Australian Health Survey: Biomedical Results for Chronic Diseases

1. Diabetes Australia, Sept 2011, What is Diabetes?, http://www.diabetesaustralia.com.au/en/Understanding-Diabetes/What-is-Diabetes, Last accessed 02/07/2013.
2. Australian Bureau of Statistics, Mar 2013, Causes of Death Australia, ABS cat. no. 3303.0, http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/3303.0Chapter42011, Last accessed 02/07/2013.
3. World Health Organization 2006, Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia, http://www.who.int/diabetes/publications/Definition%20and%20diagnosis%20of%20diabetes_new.pdf, Last accessed 16/07/2013.
4. World Health Organization 2011, Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus, http://www.who.int/diabetes/publications/report-hba1c_2011.pdf, Last accessed 16/07/2013.

Diabetes prevalence was derived using a combination of blood test results and self-reported information on diabetes diagnosis and medication use.

A person was considered to have known diabetes if:

• they had ever been told by a doctor or nurse that they have diabetes and they were taking diabetes medication (either insulin or tablets); OR
• they had ever been told by a doctor or nurse that they have diabetes and their blood test result for fasting plasma glucose was greater than or equal to the cut off point for diabetes (that is, ≥7.0 mmol/L).
   

Note: people who had been told by a doctor or nurse that they have diabetes, but who were not taking medication for diabetes and did not have a fasting plasma glucose level ≥7.0 mmol/L, were classified as not having diabetes.

People with known diabetes were further classified as having Type I, Type II or Type unknown, based on the type of diabetes that a doctor or nurse told them they had. Women with gestational diabetes were excluded.

• A person was considered to have newly diagnosed diabetes if they reported no prior diagnosis of diabetes but had a fasting plasma glucose value ≥7.0 mmol/L.
   

Total persons with diabetes was defined as the total of known diabetes and newly diagnosed diabetes.

• A person was considered to be at high risk of diabetes if they did not currently have diabetes, but had an impaired fasting plasma glucose result, that is, a fasting plasma glucose level ranging from 6.1 mmol/L to less than 7.0 mmol/L.¹
   

The NHMS diabetes classification is outlined in Figure 1. More information on diabetes prevalence is presented in Tables 1, 2, 3, 8, 9, 11 and 15 in the Data downloads section of this publication.

Information on diabetes prevalence using this same definition but based on HbA1c test results are also shown in Tables 1, 2, 3, 8, 9, 12 and 15. The relevant cut-offs for HbA1c are as follows:

• Indicates diabetes: ≥6.5%
• At high risk of diabetes: 6.0% to <6.5%
• Does not indicate diabetes: <6.0%.
   

* Cut-offs for FPG: Indicates diabetes ≥7.0 mmol/L; At high risk of diabetes 6.1 to <7.0 mmol/L; Does not indicate diabetes <6.1 mmol/L.
Cut-offs for HbA1c: Indicates diabetes ≥6.5%; At high risk of diabetes 6.0% to <6.5%; Does not indicate diabetes <6.0%.
 

1. World Health Organization 2006, Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia, http://www.who.int/diabetes/publications/Definition%20and%20diagnosis%20of%20diabetes_new.pdf, Last accessed 16/07/2013.

There was an additional 1% of people aged 18 years and over who did not have abnormal fasting plasma glucose test results and who were not taking diabetes medication, but self-reported having ever been told by a doctor or nurse that they had diabetes. This group was classified as not having diabetes.

Diabetes was more common for men than women in 2011–12 (6.3% compared with 3.9%). This was the case for both known diabetes (4.9% compared with 3.4%) and newly diagnosed diabetes (1.4% compared with 0.4%).

Overall, the prevalence of diabetes increased with age, with people aged 65–74 years having the highest rate (15.0%). Similarly, people aged between 55 and 74 years had the highest rates of newly diagnosed diabetes (2.3%). The proportion of people at high risk of diabetes also increased steadily with age, with the most 'high risk' group being those aged 75 years and over (7.5%).

