47.1 (43.2 - 51.0) 43.8 (39.8 - 47.9) ⇓
227
52.4 (51.3 - 53.5) ⇑
137
51.5 (50.2 - 52.9) ⇑
132
51.8 (50.5 - 53.1) ⇑
615
48.5 (47.7 - 49.3)
631
48.4 (47.6 - 49.2)
518
48.9 (48.1 - 49.7)
161
48.8 (47.2 - 50.3)
131
49.3 (47.8 - 50.8)
136
50.1 (48.6 - 51.7)
186
52.4 (51.4 - 53.4) ⇑
89
51.0 (4.09 - 52.9) ⇑
78
52.8 (51.2 - 54.5) ⇑
700
49.9 (49.2 - 50.6)
739
49.0 (48.3 - 49.7)
649
49.8 (49.1 - 50.5)
51.8 (34.1 - 69.6)
13
46.8 (38.6 - 55.0)
5
47.2 (35.0 - 59.5)
259
3
47.7 (46.4 - 49.0) ⇓
98
47.2 (45.1 - 49.3)
78
47.4 (44.9 - 49.9)
962
49.3 (48.7 - 49.9)
851
48.8 (48.1 - 49.4)
732
49.6 (48.9 - 50.2)
41
Mental health
Table 3.9: PCS score by demographic variables and region (cont) Variable
Work status Employed full time Employed part time Unemployed Home duties, student, retired or other Lifetime occupation Manager, professional, para-professional Trades person, clerk, sales person or personal service worker Plant or machine operator or driver, labourer or related worker Home duties, never worked Money situation Spending more money than getting Have just enough money to get through to next pay There is some money left over each week but just spent it Can save a bit every now and then Can save a lot Don’t know / not stated Gross annual household income Less than $20,000 $20,000 to < $40,000 $40,001 to < $80,000 $80,001 or more Not stated Total Receive Pension or Benefit (if not employed) Yes No
Metropolitan
Rural
n
Mean (95% CI)
n
Mean (95% CI)
389
52.1 (51.4 - 52.8) ⇑
336
52.3 (51.7 - 53.0) ⇑
302
51.9 (51.1 - 52.7) ⇑
191 12
50.9 (49.7 - 52.0) ⇑ 50.2 (45.6 - 54.8)
161 29
50.3 (49.1 - 51.5) 47.7 (43.9 - 51.4)
156 37
51.2 (50.0 - 52.4) ⇑ 47.3 (42.9 - 51.6)
370
45.6 (44.3 - 46.8) ⇓
324
44.4 (43.1 - 45.7) ⇓
237
45.9 (44.4 - 47.3) ⇓
409
50.8 (49.7 - 51.8)
159
50.0 (48.5 - 51.4)
130
50.3 (48.7 - 51.9)
215
50.0 (49.0 - 50.9)
302
48.7 (47.6 - 49.9)
267
50.4 (49.4 - 51.4)
104
47.2 (45.7 - 48.6) ⇓
276
48.4 (47.3 - 49.6)
247
48.8 (47.5 - 50.1)
93
47.9 (45.6 - 50.3)
113
48.0 (46.1 - 49.9)
89
48.1 (45.8 - 50.3)
34
49.4 (45.6 - 53.2)
41
48.5 (45.1 - 51.9)
49
49.3 (46.9 - 51.7)
n
Mean (95% CI)
181
46.9 (45.2 - 48.6) ⇓
161
46.5 (44.8 - 48.2)
141
46.3 (44.3 - 48.3)
65
52.0 (50.0 - 53.9) ⇑
45
51.0 (48.9 - 53.2)
37
51.9 (49.5 - 54.3)
48.4 (47.5 - 49.4)
359
50.1 (49.1 - 51.0)
507
49.0 (48.1 - 49.8)
416
146
51.9 (50.8 - 53.0) ⇑
149
51.0 (49.6 - 52.5)
122
52.4 (51.4 - 53.4) ⇑
38
50.7 (47.9 - 53.6)
25
43.9 (39.0 - 48.8) ⇓
29
51.8 (48.8 - 54.8)
225
44.0 (42.4 - 45.6) ⇓
238
43.6 (42.1 - 45.0) ⇓
176
45.1 (43.3 - 46.9) ⇓
169 308
47.9 (46.4 - 49.3) 52.3 (51.4 - 53.1) ⇑
161 249
49.6 (48.2 - 51.1) 51.9 (51.0 - 52.8) ⇑
140 203
49.8 (48.5 - 51.1) 51.9 (50.9 - 52.9) ⇑
120 140
52.7 (51.5 - 53.9) ⇑ 50.2 (48.7 - 51.8)
89 115
51.4 (49.7 - 53.1) ⇑ 49.4 (47.5 - 51.3)
116 97
53.1 (52.1 - 54.1) ⇑ 48.2 (46.2 - 50.2)
962
49.3 (48.7 - 49.9)
851
48.8 (48.1 - 49.4)
732
49.6 (48.9 - 50.2)
291
44.3 (43.0 - 45.7) ⇓
286
44.2 (42.9 - 45.6) ⇓
213
45.0 (43.4 - 46.5) ⇓
282
50.6 (49.5 - 51.7) ⇑
229
49.2 (47.9 - 50.5)
218
50.8 (49.6 - 51.9)
⇑ ⇓ Statistically significantly higher or lower (χ2 test, p < 0.05) than overall region figure # Insufficient numbers for statistical test Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
42
Remote
Mental health
3.3.4 MCS score by demographic variables and region Table 3.10 shows the mean scores, 95% confidence interval of the mean, standard deviation of the mean, and standard error of the mean for the mental summary scale of the SF-12 by various demographic variables. Higher mean scores indicate better overall mental health.
