Notes on the data: Long-term health conditions, by age

Long-term health conditions, by age, 2021

Policy context: The rationale for including the long-term health conditions topic in the 2021 Census was to:

allow for cross-classification with other Census topics
enable output for sub-populations (e.g., culturally and linguistically diverse or Aboriginal and Torres Strait Islander populations)
enable data outputs at finer geographies than what can be achieved through existing health collections.

Notes:

Apart from this new question in the Census, the ABS have multiple instruments to collect information about health conditions. These are in the form of the National Health Survey, National Aboriginal and Torres Strait Islander Health Survey and the Patient Experience Survey. Each instrument can be used to estimate rate of long-term health conditions across the Australian population. To understand the methodological differences in the creation of these estimates, the ABS have created a web document “Comparing ABS long-term health conditions data sources: Exploring the purpose, collection and concept of health data”, available at: https://www.abs.gov.au/statistics/detailed-methodology-information/information-papers/comparing-abs-long-term-health-conditions-data-sources

The document compares the purposes, the collection methods, and advantages and disadvantages of each of the instruments in defining estimates and provides a comparison of the derived Australian estimates for each long-term health conditions from their various collections. They highlight that the key point of difference is that the 2021 Census asks only a single long-term health conditions question while their targeted health surveys provide more detailed data about the health status of the populations under investigation. The ABS states that the “long-term health conditions data from the Census is not intended to provide prevalence estimates” and recommends that their health survey instruments should be used for national and state/territory level long-term health condition prevalence rates.

The benefit of asking the long-term health conditions question in the Australian Census context, as quoted by the ABS, is “that it allows for the analysis of long-term health conditions data at more detailed geographic and sub-population levels than ABS health surveys can support, and across a range of socio-economic and demographic dimensions.” Given PHIDU’s remit to publish small area statistics for monitoring inequality in health and wellbeing and for supporting opportunities to improve population health outcomes.

PHIDU have published the reported responses (albeit as standardised rates per 100 population) at the small area level as they can highlight variations across Australia from the national and state/ territory rates, a major purpose of the Social Health Atlas. However, given the comments above, the rates of long-term health conditions reported here at the national and state/ territory level should be used with caution, and the other caveats in the linked ABS document should also be borne in mind.

Definition of a long-term health condition:

Long-term health conditions are those conditions diagnosed by a doctor or nurse, last six months or longer and include health conditions that:

May recur from time to time, or
Are controlled by medication, or
Are in remission.

This variable records the type of selected long-term health condition(s) a person has reported. Respondents can record multiple long-term health conditions including:

arthritis
asthma
cancer (including remission)
dementia (including Alzheimer’s)
diabetes (excluding gestational diabetes)
heart disease (including heart attack or angina)
kidney disease
lung condition (including COPD) or emphysema)
mental health condition (including depression or anxiety)
stroke
and other long-term health conditions

As respondents can select multiple conditions, the count of components for this variable will not equal the total number of people.

Multiple variables are created from multiple responses from one or more long-term health conditions questions. Therefore, some variables do not have a non-response rate calculated. The non-response rate derived for the “Count of long-term health conditions (CLTHP)” in the 2021 Census was 8.1%.

Details of data presented

Long-term health conditions, by age (Aboriginal people of all ages; Aboriginal people aged 15 years and over; and Aboriginal children and young people aged 0 to 14 years)

Aboriginal people who reported they had

one long-term health condition, 2021
two long-term health conditions, 2021
three long-term health conditions, 2021
one or more long-term health conditions, 2021
no long-term health condition, 2021

Geography: Data available by Indigenous Area, Primary Health Network, Quintile of socioeconomic outcomes (based on IRSEO) and Remoteness Area

Numerator: Number of Aboriginal people who had no long-term health conditions/ one condition/ two conditions or one or more conditions on the list above, or any other long-term health conditions, by age

Denominator: Total Aboriginal population (Aboriginal people of all ages; Aboriginal people aged 15 years and over; and Aboriginal children and young people aged 0 to 14 years)

The variables are derived from responses to the long-term health conditions question and count the number of Aboriginal people who marked a condition listed on the Census form, or who reported a long-term health condition in addition to those listed.

Detail of analysis: Indirectly age-standardised rate per 100 population; and/or indirectly age-standardised ratio, based on the Australian standard

Source: Compiled by PHIDU based on the ABS Census of Population and Housing, August 2021.