One of the main risk factors for developing diabetes is being overweight or obese.¹ Excess body weight can interfere with the body's production of, and resistance to, insulin.² In 2011–12, people who were obese had much higher rates of diabetes (11.2%) than those who were overweight (4.1%) or normal weight or underweight (1.6%). A similar pattern was also evident for those at high risk of diabetes, with 5.8% of obese people being at high risk of diabetes compared with 0.9% of those of normal weight or underweight.

People with a family history of diabetes were also more likely to have the disease. The NHMS showed that over half of all people with diabetes (54.4%) and 39.9% of those at high risk of diabetes had a close family member who had the condition.

People with diabetes were more likely than those without diabetes to have signs of other chronic conditions. This was particularly the case with kidney disease, of which diabetes is a major cause.³ In 2011–12, 22.5% of people with diabetes had albuminuria, an early indicator of kidney disease, compared with 6.7% of those without diabetes. A further 12.8% had abnormal eGFR results, which measure how well the kidneys filter waste from the bloodstream, compared with 3.1% of those without diabetes. People at high risk of diabetes were also more likely than those without diabetes to have abnormal eGFR (7.2% compared with 3.1%).

Diabetes is also a major risk factor for cardiovascular disease.¹ Diabetes increases the risk of developing atherosclerosis, which is the build up of fatty deposits in the blood vessels.⁴ This was reflected in the NHMS results, where people with diabetes were more than twice as likely as those without diabetes to have abnormal levels of HDL 'good' cholesterol (48.6% compared with 21.7%) and high levels of triglycerides (31.5% compared with 12.5%). People who were at high risk of diabetes were also more likely than those without diabetes to have abnormal HDL cholesterol and triglyceride levels.

More information on diabetes prevalence is presented in tables 1, 2, 3, 8, 9, 11 and 15 in the Data downloads section of this publication.

1. Baker IDI Heart & Diabetes Institute, The Australian Diabetes Obesity and Lifestyle Study (AusDiab), 2005 https://www.baker.edu.au/-/media/documents/impact/ausdiab/reports/ausdiab-report-2005.pdf?la=en, Last accessed 24/06/2013.
2. Kahn, B.B & Flier, J.S., 2000, 'Obesity and insulin resistance'. The Journal of Clinical Investigation, http://www.jci.org/articles/view/10842, Last accessed 24/06/2013.
3. Kidney Health Australia, Jun 2013, Fast Facts on CKD in Australia http://www.kidney.org.au/KidneyDisease/FastFactsonCKD/tabid/589/Default.aspx, Last accessed 24/06/2013.
4. Australian Institute of Health and Welfare, 2012, Australia's Health http://www.aihw.gov.au/publication-detail/?id=10737422172, Last accessed 24/06/2013.

In 2011–12, over half (55.7%) of people aged 18 years and over with known diabetes were effectively managing their condition, that is, they had an HbA1c test result of 7.0% or less. Older people were more likely than younger people to meet the HbA1c target, with 70.4% of those aged 75 years and over meeting the target. Overall, there was no significant difference in HbA1c levels between males and females.

Controlling other aspects of health, such as cholesterol and blood pressure, is also important for effective diabetes management. Among those with known diabetes in 2011–12, 37.9% met the management target for total cholesterol and 37.2% met the target for blood pressure. The majority of those with known diabetes met the management targets for triglycerides (70.0%) and albumin creatinine ratio, which measures levels of kidney damage (71.1%).

The diabetes management guidelines also outline optimum targets for health behaviours. While the majority of people with known diabetes met the management target for smoking in 2011–12 (85.6% were non-smokers), only 12.8% met the target for a normal Body Mass Index (i.e. a BMI score of between 18.0 and 24.9).

For more information on diabetes management, see Table 13 in the Data downloads section of this publication.

1. Diabetes Australia, August 2012, Diabetes Management in General Practice. Guidelines for Type 2 Diabetes. http://www.diabetesaustralia.com.au/Documents/DA/What's%20New/12.10.02%20Diabetes%20Management%20in%20General%20Practice.pdf, Last accessed 20/06/2013.