43
Mental health
Table 3.10: MCS score by demographic variables and region Variable Gender Male Female Age group (years) 18 to 24 years 25 to 34 years 35 to 44 years 45 to 54 years 55 to 64 years 65 to 74 years 75 or more years Household size (18 years and over) 1 adult 2 adults 3 adults 4 or more adults Number of children (less than 18 years) No children 1 or more children Marital Status Married/De Facto Separated/Divorced Widowed Never Married Highest educational qualification obtained Secondary Trade/Apprenticeship/Certif icate/ Diploma Degree or higher Country of birth Australia - non-Aboriginal & Torres Strait Islander Australia - Aboriginal & Torres Strait Islander Overseas Total
44
Metropolitan
Rural
Remote
n
Mean (95% CI)
n
Mean (95% CI)
n
Mean (95% CI)
466
53.1 (52.3 - 53.8)
429
53.9 (53.2 - 54.7)
388
53.2 (52.4 - 54.0)
496
51.1 (50.4 - 51.9)
422
52.7 (51.8 - 53.5)
344
51.3 (50.3 - 52.3)
123 181
50.5 (49.0 - 52.0) 51.6 (50.3 - 52.8)
84 151
55.2 (54.0 - 56.3) ⇑ 53.5 (52.4 - 54.6)
81 159
51.6 (49.7 - 53.6) 52.0 (50.6 - 53.3)
191 172
51.3 (50.1 - 52.5) 52.2 (50.9 - 53.5)
175 156
51.7 (50.4 - 53.0) ⇓ 51.7 (50.4 - 53.1) ⇓
164 130
51.6 (50.3 - 52.9) 51.3 (49.7 - 53.0)
114 98
53.0 (51.3 - 54.7) 53.1 (51.2 - 55.0)
116 95
53.5 (52.0 - 55.1) 54.1 (52.6 - 55.7)
89 61
53.3 (51.6 - 55.0) 53.9 (51.5 - 56.3)
83
54.5 (52.6 - 56.3) ⇑
74
56.5 (54.7 - 58.2) ⇑
48
56.1 (54.3 - 58.0) ⇑
138
50.9 (49.2 - 52.6)
118
51.2 (49.3 - 53.1) ⇓
100
53.2 (51.3 - 55.1)
555 160
52.6 (51.9 - 53.3) 51.3 (50.0 - 52.7)
591 101
53.5 (52.9 - 54.2) 53.5 (51.9 - 55.1)
488 114
52.1 (51.3 - 52.9) 52.2 (50.7 - 53.8)
108
52.1 (50.7 - 53.6)
41
55.3 (54.2 - 56.5)
29
54.2 (52.1 - 56.3)
613 349
52.4 (51.7 - 53.1) 51.5 (50.6 - 52.4)
502 349
53.9 (53.2 - 54.6) 52.5 (51.7 - 53.4)
400 332
52.9 (52.0 - 53.8) 51.7 (50.8 - 52.6)
613
52.7 (52.0 - 53.3)
618
53.6 (53.0 - 54.2)
521
52.7 (52.0 - 53.3)
60 31
49.6 (47.0 - 52.3) ⇓ 54.4 (52.4 - 56.5) ⇑
48 48
48.1 (44.8 - 51.4) ⇓ 53.0 (50.3 - 55.7)
44 35
47.5 (43.4 - 51.6) ⇓ 54.9 (52.0 - 57.7)
227
50.5 (49.3 - 51.7) ⇓
137
54.1 (52.8 - 55.3)
132
52.1 (50.5 - 53.6)
615
51.9 (51.2 - 52.6)
631
53.3 (52.6 - 53.9)
518
52.7 (51.9 - 53.4)
161
53.1 (51.8 - 54.3)
131
53.7 (52.4 - 55.0)
136
50.8 (49.2 - 52.4)
186
51.8 (50.7 - 52.9)
89
53.0 (51.5 - 54.6)
78
52.7 (50.9 - 54.5)
700
52.1 (51.5 - 52.7)
739
53.3 (52.7 - 53.9)
649
52.5 (51.9 - 53.2)
3
60.5 (59.3 - 61.7)
13
50.9 (46.4 - 55.4)
5
45.5 (26.5 - 64.6)
259
52.0 (50.8 - 53.1)
98
53.6 (52.0 - 55.2)
78
51.3 (49.1 - 53.5)
962
52.1 (51.5 - 52.6)
851
53.3 (52.8 - 53.8)
732
52.3 (51.7 - 53.0)
Mental health
Table 3.10: MCS score by demographic variables and region (cont) Variable
Work status Employed full time Employed part time Unemployed Home duties, student, retired or other Lifetime occupation Manager, professional, para-professional Trades person, clerk, sales person or personal service worker Plant or machine operator or driver, labourer or related worker Home duties, never worked
Metropolitan
Rural
Remote
n
Mean (95% CI)
n
Mean (95% CI)
n
Mean (95% CI)
389 191
52.9 (52.2 - 53.7) 52.0 (51.0 - 53.1)
336 161
53.6 (52.9 - 54.4) 53.1 (52.0 - 54.2)
302 156
53.1 (52.2 - 54.0) 52.0 (50.7 - 53.3)
12
47.6 (40.4 - 54.8)
29
52.7 (49.2 - 56.2)
37
46.3 (42.9 - 49.8) ⇓
370
51.3 (50.3 - 52.4)
324
53.1 (52.1 - 54.1)
237
52.5 (51.3 - 53.7)
409
52.6 (51.5 - 53.6)
159
53.3 (52.1 - 54.5)
130
