Dr Paul Jelfs, ABS: Monitoring and Reporting on Socioeconomic Difference
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Transcript of Dr Paul Jelfs, ABS: Monitoring and Reporting on Socioeconomic Difference
Health – relationships with
socioeconomic status Dr Paul Jelfs
First Assistant Statistician
Population, Labour and Social Statistics Group
Australian Bureau of Statistics
Drivers of health outcomes
• Economic income and wealth
– Mostly measured as income and SEIFA (IRSD)
• Education/language skills
• Location and access to services
• Occupation
• Environment
• Health beliefs
• Health literacy
Socio-economic measurement
Couldn’t raise $2,000 in a week – Low Inc 33%, LER 43%
Couldn’t pay gas/elect on time – Low Inc 23%, LER 31%
Went without meals – Low Inc 8%, LER 10%
Vulnerable populations
• Low economic resource households (income/wealth)
• Some Aboriginal and Torres Strait Islanders
• Some migrant populations
• Some rural/remote locations & some
urban locations
• Those with a disability or multiple
chronic health conditions
Key data sets that contribute to this
discussion
• Census of population and housing (2011)
• Survey of Income and Housing (2009-10, 2011-12)
• Australian Health Survey – General and Aboriginal
and Torres Strait Islander populations (2011-13)
• Patient Experience Survey (2012-13)
• Survey of Disability, Ageing and Carers (2012)
• Adult Literacy and Life Skills Survey (2006)
Risk factors
• Smoking – Low SES 24%, High SES 10%
• Low exercise – Low SES 76%, High SES 59%
• Obesity* – Females Low SES 64%, Females High SES 50%
• Alcohol risk (lifetime)* – Low SES 16.7%, High SES 22%
Adequate health literacy
Aboriginal and Torres Strait
Islander people
Smoking rates
Non-Indigenous smoking rates – 16.1%
Alcohol – long term risk
Proportion of Aboriginal and Torres Strait Islander people 15
years and over who exceeded alcohol guidelines for lifetime risk,
by remoteness and sex, 2012-13
Overweight and obesity
Health services
Private Health insurance
Access to health services
Barriers to accessing health services
Some people that needed to see a health professional or fill a prescription delayed or did not do so because of the cost:
• GP: 7%
• Medical Specialist: 8%
• Prescription for medication: 9%
• Dentist: 21%
Barriers to accessing health services
• 21% of people delayed or did not see the dentist due to cost – who were they?
Barriers to accessing health services
• 21% of people delayed or did not see the dentist due to cost – who were they?
Health outcomes
• Diabetes – Low SES 8.3%, High SES 5.1%
• Diabetes (Self report) – Low SES 5.4%, High SES 2.5%
• Abnormal cholesterol * – Low SES 29%, High SES 35%
• Abnormal tryglicerides – Low SES 18%, High 11.5%
• Abnormal kidney – Low SES 5.5%, High SES 2.9%
• Arthritis - Low SES 17.2%, High SES 14.2%
• Asthma - Low SES 12.1%, High SES 8.9%
Self assessed Health Status
Disability
• Key health related conditions – Musculoskeletal
(56%), Circulatory (39%), Mental health (35%)
• Year 12 completion rates – with a disability 37%,
without a disability 59%
• Further qualification – with a disability 52%,
without a disability 60%
• Labour participation – with a disability 29.7%
(profound)/60.4%(other), without a disability 82.5%
Key messages
• Socio-economic disadvantage measures are good indicators
of risk and outcome ....but are not always perfect at an individual or small group level
• The relationship between SES and health is not always in a
positive direction
• The relationship of health with SES does not always hold
for all population groups
• There is a cumulative effect of health risk and SES and
therefore a cumulative effect on health outcomes
Key Messages 2
• Australia has some very good data to describe and
unpack the SES/health relationship
• Driving change in health requires continuously
addressing the key elements of education and
income which will have an impact on risk
exposures and capacities to use health services
– Cross sectional and across cohorts