South Australian Health and Wellbeing Survey - Faculty of Health and ...

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

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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.

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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

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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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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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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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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.

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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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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

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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: • • •

•

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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

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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.

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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?


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


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


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


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


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


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


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


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


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


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


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


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 #


85 41

13.9 11.8

48 45

9.5 12.8

56 41

14.0 12.3


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


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


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)


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


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


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


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 #


90 39

14.7 11.2

46 42

9.2 12.0

38 32

9.5 9.7


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


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


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


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


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


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


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



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


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


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


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



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