51.9 (50.3 - 53.5)
215
52.2 (51.4 - 53)
302
53.6 (52.7 - 54.4)
267
51.6 (50.5 - 52.6)
104
52.6 (51.5 - 53.8)
276
53.2 (52.2 - 54.2)
247
53.3 (52.3 - 54.4)
93
49.4 (47.3 - 51.4) ⇓
113
52.8 (51.2 - 54.5)
89
52.5 (50.7 - 54.4)
34
47.1 (43.2 - 51.0) ⇓
41
48.4 (45.5 - 51.2) ⇓
49
46.7 (43.7 - 49.7) ⇓
181
49.2 (47.7 - 50.6) ⇓
161
50.2 (48.6 - 51.8) ⇓
141
51.4 (49.9 - 52.8)
65
52.7 (50.6 - 54.9)
45
54.3 (52.3 - 56.3)
37
52.7 (50.6 - 54.8)
507
52.8 (52.1 - 53.5)
416
54.3 (53.6 - 55.0)
359
53.1 (52.2 - 54.0)
146 29
54.0 (52.9 - 55.1) ⇑ 51.7 (47.8 - 55.6)
149 38
54.5 (53.4 - 55.5) ⇑ 55.2 (53.4 - 57.0)
122 25
53.5 (52.0 - 55.0) 51.6 (48.7 - 54.5)
225 169
50.8 (49.4 - 52.1) ⇓ 52.6 (51.3 - 53.8)
238 161
51.7 (50.4 - 53.0) ⇓ 53.1 (51.8 - 54.4)
176 140
52.1 (50.6 - 53.5) 51.7 (50.2 - 53.2)
308 120
52.0 (51.1 - 52.9) 53.4 (52.1 - 54.7)
249 89
54.0 (53.1 - 54.8) 54.4 (53.2 - 55.5)
203 116
53.0 (52.0 - 54.0) 52.9 (51.5 - 54.3)
140
52.6 (51.2 - 54.1)
115
54.6 (53.3 - 55.8)
97
51.7 (49.7 - 53.7)
Total
962
52.1 (51.5 - 52.6)
851
53.3 (52.8 - 53.8)
732
52.3 (51.7 - 53.0)
Receive Pension or Benefit (if not employed) Yes No
291 282
51.9 (50.8 - 53.0) 51.1 (50.0 - 52.1)
286 229
52.7 (51.7 - 53.8) 53.6 (52.6 - 54.6)
213 218
52.3 (51.0 - 53.7) 51.2 (50.1 - 52.4)
Money situation Spending more money than getting Have just enough money to get through to next pay There is some money left over each week but just spent it Can save a bit every now and then Can save a lot Don’t know / not stated Gross annual household income Less than $20,000 $20,000 to < $40,000 $40,001 to < $80,000 $80,001 or more Not stated
⇑ ⇓ Statistically significantly higher or lower (χ2 test, p < 0.05) than overall region figure # Insufficient numbers for statistical test Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
45
Mental health
3.4 Self-reported mental health condition 3.4.1 Mental health condition diagnosed in the last 12 months Respondents were asked if, in the last 12 months, they had been told by a doctor that they had any specified mental health conditions. These responses, by the specified conditions, are presented in Table 3.11. Overall, 12.5% (95% CI 10.8-13.4, n=307) of the respondents were diagnosed with a mental health condition in the last 12 months. There were no statistically significant differences in the respondents who had any mental health conditions in the last 12 months between the 2000 and 1997 surveys. Table 3.11: Medically confirmed mental health condition in the previous 12 months 1997 [7]
2000 n
%
n
%
Anxiety
129
5.1
108
4.3
Depression
148
5.8
125
5.0
A stress-related problem
149
5.9
150
6.0
12
0.5
12
0.5
Yes
307
12.1
271
10.8
No
2235
87.8
2230
89.2
3
0.1
-
2545
100.0
2501
Mental health condition in the last 12 months *
Any other mental health problem
At least one of the conditions above in last 12 months
Refused Total * Multiple responses were possible
46
100.0
Mental health
Figure 3.3: Medically confirmed mental health condition in the previous 12 months by year of survey 16 14 1997 2000
Proportion
12 10 8 6 4 2 0 Anxiety
Depression
A stressrelated problem
Any other mental health problem
At least one of conditions
Respondents indicating that a doctor had told them, in the last 12 months, that they had a mental health condition were asked if they still had the specific condition (Table 3.12). There were no statistically significant differences between the 2000 and 1997 surveys. Table 3.12: Current have medically confirmed mental health condition 1997 [7]
