Prevalence of risk factors for chronic diseases

Risk factors are highly prevalent in Australia. For example, around 20% Australians aged 14 years and over are daily smokers, 10% consume alcohol at risky levels, 30% Australians aged 25 years and over had high blood pressure, 50% had high blood cholesterol levels, and 60% carried excess weight.

This page provides information on prevalence of the risk factors that affect the onset, maintenance and prognosis of a variety of chronic diseases. 
Those risk factors include: 

• poor diet and nutrition
• physical inactivity
• tobacco smoking
• alcohol misuse
• high blood pressure
• high blood cholesterol
• excess weight. 

Prevalence estimates are based on either self-reported or measured data from various national surveys (see the AIHW web site Risk factors for detailed data sources and other useful information).  

Poor diet and nutrition

There have been limited data collected in recent years on food and nutrient intake of Australians. National data are available mainly from the 1983 National Dietary Survey of Adults, the 1985 National Dietary Survey of School Children and the 1995 National Nutrition Survey. 

Data from the 1995 National Nutrition Survey indicate a 32.5% contribution of fats to energy intake for Australians aged 19 and over (maximum recommended level, 30%), of which 12.5% is from saturated fats (maximum recommended level, 10%).  Similarly, persons aged 19 and over are reported to consume 144g of fruit (minimum recommended level, 300g) and 259g of vegetables (minimum recommended level, 300g) per day. Put differently, 2 in 3 Australians are not consuming the recommended level of vegetables, 4 in 5 are not consuming enough fruit, and 1 in 2 males and 2 in 3 females are not eating the recommended levels of cereal foods (Table 1).

Table 1: Comparison of food intake with recommended levels in Australia, 1995

Food group	Amount	Proportion of persons with inadequate intake	Recommended level
Vegetables	Too little	2 in 3	300g per day (minimum)
Fruit	Too little	4 in 5	300g per day (minimum)
Cereal foods	Too little	1 in 2 males              2 in 3 females	210g per day (minimum)
Fat	Too much	2 in 3 males     1 in 2 females	30% of energy (maximum)
Saturated fat	Too much	2 in 3	10% of energy (maximum)

Source: Cancer Council Australia 2001. National cancer prevention policy 2001-2003. Sydney: The Cancer Council Australia.

There have been significant changes in food and nutrient intake in the Australian population in the past two decades. For both adults and children, intake of energy, dietary fibre, carbohydrate and iron all increased significantly during this period (Table 2). The calcium intake among adults and protein consumption among children also increased considerably. By contrast, fat intake among adults decreased. There was a decrease in vitamin C consumption, largely attributable to a fall in fruit consumption among adults and fruit juices among children.

Table 2: Comparison of nutrient intake in Australia, 1980s and 1995

Nutrient/indicator	Adults (aged 25-64 years)		Adolescents (aged 10-15 years)
	Direction (a)	Extent of change	Direction (a)	Extent of change
Energy	Increased	Males-3% Females-4%	Increased	Boys-15% Girls-11%
Protein	Unchanged		Increased	Boys-14% Girls-13%
Carbohydrate	Increased	Males-17% Females-16%	Increased	Boys-22% Girls-18%
Fat	Decreased	Males-6% Females-4%	Unchanged
Cholesterol	Decreased	Males-14% Females-22%	Unchanged
Fibre	Increased	Males-13% Females-10%	Increased	Boys-13% Girls-8%
Calcium	Increased	Males-18% Females-14%	Unchanged
Iron	Increased	Males-11% Females-15%	Increased	Boys-16% Girls-11%
Vitamin C	Decreased	Males-8% Females-7%	Decreased	Boys-not significant Girls-10%

Note: (a) Where there is a trend in mean intake it is significant at 1% level.
Source: Cook et al. 2001. Comparable data on food and nutrient intake and physical measurements from the 1983, 1985 and 1995 national surveys. Canberra: Department of Health and Ageing.

Physical inactivity

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Data from the 2000 National Physical Activity Survey showed that around 43% of Australians aged 18-75 years did not undertake physical activity at the levels recommended to achieve health benefits. Around 15% of people reported undertaking no physical  activity at all, and 28% reported undertaking insufficient activity (some activity but for either insufficient time or for too few sessions) (Figure 1). More men (18%, age-standardised) than women (13%) reported 'no physical activity'.

Figure 1: Level of physical activity among Australians aged 18-75, 2000

Note: 'Sufficient' activity is defined as 150 minutes of activity per week (30 mins/day - 5 days/week), using the sum of walking, moderate activity and vigorous activity (weighted by two). Source: Derived from Bauman et al. 2001. Trends in population levels of reported physical activity in Australia, 1997, 1999 and 2000. Canberra: Australian Sports Commission.