1. Australian Bureau of Statistics, Mar 2013, Causes of Death Australia, ABS cat. no. 3303.0, http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/3303.0Chapter42011, Last accessed 02/07/2013.

Total cholesterol is a measure of all the different types of fats in the blood. Abnormal or high total cholesterol is a major risk factor for coronary heart disease and stroke.¹

In 2011–12, one in three Australians aged 18 years and over (32.8% or 5.6 million people) had abnormal or high total cholesterol levels according to their blood test results. Yet only 10.1% of this group self-reported having high cholesterol as a current long-term health condition, which suggests that the majority of people with high cholesterol results were either unaware that they had the condition or did not consider it to be a long-term or current problem. A further 19.1% of adults had a total cholesterol level that was close to the abnormal cut off (i.e. in the 5.0–5.4 mmol/L range).

The proportion of people with high total cholesterol levels increased with age, peaking at 55–64 years (47.8%), before decreasing in late adulthood. Overall there was no significant difference in rates of total cholesterol for men and women.

The NHMS also collected cholesterol information for children. Of those aged 12–17 years, 3.5% had high total cholesterol levels in 2011–12.

Research shows that certain lifestyle risk factors, such as smoking and obesity, are associated with high cholesterol.² In 2011–12, current smokers were more likely to have high cholesterol than people who never smoked (38.1% compared with 30.4%). Similarly, adults who were obese were more likely to have high cholesterol than those who were normal weight or underweight (37.0% compared with 25.8%).

People with high total cholesterol were also likely to have other indicators of cardiovascular disease. For example, 84.7% of those with high total cholesterol also had high LDL 'bad' cholesterol. They were also more likely than those with normal total cholesterol levels to have high triglycerides (22.9% compared with 9.5%). Similarly, people with high blood pressure had higher rates of total cholesterol that those with normal blood pressure (40.8% compared with 31.0%).

LDL cholesterol is the measure of 'bad' cholesterol in the blood. Over time, LDL cholesterol can build up in the blood vessels and arteries, blocking the passage of blood flow.³

In 2011–12, one in three Australian adults (33.2%) had abnormal or high LDL cholesterol. High levels of LDL cholesterol were more common among men (35.0%) than women (31.6%).

Like total cholesterol, people aged 55–64 years had the highest rates of LDL cholesterol (45.7%). Rates then sharply declined from 65 years onwards. One in twenty children aged 12–17 years (5.2%) had high LDL cholesterol in 2011–12.

The associations between LDL cholesterol and health risk factors were very similar to that for total cholesterol, with higher rates of abnormal LDL cholesterol among smokers and those who were overweight or obese.

People with high LDL cholesterol were more likely to have high triglycerides than those with normal LDL levels (15.7% compared with 11.7%). However, there was no association between high LDL cholesterol and lower than normal HDL 'good' cholesterol.

HDL cholesterol is the measure of 'good' cholesterol. HDL picks up excess cholesterol in the blood and takes it to the liver where it is broken down.³

In 2011–12, 23.1% of Australian adults had abnormal or low levels of HDL cholesterol. Abnormal HDL cholesterol was more prevalent for women (27.2%) than men (18.9%).

Unlike the other measures of cholesterol, levels of low HDL cholesterol remained fairly stable across all age groups at between 21.0% and 24.7%.

People with low HDL cholesterol had a greater likelihood of also having signs of other chronic diseases. For example, 10.5% of those with low levels of HDL cholesterol also had diabetes, compared with 3.4% of those with normal levels. They were also more likely than those with normal HDL cholesterol to have high triglycerides and abnormal alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) levels, increasing their risk of heart and liver diseases.

For more information on cholesterol, see tables 1, 2, 3, 4, 8, 9 and 15 in the Data downloads section of this publication.