2000 n
%
n
%
Yes
205
66.7
183
67.4
No
101
32.9
88
32.6
1
0.4
-
307
100.0
271
Refused Total
100.0
47
Mental health
3.4.2 Receiving treatment for mental health condition All respondents (n=2545) were asked if they were currently receiving treatment for anxiety, depression, stress related problems or any other mental health problem (Table 3.13). There were no statistically significant differences in the respondents who were currently receiving treatment for their mental health condition between the 2000 and 1997 surveys. Table 3.13: Currently receiving treatment for anxiety, depression, stress related problems or any other mental health problem 1997 [7]
2000 n
%
n
%
Yes
148
5.8
137
5.5
No
2396
94.2
2364
94.5
1
0.1
-
2545
100.0
2501
Refused Total
100.0
Respondents with a current mental health problem and/or currently receiving treatment for a mental health problem (n=235) were asked how often, in the past four weeks, these mental problems were caused by physical health problems. The responses to this question is shown in Table 3.14. Table 3.14: Frequency of anxiety, depression or any other mental health condition being caused by physical health problems in the last four weeks n
%
All of the time
15
6.5
Most of the time
16
6.7
A good bit of the time
22
9.4
Some of the time
32
13.7
A little of the time
30
12.7
None of the time
120
51.0
Total
235
100.0
48
Mental health
3.4.3 Prevalence of current self-reported diagnosed mental health condition Current diagnosed mental health condition was determined if the respondent: • was diagnosed with a mental health condition in the last 12 months; or • currently receiving treatment for a mental health condition. Overall, 12.9% (95% CI 11.6-14.3, n=328) of respondents in South Australia reported a diagnosed mental health condition using this definition. There were no statistically significant differences between the 2000 and 1997 surveys (Table 3.15). Table 3.15: Self-reported diagnosed mental health condition in South Australia 1997 [7]
2000 n
%
n
%
Yes
328
12.9
299
12.0
No
2217
87.1
2202
88.0
Total
2545
100.0
2501
100.0
The prevalence of self-reported diagnosed mental health conditions for each of the South Australian regions is shown in Table 3.16. Respondents who lived in the rural and remote areas of South Australia were statistically significantly less likely to report a mental health condition diagnosed by a doctor. Table 3.16: Self-reported diagnosed mental health condition in South Australia by region Metropolitan n
Rural
% (95% CI)
n
% (95% CI)
Remote n
% (95% CI)
Yes
130
13.5 (11.4 - 15.9)
88
10.3 (8.4 - 12.6) ∨
70
9.6 (7.6 - 12.0) ∨
No
832
86.5 (84.1 - 88.6)
763
89.7 (87.4 - 91.6)
662
90.4 (88.0 - 92.4)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ test, p < 0.05) than state overall figure 2
Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
49
Mental health
Figure 3.4: Self-reported diagnosed mental health condition in South Australia by region 18.0 16.0
Proportion
14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0 SA State 1997
SA State 2000 Metropolitan
Rural
Remote
Table 3.17 shows the demographic profile of people with a current self-reported diagnosed mental health condition for each of the South Australian regions.