There were declines in physical activity between 1997 and 2000 for adult Australians. The proportion of Australians reporting lower-than-recommended levels of physical activity rose from 38% to 43% (age-standardised). These declines were also observed across all age groups, with exception of those aged 60-75 for whom activity levels remained fairly stable (Figure 2). The greatest increase in insufficient or no physical activity was seen among those aged 30-44, from 36% to 46%. 

Figure 2: Trends in insufficient or no physical activity among Australians aged 18-75, 1997-2000

Source: Derived from Bauman et al. 2001. Trends in population levels of reported physical activity in Australia, 1997, 1999 and 2000. Canberra: Australian Sports Commission.

Physical inactivity data are available in the Risk factor data store on the AIHW web site.

Tobacco

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Estimates from the 2001National Drug Strategy Household Survey indicate that around 19.5% of Australians aged 14 years and over (3.1 million) smoked tobacco daily (smoking at least once a day). A further 3.6% (600,000) reported occasional smoking (smoking less than daily, that is once a week or less than once a week), and a further 26.2% were former smokers (smoked more than 100 cigarettes or the equivalent amount of tobacco in their life, and reporting no longer smoking). 50.6% had never smoked. Males were more likely to be daily smokers, with a rate of 21.1%, compared with 18.0% for females. 

Daily smoking was most prevalent in the 20-29 age group (28.5% males and 23.7% females), and lowest among those 60 and over (10.2% and 7.8% respectively) (Figure 3). Among teenagers aged 14-19 years, 15.1% were daily smokers, with 16.2% and 14.1% for girls and boys respectively. For all other ages, males had higher daily smoking rates than females.

Figure 3: Proportion of daily smokers by age group, Australia, 2001

Source: Derived from AIHW 2002. 2001 National Drug Strategy Household Survey: First results. AIHW cat. no. PHE35. Canberra: AIHW (Drug Statistics Series NO. 9).

Daily smoking rates in Australia have been declining since the 1950s, when it was estimated that around 70% of males and 30% of females smoked. Over the past 15 years, both male and female smoking prevalence have continued to decline, with a rate of 21% for males and 18% for females in 2001 (Figure 4).

Figure 4: Daily smokers: proportion of people aged 14 years and over, Australia, 1985 to 2001

Source: Derived from AIHW 2003. Statistics on drug use in Australia 2002. AIHW cat. no. PHE 43. Canberra: AIHW (Drug Statistics Series no. 12).

The impact of smoking can been seen in both the increases and decline in COPD and lung cancer death rates among males, which occurred about 20 years after the increase and decline in tobacco consumption in Australia (Figure 5).

Figure 5: Per capita consumption of tobacco and death rates for COPD and lung cancer, 1945 to 1998

Source: AIHW: deloop M & Bhatia K 2001: Australian Health Trends 2001. AIHW Cat. No. PHE 24. Canberra: AIHW; the National Mortality Database.

Tobacco smoking data are available in the Risk factor data store on the AIHW web site.

Alcohol misuse

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The National Health and Medical Research Council Australian Alcohol Guidelines are used to assess the prevalence of alcohol misuse.

Results from the 2001 National Drug Strategy Household Survey show that around 18% of Australians aged 14 years and over abstained from alcohol, 73% consumed alcohol at levels considered a  low risk to health in the long term, and 10% at levels considered risky or a high risk to health in the long term (Table 3). 

The proportion of males and females drinking at risky or high risk levels for harm in the long term were similar (10.2% and 9.4% respectively, age-standardised).

Table 3: Proportion of Australians aged 14+ at risk of harm in the long term, 2001

Long term risk	Males	Females	Persons
	Per cent
Abstainers	14.1	20.8	17.5
Low risk	75.6	69.8	72.7
Risk	6.7	7.2	7.0
High risk	3.5	2.2	2.9

Note: Abstainers refer to those who did not consume alcohol in the last 12 months.
Source: AIHW 2003. Statistics on drug use in Australia 2002. AIHW cat. no. PHE 43. Canberra: AIHW (Drug Statistics Series no. 12).

People in the 20-29 age group and females aged 15-19 are most likely to drink at levels considered risky or a high risk for long term alcohol related harm (Figure 6). 

Figure 6: Proportion of Australians aged 14+ at risk of harm in the long term, by age group, 2001

Source: Derived from AIHW 2003. Statistics on drug use in Australia 2002. AIHW cat. no. PHE 43. Canberra: AIHW (Drug Statistics Series no. 12).

Alcohol consumption data are available in the Risk factor data store on the AIHW web site.