1. Australian Institute of Health and Welfare, 2013, High blood cholesterol, http://www.aihw.gov.au/high-blood-cholesterol, Last accessed 18/06/2013.
2. National Heart Foundation of Australia, 2007, Policy paper: Tobacco and cardiovascular disease, http://www.heartfoundation.org.au/SiteCollectionDocuments/TobaccoandCardiovascularDiseasePolicyPaper.pdf, Last accessed 08/07/2013.
3. National Heart Foundation of Australia, 2013, Cholesterol, http://www.heartfoundation.org.au/SiteCollectionDocuments/NAHU-Cholesterol.pdf, Last accessed 08/07/2013

In 2011–12, 13.9% of people aged 18 years and over had high triglyceride levels. High triglycerides were more common among men (19.0%) than women (9.0%).

The proportion of people with high triglycerides steadily increased with age until middle adulthood, before gradually declining in older age. Overall, rates were highest among those aged 45–54 years (18.5%).

Being overweight or obese, tobacco smoking and having high blood pressure were all associated with higher levels of triglycerides. In 2011–12, overweight or obese adults were more than three times as likely to have high triglyceride levels than those who were normal weight or underweight (19.1% compared with 5.3%). Likewise, people with high blood pressure had a greater likelihood of having high triglycerides levels (20.9%) than those with normal blood pressure (11.9%). Current smokers (20.6%) and ex-smokers (15.7%) were also more likely to have high triglycerides than people who had never smoked (11.4%).

Research shows that the risk of heart disease increases when high triglycerides accompany high LDL or 'bad' cholesterol.² In 2011–12, 54.2% of adults with high triglycerides also had high total cholesterol. People with high triglycerides also had a greater likelihood of having low levels of 'good' HDL cholesterol (45.2%) and high levels of 'bad' cholesterol (37.6%) compared with people with normal triglyceride levels (20.0% and 32.5% respectively).

High levels of triglycerides are also associated with diabetes.³ In 2011–12, people with high triglycerides were nearly three times as likely as those with normal triglycerides to have diabetes (11.5% compared with 4.1%).

Similarly, high triglycerides are a known risk factor for liver disease.⁴ In 2011–12, 21.5% of adults with high triglycerides had abnormal alanine aminotransferase (ALT) levels (which measures liver function) compared with 9.6% of those with normal triglycerides.

For more information on triglycerides, see tables 1, 2, 3, 4, 8. 9 and 15 in the Data downloads section of this publication.

1. Talayero, BG and Sacks, FM, 2011, 'The Role of Triglycerides in Atherosclerosis', Current Cardiology Reports, http://link.springer.com/article/10.1007%2Fs11886-011-0220-3#page-1, Last accessed 24/06/2013.
2. World Heart Federation, 2013, Cardiovascular disease risk factors: Cholesterol, http://www.world-heart-federation.org/cardiovascular-health/cardiovascular-disease-risk-factors/cholesterol, Last accessed 24/06/2013.
3. Tirosh, A et al. 2008, 'Changes in Triglyceride Levels Over Time and Risk of Type 2 Diabetes in Young Men', Diabetes Care, http://care.diabetesjournals.org/content/31/10/2032.full, Last accessed 24/06/2013.
4. Marchesini, G et al. 2001, 'Nonalcoholic Fatty Liver Disease: A Feature of the Metabolic Syndrome', Diabetes, http://diabetes.diabetesjournals.org/content/50/8/1844.full, Last accessed 08/01/2013.

The risk of heart disease generally increases with age, particularly after the age of 45. In 2011–12, 76.4% of people aged 45 years and over had dyslipidaemia. However, rates were also high for those aged under 45 years, with nearly half (49.8%) of those aged 18–44 having at least one lipid disorder. 

For more information on dyslipidaemia, see table 10 in the Data downloads section of this publication.

1. Australian Bureau of Statistics, Mar 2013, Causes of Death Australia, ABS cat. no. 3303.0, http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/3303.0Chapter42011, Last accessed 02/07/2013.
2. Kidney Health Australia, Jun 2013, Chronic Kidney Disease (CKD) Management in General Practice. 2nd Edition 2012 http://www.kidney.org.au//LinkClick.aspx?fileticket=vfDcA4sEUMs%3d&tabid=635&mid=1584, Last accessed 02/07/2013.