50
Mental health
Table 3.17: Self-reported diagnosed mental health condition by demographic variables and region Variable
Metropolitan n
%
Rural n
Remote %
n
%
Gender Male Female
35 95
7.5 ⇓ 19.1 ⇑
39 49
9.1 11.6
29 41
7.5 12.1
Age group (years) 18 to 24 years 25 to 34 years 35 to 44 years 45 to 54 years 55 to 64 years 65 to 74 years 75 or more years
15 25 22 31 20 9 9
12.6 13.5 11.4 17.7 17.2 9.1 10.6
2 13 24 22 15 6 6
2.5 # 8.4 13.7 14.2 12.8 6.1 8.7
3 19 17 16 9 7 1
3.4 # 11.9 10.1 11.9 9.8 12.1 1.2 #
Household size (18 years and over) 1 adult 2 adults 3 adults 4 or more adults
29 64 23 14
21.1 ⇑ 11.4 14.1 13.4
14 63 11 -
11.5 10.7 11.0 -
15 46 8 2
15.3 9.4 6.7 5.6 #
Number of children (less than 18 years) No children 1 or more children
90 39
14.7 11.2
46 42
9.2 12.0
38 32
9.5 9.7
Marital Status Married/De Facto Separated/Divorced Widowed Never Married
69 19 10 32
11.2 31.6 ⇑ 15.9 14.1
67 9 5 7
10.9 18.0 10.7 5.0
45 12 4 9
8.7 28.1 ⇑ 10.5 7.0
87
14.2
67
10.6
50
9.7
19 23
11.9 12.5
15 6
11.2 6.9
12 8
8.9 10.2
97
13.9
78
10.5
61
9.4
32
12.5
1 8
1 8
13.5 # 10.9
130
13.5
88
70
9.6
Highest educational qualification obtained Secondary Trade/Apprenticeship/Certificate/ Diploma Degree or higher Country of birth Australia - non-Aboriginal & Torres Strait Islander Australia - Aboriginal & Torres Strait Islander Overseas Region overall
7.9 # 8.3 10.3
⇑ ⇓ Statistically significantly higher or lower (χ2 test, p < 0.05) than overall region figure # Insufficient numbers for statistical test Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
51
Mental health
Table 3.17: Self-reported diagnosed mental health condition by demographic variables and region (cont) Variable
Metropolitan n
Work status Employed full time Employed part time Unemployed Home duties, student, retired or other Lifetime occupation Manager, professional, paraprofessional Trades person, clerk, sales person or personal service worker Plant or machine operator or driver, labourer or related worker Home duties, never worked Money situation Spending more money than getting Have just enough money to get through to next pay There is some money left over each week but just spent it Can save a bit every now and then Can save a lot Don’t know / not stated Gross annual household income Less than $20,000 $20,000 to < $40,000 $40,001 to < $80,000 $80,001 or more Not stated Region overall Receive Pension or Benefit (if not employed) Yes No
%
Rural n
Remote %
%
32 39 3 57
8.2 ⇓ 20.2 ⇑ 21.9 # 15.3
24 23 2 39
7.1 14.4 7.9 # 11.9
23 11 8 28
7.7 6.9 22.8 ⇑ 11.8
22
9.4
12
7.7
11
8.3
37
9.1
21
7.0
17
6.6
10 13
4.4 ⇓ 12.2
13 6
4.6 5.4
13 5
5.1 5.3
22.7 ⇑
11
22.9 ⇑
5
16.1
9
32
17.7
24
15.1
26
18.3 ⇑
9 70 8 6
13.7 13.8 5.2 19.1 ⇓
4 40 10 -
8.7 9.6 6.8 -
3 19 10 2
7.6 # 5.2 ⇓ 8.2 8.1 #
37 23 41 9 20
16.3 13.8 13.3 7.4 14.4
37 17 19 6 8
15.7 ⇑ 10.6 7.7 7.3 6.9
31 12 15 6 6
17.7 ⇑ 8.7 7.4 5.4 5.9
130
13.5
88
10.3
70
9.6
15.1 19.1 ⇑
40 25
13.8 10.8
33 15
15.3 ⇑ 6.7
44 54
⇑ ⇓ Statistically significantly higher or lower (χ2 test, p < 0.05) than overall region figure # Insufficient numbers for statistical test Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
52
n
CHAPTER 4: HEALTH CONDITIONS
Health conditions
4.1 Introduction Respondents were asked a series of questions about various health conditions: • diabetes, • arthritis, • heart disease, • stroke, • cancer, • osteoporosis, • asthma, • other respiratory conditions such bronchitis, emphysema or chronic lung disease, • high cholesterol, • high blood pressure, and • an injury requiring medical treatment in the last 12 months. For each of the health conditions respondents were asked if they had ever been told by a doctor that they had the condition and for some conditions, if they still have the condition.
54
Health conditions
4.2 Diabetes Overall, 6.2% (95% CI 5.3-7.2, n=157) of respondents in South Australia reported having medically confirmed diabetes (Table 3.2). The prevalence of diabetes has increased significantly since the 1997 survey (χ2trend = 10.2, p =0.001). Table 4.1: Medically confirmed diabetes by year of survey No Year of survey
Yes
n
Total
%
n
%
1997 July [7]
2416
96.6
85
3.4
2501
1997 September [16]
5696
95.5
269
4.5
5965
1998 September [17]
5717
95.1
295
4.9
6012
1998 October [18]
2893
94.6
166
5.4
3059
1999 September [19]
5742
95.6
262
4.4
6004
2000 December
2388
93.8
157
6.2
2545
Figure 4.1: Medically confirmed diabetes by year of survey 8 7 Proportion
6 5 4 3 2 1 0 1997
1998
1999
2000
Year
Note: 1997 and 1998 figures are the average of the two surveys conducted in 1997 and 1998.
55
Health conditions
The prevalence of self-reported medically confirmed diabetes for each of the South Australian regions is shown in Table 4.2. There were no statistically significant differences in the proportion of respondents reporting diabetes between the regions.