High blood pressure

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Data from the 1999-2000 Australian Diabetes, Obesity and Lifestyle Study indicate that 30% or 3.7 million Australians over the age of 25 years had high blood pressure or were on medication for that condition - 32% of men and 27% of women. The proportion of men and women with high blood pressure increased with age (Figure 7).

Figure 7: Proportion of Australians aged 25 years and over with high blood pressure, by age group, 1999-2000

Note: High blood pressure is defined as systolic blood pressure of 140 mmHg or more; or diastolic blood pressure of 90 mmHg or more; or receiving medication for high blood pressure. Source: AIHW analysis of the 1999-2000 AusDiab.

Since 1980 the prevalence of high blood pressure has decreased markedly for both males and females (Figure 8). The proportion of men aged 25-64 years with high blood pressure has more than halved from 47% in 1980 to 21% in 1999-2000 and has halved for women from 32% in 1980 to 16% in 1990-2000. 

Figure 8: Proportion of Australians aged 25-64 years with high blood pressure, 1981 to 1999-2000

Notes:  1. Age-standardised to the 2001 Australian population. 2. High blood pressure is defined as systolic blood pressure of 140 mmHg or more; or diastolic blood pressure of 90 mmHg or more; or receiving medication for high blood pressure. 3. Urban areas only. Source: AIHW analysis of the 1980, 1983, and 1989 Risk Factor Prevalence surveys, the 1995 National Nutrition Survey and the 1999-2000 AusDiab.

Blood pressure data are available in the Risk factor data store on the AIHW web site.

High blood cholesterol

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The 1999-2000 Australian Diabetes, Obesity and Lifestyle Study found that around 50% of men and women in Australia had high blood cholesterol levels, that is, nearly 6.5 million Australian adults aged 25 years and over. The prevalence increased with age, reaching 74% for women aged 65-74  and 62% for men aged 55-64 in men (Figure 9).

Figure 9: Proportion of Australians aged 25 years and over with high blood cholesterol, by age group, 1999-2000

Note: high blood pressure is 5.5 mmol/L or more. Source: AIHW analysis of the 1999-2000 AusDiab.

There has been no apparent reduction in the prevalence of people with high blood cholesterol since 1980 (Figure 10).

Figure 10: Proportion of Australians aged 25-64 years with high blood cholesterol, 1981 to 1999-2000

Notes:  1. Age-standardised to the 2001 Australian population. 2. High blood cholesterol is 5.5 mmol/L or more. 3. Capital cities only. Source: AIHW analysis of the 1980, 1983, and 1989 Risk Factor Prevalence surveys and the 1999-2000 AusDiab.

Blood cholesterol data are available in the Risk factor data store on the AIHW web site.

Excess weight

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The most recent estimates of levels of excess weight in the Australian population are from the 1999-2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). The survey measured height, weight (which are used to calculate body mass index) and waist circumference.

Body mass index (BMI)

According to the AusDiab survey, 19% of males and 22% of females aged 25 and over were obese. And additional 48% of males and 30% of females were overweight but not obese. Total proportions with excess weight therefore were 67% of males and 52% of females.

In both males and females, excess weight increases with age, peaking in the 55-64 age group for males and 65-74 for females (Figure 10). For both sexes, obesity is most common among those aged 55-64. 

Figure 11: Proportion of Australians aged 25 years and over with excess weight, by age group, 1999-2000

Source: AIHW analysis of the 1999-2000 AusDiab.

In Australian adults, excess weight as measured by BMI appears to have increased since the 1980s. The proportion of males aged 25-64 with excess weight increased from 47% in 1980 to 67% in 1995, before declining slightly to 65% in 1999-2000. The proportion increased from 26% to 48% for females from 1980 to 1995, with a decline to 45% in 1999-2000 (Figure 11). Looking just at the population classified as obese, the proportions increased from around 8% for both males and females in 1980 to 16% for males and 19% for females in 1999-2000.

Figure 12: Proportion of Australians aged 25-64 years who are overweight or obese, 1981 to 1999-2000

Notes:  1. Age-standardised to the 2001 Australian population. 2. Urban areas only 3. Based on BMI classification. Source: AIHW analysis of the 1980, 1983, and 1989 Risk Factor Prevalence surveys, the 1995 National Nutrition Survey and the 1999-2000 AusDiab.

BMI data are available in the Risk factor data store on the AIHW web site.

Waist circumference

According to the waist circumference measurements in the 1999-2000 Australian Diabetes, Obesity and Lifestyle Study, an estimated 27% of adult males and 34% of adult females are classified as abdominally obese. A further 20% of males and 22% of females were classified as abdominally overweight but not obese.

Last reviewed by on 23 June 2005