Estimated glomerular filtration rate measures the rate at which the kidneys filter wastes from the blood, and is considered to be the best measure of kidney function.² Impaired eGFR levels indicate that the kidneys are not working properly.

In 2011–12, 3.6% or around 620,000 people aged 18 years and over had impaired eGFR, with no significant difference between men (3.3%) and women (3.9%). Rates of impaired eGFR were very low for people aged under 54 years (less than 1%) but then markedly increased to 29.6% of people aged 75 years and over.

Around one in ten adults (10.9%) with impaired eGFR self-reported that they had kidney disease as a current and long-term health condition.

High blood pressure is an important risk factor for chronic kidney disease as high blood pressure can damage the blood vessels supplying the kidneys.³ People who had high blood pressure in 2011–12 were more likely than those with normal blood pressure to have impaired eGFR (7.2% compared with 2.7%). The NHMS also showed that obesity, which is another risk factor for kidney disease, is also related to eGFR. In 2011-12, people who were obese had higher rates of impaired eGFR than those of normal weight or underweight (4.2% compared with 2.7%).

Impaired eGFR was associated with a number of other biomarkers of chronic disease. This was particularly the case for diabetes, which is a major cause of kidney disease. In 2011–12, 17.5% of people with impaired eGFR had diabetes compared with only 4.6% of those with normal eGFR. Kidney disease was also associated with anaemia, as kidney malfunction can reduce the number of red blood cells produced by the body.² One in five (19.7%) people with impaired eGFR were at risk of anaemia in 2011–12 compared with 4.0% of those with normal eGFR.

Overall, 31.2% of those with impaired eGFR also had albuminuria.

Albuminuria is the presence of albumin (a type of protein) in the urine.³ Low levels of albumin in the urine are normal, but elevated levels may occur when kidney damage is present.¹

In 2011–12, 1.3 million (or 7.7%) people aged 18 years and over had albuminuria, with higher rates for men than women (8.5% compared to 6.9%).

Like eGFR, the prevalence of albuminuria sharply increased from the age of 65 years, with people aged 75 years and over having the highest rates (22.5%).

The relationship between albuminuria and the other chronic disease biomarkers was similar to that for eGFR. For example, people who had albuminuria were more likely than those without albuminuria to have diabetes (15.1% compared with 4.0%), and to be at risk of anaemia (10.1% compared with 4.0%).

People who had high blood pressure were also more likely to have albuminuria than those who did not have high blood pressure (13.8% compared with 6.2%).

For more information on kidney disease biomarkers, see tables 1, 2, 3, 6, 8, 9, and 15 in the Data downloads section of this publication.

1. Department of Health, Victoria, Australia, Nov 2012, The Victorian Health Monitor, 2009-2010 http://docs.health.vic.gov.au/docs/doc/CC6A20C055B5AA75CA257A80001A7128/$FILE/VHM%20report.pdf, Last accessed 24/06/2013.
2. Kidney Health Australia, Jun 2013, Chronic Kidney Disease (CKD) Management in General Practice. 2nd Edition 2012 http://www.kidney.org.au/HealthProfessionals/CKDManagementinGeneralPractice/tabid/789/Default.aspx, Last accessed 24/06/2013.
3. Australian Institute of Health and Welfare, Jun 2013, An overview of Chronic Kidney Disease in Australia, 2009 http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442459911, Last accessed 24/06/2013.

In 2011–12, around 1.7 million people (10.0%) aged 18 years and over had indicators of chronic kidney disease, with similar rates for men (10.3%) and women (9.8%). Around 4% of all adults were in Stage 1, 2.5% were in Stage 2 and less than 1% were in Stages 4–5.

Among those who had indicators of chronic kidney disease in the National Health Measures Survey (NHMS), only 6.1% self-reported having the condition. However, this is not unexpected as unlike other tests for chronic disease, results for albuminuria or abnormal eGFR alone cannot provide a diagnosis for kidney disease and could indicate the presence of an acute kidney condition or infection instead. Kidney disease can only be confirmed if albuminuria or eGFR of less than 60 mL/min/1.73 m² are persistent for at least three months.¹ The majority (65.3%) of people with indicators of chronic kidney disease who self-reported the condition had test results that indicated they were in Stages 3 to 5.