Table 4.2: Medically confirmed diabetes by region Metropolitan n
% (95% CI)
Rural n
% (95% CI)
Remote n
% (95% CI)
Yes
59
6.1 (4.7 - 7.9)
55
6.4 (4.9 - 8.4)
47
6.4 (4.8 - 8.5)
No
903
93.9 (92.1 - 95.3)
796
93.6 (91.6 - 95.1)
685
93.6 (91.5 - 95.2)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ2 test, p < 0.05) than state overall figure Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
Figure 4.2: Medically confirmed diabetes by region 9.0 8.0 Proportion
7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 SA State
56
Metropolitan
Rural
Remote
Health conditions
4.3 Arthritis Overall, 20.5% (95% CI 19.0-22.1, n=522) of respondents in South Australia reported having arthritis (Table 4.3). The prevalence of arthritis has remained constant over the last four years. Table 4.3: Medically confirmed arthritis by year of survey No Year of survey
Yes
n
Total
%
n
%
1997 July [7]
2005
80.2
496
19.8
2501
1998 October [18]
2302
75.2
757
24.8
3059
2000 December
2023
79.5
522
20.5
2545
Figure 4.3: Medically confirmed arthritis by year of survey 30
Proportion
25 20 15 10 5 0 1997
1998
1999
2000
Year
The prevalence of self-reported medically confirmed arthritis for each of the South Australian regions is shown in Table 4.4. Respondents who lived in the remote areas of South Australia were statistically significantly less likely to report arthritis. Table 4.4: Medically confirmed arthritis by region Metropolitan n
% (95% CI)
Rural
Remote
n
% (95% CI)
n
% (95% CI)
Yes
198
20.6 (18.1 - 23.3)
180
21.1 (18.5 - 24.1)
114
15.5 (13.1 - 18.5) ∨
No
764
79.4 (76.7 - 81.9)
671
78.9 (75.9 - 81.5)
618
84.5 (81.5 - 86.9)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ2 test, p < 0.05) than state overall figure Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
57
Health conditions
Figure 4.4: Medically confirmed arthritis by region 25.0
Proportion
20.0 15.0 10.0 5.0 0.0 SA State
Metropolitan
Rural
Remote
4.4 Heart disease Overall, 6.2% (95% CI 5.4-7.3, n=159) of respondents in South Australia reported ever having heart disease. Table 4.5: Medically confirmed heart disease 2000 n
%
Yes
159
6.2
No
2386
93.8
Total
2545
100.0
The prevalence of self-reported medically confirmed heart disease for each of the South Australian regions is shown in Table 4.6. There were no statistically significant differences in the proportion of respondents reporting heart disease between the regions.
58
Health conditions
Table 4.6: Medically confirmed heart disease by region Metropolitan n
% (95% CI)
Rural n
Remote
% (95% CI)
n
% (95% CI)
Yes
60
6.3 (4.8 - 8.0)
53
6.2 (4.7 - 8.1)
41
5.7 (4.1 - 7.6)
No
902
93.7 (92.0 - 95.2)
798
93.8 (91.9 - 95.3)
691
94.3 (92.4 - 95.9)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ2 test, p < 0.05) than state overall figure Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
Figure 4.5: Medically confirmed heart disease by region 9.0 8.0 Proportion
7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 SA State
Metropolitan
Rural
Remote
4.5 Stroke Overall, 2.0% (95% CI 1.5-2.6, n=51) of respondents in South Australia reported ever having a stroke. There were no statistically significant differences in the prevalence of stroke between the 2000 and 1997 surveys. Table 4.7: Medically confirmed stroke by year of survey No Year of survey
n
Yes
Total
%
n
%
1997 July [7]
2456
98.2
45
1.8
2501
2000 December
2494
98.0
51
2.0
2545
59
Health conditions
The prevalence of self-reported medically confirmed stroke for each of the South Australian regions is shown in Table 4.8. There were no statistically significant differences in the proportion of respondents reporting stroke between the regions. Table 4.8: Medically confirmed stroke by region Metropolitan n
% (95% CI)
Rural n
% (95% CI)
Remote n
% (95% CI)
Yes
21
2.1 (1.4 - 3.4)
11
1.3 (0.7 - 2.4)
11
1.5 (0.8 - 2.8)
No
941
97.9 (96.6 - 98.6)
840
98.7 (97.6 - 99.3)
721
98.5 (97.2 - 99.2)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ2 test, p < 0.05) than state overall figure Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
Figure 4.6: Medically confirmed stroke by region 3.0
Proportion
2.5 2.0 1.5 1.0 0.5 0.0 SA State
60
Metropolitan
Rural
Remote
Health conditions
4.6 Cancer Overall, 4.8% (95% CI 4.0-5.7, n=122) of respondents in South Australia reported ever having cancer. The prevalence of cancer has remained constant over the last four years. Table 4.9: Medically confirmed cancer by year of survey No Year of survey
Yes
n
Total
%
n
%
1997 July [7]
2393
95.7
108
4.3
2501
1999 September [19]
5732
95.5
272
4.5
6004
2000 December
2423
95.2
122
4.8
2545
Figure 4.7: Medically confirmed cancer by year of survey 6
Proportion
5 4 3 2 1 0 1997
1998
1999
2000
Year
61
Health conditions
The prevalence of self-reported medically confirmed cancer for each of the South Australian regions is shown in Table 4.10. There were no statistically significant differences in the proportion of respondents reporting cancer between the regions.
Table 4.10: Medically confirmed cancer by region Metropolitan n
Rural
% (95% CI)
n
% (95% CI)
Remote n
% (95% CI)
Yes
47
4.9 (3.6 - 6.5)
36
4.2 (3.0 - 5.9)
36
4.9 (3.5 - 6.8)
No
915
95.1 (93.5 - 96.4)
815
95.8 (94.1 - 97.0)
696
95.1 (93.2 - 96.5)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ test, p < 0.05) than state overall figure 2
Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
Figure 4.8: Medically confirmed cancer by region 7.0
Proportion
6.0 5.0 4.0 3.0 2.0 1.0 0.0 SA State
62
Metropolitan
Rural
Remote
Health conditions
4.7 Osteoporosis Overall, 4.2% (95% CI 3.5-5.1, n=108) of respondents in South Australia reported having osteoporosis. The prevalence of osteoporosis has remained constant over the last four years. Table 4.11: Medically confirmed osteoporosis by year of survey No Year of survey
n
Yes
Total
%
n
%
1997 July [7]
2433
97.3
68
2.7
2501
1998 October [18]
2945
96.3
114
3.7
3059
1999 September [19]
5835
97.2
169
2.8
6004
2000 December
2437
95.8
108
4.2
2545
Figure 4.9: Medically confirmed osteoporosis by year of survey 6.0 Proportion
5.0 4.0 3.0 2.0 1.0 0.0 1997
1998
1999
2000
Year
63
Health conditions
The prevalence of self-reported medically confirmed osteoporosis for each of the South Australian regions is shown in Table 4.12. Respondents who lived in the rural areas of South Australia were statistically significantly less likely to report osteoporosis.
Table 4.12: Medically confirmed osteoporosis by region Metropolitan n
% (95% CI)
Rural n
% (95% CI)
Remote n
% (95% CI)
Yes
44
4.6 (3.4 - 6.1)
21
2.4 (1.6 - 3.8) ∨
20
2.8 (1.7 - 4.3)
No
918
95.4 (93.9 - 96.6)
830
97.6 (96.2 - 98.4)
712
97.2 (95.7 - 98.3)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ2 test, p < 0.05) than state overall figure Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
Figure 4.10: Medically confirmed osteoporosis by region 7.0
Proportion
6.0 5.0 4.0 3.0 2.0 1.0 0.0 SA State
64
Metropolitan
Rural
Remote
Health conditions
4.8 Asthma Reported diagnosis by a doctor of asthma, and current asthma status, are shown in Table 4.13 & Table 4.14. Overall, 12.7% (95% CI 11.5-14.1, n=324) of respondents have current medically confirmed asthma. Table 4.13: Prevalence of asthma n
%
Yes
460
18.1
No
2085
81.9
Yes
324
12.7
No
2212
86.9
8
0.3
2545
100.0
Ever been told by a doctor have asthma?
Have been told by a doctor currently have asthma
Don’t know Total
The prevalence of ever having medically diagnosed (χ2trend = 8.8, p =0.003) and currently having asthma (χ2trend = 6.4, p =0.01) have been rising over the last four years (Table 4.14). Table 4.14: Prevalence of asthma by year of survey No / don’t know Year of survey
n
Yes
Total
%
n
%
Ever been told by a doctor have asthma? 1997 July [7]
2181
87.2
320
12.8
2501
1998 October [18]
2538
83.0
521
17.0
3059
1999 September [19]
5199
86.6
805
13.4
6004
2000 December
2085
81.9
460
18.1
2545
1997 July [7]
2240
89.6
261
10.4
2501
1998 October [18]
2688
87.9
371
12.1
3059
2000 December
2220
87.3
324
12.7
2545
Have been told by a doctor currently have asthma
65
Health conditions
Figure 4.11: Prevalence of ever and current asthma by year of survey 25
Proportion
20 15 10
Confirmed asthma 5
Current confirmed asthma
0 1997
1998
1999
2000
Year
The prevalence of self-reported current medically confirmed asthma for each of the South Australian regions is shown in Table 4.15. There were no statistically significant differences in the proportion of respondents reporting current asthma between the regions.