Like the patterns seen for the individual kidney disease biomarkers, the prevalence of chronic kidney disease markedly increased with age, with only 5.5% of people aged under 55 years having indicators of the disease compared with 42.2% of people aged 75 years and over.

For more information on chronic kidney disease stages, see tables 6 and 15 in the Data downloads section of this publication.

1. Kidney Health Australia, Jun 2013, Chronic Kidney Disease (CKD) Management in General Practice. 2nd Edition 2012 http://www.kidney.org.au//LinkClick.aspx?fileticket=vfDcA4sEUMs%3d&tabid=635&mid=1584, Last accessed 02/07/2013.

1. Angulo, P and Lindor, KD, 2002, 'Non-alcoholic fatty liver disease', Journal of Gastroenterology and Hepatology, http://www.gastrohep.com/conreports/bangkok/jghs2.pdf, Last accessed 01/08/2013.
2. Schindhelm, RK, et al. 2006, 'Alanine aminotransferase as a marker of non-alcoholic fatty liver disease in relation to type 2 diabetes mellitus and cardiovascular disease', Diabetes/Metabolism Research and Reviews, http://dare.ubvu.vu.nl/bitstream/handle/1871/13286/21810_Schindhelm_proefschrift_V3.pdf?sequence=1#page=95, Last accessed 08/01/2013.
3. Farrell, GC et al. 2006, 'Nonalcoholic fatty liver disease: From steatosis to cirrhosis', Hepatology, http://onlinelibrary.wiley.com/doi/10.1002/hep.20973/full, Last accessed 08/01/2013.
4. Lee, DS, et al. 2007, 'Gamma Glutamyl Transferase and Metabolic Syndrome, Cardiovascular Disease, and Mortality Risk: The Framingham Heart Study', Arteriosclerosis, Thrombosis, and Vascular Biology, http://atvb.ahajournals.org/content/27/1/127.full, Last accessed 08/01/2013.
5. Ruttman, E, et al. 2005, 'Gamma-Glutamyltransferase as a Risk Factor for Cardiovascular Disease Mortality: An Epidemiological Investigation in a Cohort of 163 944 Austrian Adults', Circulation: Journal of the American Heart Association, http://circ.ahajournals.org/content/112/14/2130.full, Last accessed 08/01/2013.

1. Benowitz, NL, 1996, Cotinine as a Biomarker of Environmental Tobacco Smoke Exposure, Epidemiologic Reviews http://epirev.oxfordjournals.org/content/18/2/188.citation, last accessed 02/07/2013.
2. Australian Bureau of Statistics, Jun 2013, Australian Health Survey: Updated Results, 2011–2012, ABS cat. no 4364.0.55.003 https://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.003, Last accessed 02/07/2013.

Haemoglobin levels were measured using a blood test. Abnormal levels of haemoglobin indicating a risk of anaemia are defined differently for males and females, young people, and pregnant women, as based on World Health Organization guidelines¹:

• Less than 120 g/L for people aged 12-14 years and females aged 15 years or older who are not pregnant
• Less than 130 g/L for males aged 15 years or older
• Less than 110 g/L for pregnant women

1. World Health Organization (WHO) 2011, Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity, Vitamin and Mineral Nutrition Information System, http://www.who.int/vmnis/indicators/haemoglobin/en/, Last accessed 26/06/2013.
2. Mehdi, U & Toto, RD 2009, 'Anemia, Diabetes, and Chronic Kidney Disease', Diabetes Care, http://care.diabetesjournals.org/content/32/7/1320.short, Last accessed 02/07/2013.