Table 4.15: Current medically confirmed asthma by region Metropolitan n
% (95% CI)
Rural n
% (95% CI)
Remote n
% (95% CI)
Yes
121
12.6 (10.6 - 14.9)
117
13.8 (11.5 - 16.3)
84
11.5 (9.3 - 14.1)
No
841
87.4 (85.1 - 89.4)
734
86.2 (93.7 - 88.5)
648
88.5 (85.9 - 90.7)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ2 test, p < 0.05) than state overall figure Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
66
Health conditions
Figure 4.12: Current medically confirmed asthma by region 18.0 16.0 Proportion
14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0 SA State
Metropolitan
Rural
Remote
4.9 Other respiratory conditions Table 4.16 shows the prevalence of the respondent ever having and currently having other respiratory problems such as bronchitis, emphysema, or chronic lung disease, that has lasted six months or more. Overall, 2.6% (95% CI 2.1-3.4, n=67) of respondents reported current respiratory conditions other than asthma.
Table 4.16: Prevalence of other respiratory problems such as bronchitis, emphysema, or chronic lung disease, that has lasted six months or more n
%
Yes
105
4.1
No
2432
95.6
7
0.3
67
2.6
2471
97.1
7
0.3
2545
100.0
Ever been told by a doctor have any other respiratory problem (bronchitis, emphysema, chronic lung diseases) that has lasted six months or more?
Don’t know Currently have this (these) other respiratory problem(s)? Yes No Don’t know Total
67
Health conditions
The prevalence of self-reported current medically confirmed respiratory condition for each of the South Australian regions is shown in Table 4.17. There were no statistically significant differences in the proportion of respondents reporting current respiratory condition (excluding asthma) between the regions. Table 4.17: Other respiratory problems by region Metropolitan n
% (95% CI)
Rural n
% (95% CI)
Remote n
% (95% CI)
Yes
24
2.5 (1.6 - 3.7)
25
3.0 (1.9 - 4.4)
28
3.8 (2.6 - 5.6)
No
938
97.5 (96.3 - 98.4)
826
97.0 (95.6 - 98.1)
704
96.2 (94.4 - 97.4)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ2 test, p < 0.05) than state overall figure Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
Figure 4.13: Other respiratory problems by region 6.0
Proportion
5.0 4.0 3.0 2.0 1.0 0.0 SA State
68
Metropolitan
Rural
Remote
Health conditions
4.10 High cholesterol Table 4.18 shows the prevalence of ever having and currently having high cholesterol. Overall, 7.5% (95% CI 6.5-8.6, n=191) of respondents in South Australia reported having current high cholesterol. Table 4.18: Ever been told by a doctor and currently have high cholesterol n
%
Yes
501
19.7
No
2008
78.9
35
1.4
Yes
191
7.5
No
2220
87.2
134
5.3
2545
100.0
Ever been told by a doctor have high cholesterol?
Don’t know Currently have high cholesterol?
Don’t know Total
The prevalence of ever having high cholesterol has risen significantly (χ2trend = 9.2, p < 0.001) over the last four years (Table 4.19). Table 4.19: Ever been told have high cholesterol by year of survey No / don’t know Year of survey
n
%
Yes n
Total %
1997 September [16]
4957
83.1
1008
16.9
5965
1998 September [17]
4861
80.9
1151
19.1
6012
1998 October [18]
2490
81.4
569
18.6
3059
2000 December
2044
80.3
501
19.7
2545
69
Health conditions
Figure 4.14: Prevalence of ever been told have high cholesterol by year 25.0
Proportion
20.0 15.0 10.0 5.0 0.0 1997
1998
1999
2000
Year
Note: 1998 figure is the average of the two surveys conducted in 1998.
The prevalence of self-reported current medically confirmed high cholesterol for each of the South Australian regions is shown in Table 4.20. There were no statistically significant differences in the proportion of respondents reporting current high cholesterol between the regions. Table 4.20: Current high cholesterol by region Metropolitan n
Rural
% (95% CI)
n
% (95% CI)
Remote n
% (95% CI)
Yes
75
7.8 (6.2 - 9.7)
54
6.3 (4.8 - 8.3)
45
6.1 (4.6 - 8.2)
No
887
92.2 (90.3 - 93.8)
797
93.7 (91.7 - 95.2)
687
93.9 (91.8 - 95.4)
Total
962
100.0
851
100.0
732
100.0
∧ ∨ Statistically significantly higher or lower (χ test, p < 0.05) than state overall figure 2
Note: The weighting of the data can result in rounding discrepancies or totals not adding (see Section 1.5.2).
70
Health conditions
Proportion
Figure 4.15: Current high cholesterol by region 10.0 9.0 8.0 7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 SA State
Metropolitan
Rural
Remote
4.11 High blood pressure Table 4.21 shows the prevalence of ever having and currently having high blood pressure. Overall, 11.0% (95% CI 9.8-12.3, n=279) of respondents in South Australia reported having current high blood pressure. Table 4.21: Ever been told by a doctor and currently have high blood pressure n
%
Yes
577
22.7
No
1960
77.0
8
0.3
Ever been told by a doctor have high blood pressure?
Don’t know Currently have high blood pressure? Yes
279
11.0
No
2215
87.0
51
2.0
2545
100.0
Don’t know Total
71
Health conditions
The prevalence of ever having high blood pressure has decreased (χ2trend = 14.2, p