1. Dunstan et al. 2002, The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) – methods and response rates, Diabetes Research and Clinical Practice 57:119–129.
2. Department of Health 2012, The Victorian Health Monitor, http://docs.health.vic.gov.au/docs/doc/CC6A20C055B5AA75CA257A80001A7128/$FILE/VHM%20report.pdf, Last accessed 05/07/2013.
3. Dunstan et al. 2002, The Rising Prevalence of Diabetes and Impaired Glucose Tolerance, The Australian Diabetes, Obesity and Lifestyle Study, Diabetes Care 25: 829–834.
4. Diabetes Institute 2001, Diabesity & Associated Disorders in Australia - 2000. The Accelerating Epidemic, The Australian Diabetes, Obesity and Lifestyle Study (AusDiab), https://baker.edu.au/-/media/documents/impact/ausdiab/reports/ausdiab-report-2000.pdf?la=en, Last accessed 05/07/2013.
5. White et al. 2010, Comparison of the Prevalence and Mortality Risk of CKD in Australia Using the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study GFR Estimating Equations: The AusDiab (Australian Diabetes, Obesity and Lifestyle) Study, http://www.kidney.org/news/keep/pdf/adr2010/2_Stevens_KEEP_2010.pdf, Last accessed 05/07/2013.

This publication is one of several ABS releases for the 2011–13 Australian Health Survey (AHS) and is the first publication of biomedical results.

The AHS is the largest, most comprehensive health survey ever conducted in Australia. It combines the existing ABS National Health Survey (NHS) and the National Aboriginal and Torres Strait Islander Health Survey together with two new elements - a National Nutrition and Physical Activity Survey (NNPAS) and a National Health Measures Survey (NHMS).

The following diagram shows how the various elements combine to provide comprehensive health information for the overall Australian population. The content for each component survey is listed along with the ages of respondents for which topics were collected.

As shown in the above diagram, the AHS is made up of 3 components:

• the National Health Survey (NHS);
• the National Nutrition and Physical Activity Survey (NNPAS); and
• the National Health Measures Survey (NHMS)
   

All people selected in the AHS were selected in either the NHS or the NNPAS, however data items in the 'Core' were common to both surveys and therefore information for these data items is available for all persons in the AHS. All people aged 5 years and over were then invited to participate in the voluntary NHMS. This sample design allows comparisons across a wide range of information about people's health, as well as use of this information in the estimation process.

The NHMS had approximately 11,000 participants aged 5 years and over across Australia. Respondents voluntarily provided blood and urine samples, which were then analysed for specific chronic disease and nutrition biomarkers. See Appendix A for the full list of tests conducted.

The AHS also includes an additional representative sample of around 13,000 Aboriginal and Torres Strait Islander people, which was collected between April 2012 and July 2013. This is a separate collection of Aboriginal and Torres Strait Islander people living in remote and non-remote areas, including discrete communities. The structure is the same as outlined above, comprised of the National Aboriginal and Torres Strait Islander Health Survey component, the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey component and the National Aboriginal and Torres Strait Islander Health Measures Survey component. The Aboriginal and Torres Strait Islander Health Measures Survey will provide the first biomedical results for Aboriginal and Torres Strait Islander people at the population level and provides a unique opportunity to compare results with the non-Indigenous population.

The results from these surveys will be released progressively from November 2013. For more information on future releases see Release schedule.

Results from the Australian Health Survey have been released progressively from October 2012 and will continue into 2015. Please see the Australian Health Survey: Users' Guide (cat. no. 4363.0.55.001) and the Australian Aboriginal and Torres Strait Islander Health Survey: Users' Guide (cat. no .4727.0.55.002) for more information on the release schedule.

17/11/2021 - Tables 8 and 9 were replaced to correct the tables containing chronic disease biomarkers by selected health risk factors and chronic disease biomarkers by selected population characteristics. 

27/04/2015 - Amendment made to release schedule page to direct users to the release schedules in the AATSIHS and AHS Users' Guide.

26/09/2014 - This release contains replacement content on the Diabetes Management and Glossary pages. The phrase albumin creatinine ratio (ACR), which measures kidney function has been revised to albumin creatinine ratio (ACR), which measures levels of kidney damage.