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Many data sources are used for monitoring the health of populations and measuring disease frequency. All data sources have some limitations (or sources of error) and it is important to understand the potential impact these may have on reliability of results.

Provided below is information on the key national survey data sources the AIHW uses for population health monitoring, along with descriptions of some of their limitations for this purpose.

This information was last updated in April 2016.

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National Health Survey

The National Health Survey (NHS) is conducted by the Australian Bureau of Statistics (ABS) to obtain national information on the health status of Australians, their use of health services and facilities, and health-related aspects of their lifestyle. The most recent NHS was conducted in 2014–15, with previous surveys conducted in 2011–12 (as part of the Australian Health Survey), 2007–08, 2004–05, 2001, 1995, 1989–90, 1983 and 1977–78.

The NHS collects information on various long-term health conditions, including conditions that the AIHW routinely monitors such as:

  • arthritis
  • asthma
  • back problems
  • cancer
  • cardiovascular disease (CVD)
  • chronic kidney disease (CKD)
  • chronic obstructive pulmonary disease (COPD)
  • diabetes
  • mental health.

For certain long-term health conditions, the NHS collects information about health services and medicine use and other health-related actions taken to manage conditions.

Scope of the NHS

The 2014–15 NHS surveyed around 19,000 people and included urban and rural areas in all states and territories. Very remote areas and discrete Aboriginal and Torres Strait Islander communities were excluded.

The survey excluded non-private dwellings, such as hospitals, nursing homes, hotels, motels and short-stay caravan parks. The survey also excluded: certain diplomatic personnel of overseas governments; persons whose usual place of residence was outside Australia; members of non-Australian defence forces (and their dependents) stationed in Australia; and visitors to private dwellings.

Data quality

When interpreting data from the 2014–15 NHS, some limitations need to be considered:

  • Much of the data is self-reported and therefore relies heavily on respondents knowing and providing accurate information.
  • The survey is community-based and does not include information from people living in nursing homes or otherwise institutionalised.
  • Residents of Very remote areas and discrete Aboriginal and Torres Strait Islander communities were excluded from the survey. This is unlikely to affect national estimates, but will impact prevalence estimates by remoteness.  

While data from the 2014–15 NHS are largely comparable with earlier surveys, there are some exceptions. In the 2014–15 NHS:

  • The definition of 'Back problems' was expanded to include sciatica, disc disorders, back pain/problems not elsewhere classified and curvature of the spine.
  • A new category ('Transient ischaemic attack' (TIA, 'mini stroke')) was introduced to the prompt card for circulatory conditions and coded to 'Other cerebrovascular diseases'. Estimates of 'Other cerebrovascular diseases' have increased while estimates of 'Stroke' have decreased.
  • A new module dedicated to mental and behavioural conditions was introduced. In previous surveys, these conditions were collected in a module that included a range of long-term health conditions. Estimates of mental and behavioural conditions have increased, potentially because of the prominence of these conditions in the new module, and are not comparable to earlier years.

For further details, see the ABS publication National Health Survey: First Results, 2014–15 (ABS cat. no. 4364.0.55.001) and National Health Survey: Users' Guide, 2014-15 (forthcoming).

Australian Health Survey

In 2011–13, the ABS conducted the Australian Health Survey (AHS). The AHS was designed to collect a range of information from Australians about health-related issues, including health status, risk factors, actions, and socioeconomic circumstances. The AHS included the 2011–12 NHS as well as new information on nutrition and physical activity and the first national biomedical information collection conducted by the ABS. The 2011–13 AHS was made up 3 components (see Figure 1 below):

All people selected in the 2011–13 AHS were selected in either the 2011–12 NHS or the 2011–12 NNPAS. However, some data items were common to both surveys. These items are often referred to as the AHS Core Content and include household information, demographics, self-assessed health status and information on selected conditions. All persons aged 5 and over in the 2011–12 NHS and 2011–12 NNPAS were invited to participate in the voluntary 2011–12 NHMS.

The NHMS component collected voluntary samples from Australian adults and children across urban and rural areas. Voluntary urine samples were collected from respondents aged 5 and over and voluntary blood samples from respondents aged 12 and over. The survey focused on test results related to chronic diseases, including diabetes, CVD, CKD and liver function. Results also included measures of exposure to tobacco smoke and risk of anaemia.

Figure 1: Structure of the Australian Health Survey

Flow chart diagram showing structure of the Australian Health Survey; National Health Survey (NHS); National Nutritional and Physical Activity Survey (NNPAS); Core content; National Health Measures Survey (NHMS).

Source: ABS 2013.

Scope of the AHS

The 2011–13 AHS surveyed around 32,000 people. The survey included urban and rural areas in all states and territories and excluded Very remote areas and discrete Aboriginal and Torres Strait Islander communities. The Australian Aboriginal and Torres Strait Islander Health Survey was conducted in 2012–13 to obtain the same health data for Indigenous Australians (see below for details).

The survey excluded non-private dwellings, such as hospitals, nursing homes, hotels, motels and short-stay caravan parks. It also excluded: certain diplomatic personnel of overseas governments; persons whose usual place of residence was outside Australia; members of non-Australian defence forces (and their dependents) stationed in Australia; and visitors to private dwellings.

Data quality

The AHS is subject to some of the same limitations described above for the NHS, including those related to self-reported data, exclusion of institutionalised persons, and issues with remoteness estimates. Additionally, the NHMS component of the AHS had a much lower response rate (37.1%) than the NHS component (84.8%) and the NNPAS component (77.0%).

Further information about the data quality of the AHS can be found in the ABS publication Australian Health Survey: Users' Guide, 2011–13 (ABS cat. no. 4363.0.55.001).

Australian Aboriginal and Torres Strait Islander Health Survey

The Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) was conducted by the ABS in 2012–13. Like the 2011–13 AHS, the AATSIHS was made up of three components:

  • the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS)
  • the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS)
  • the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS).

The NATSIHS is conducted by the ABS to obtain national information on the health status of Aboriginal and Torres Strait Islander Australians, their use of health services and facilities, and health-related aspects of their lifestyle. The NATSIHS has been previously conducted in 2004–05, 2001 and 1995, while the NATSINPAS and NATSIHMS were conducted for the first time in 2012–13.

All people selected in the 2012–13 AATSIHS were selected in either the 2012–13 NATSIHS or the 2012–13 NATSINPAS. Some data items were common to both surveys; for example, household information, demographics, self-assessed health status and self-assessed body mass.

All persons aged 18 and over in the 2012–13 NATSIHS and 2012–13 NATSINPAS were invited to participate in the voluntary 2012-13 NATSIHMS. The NATSIHMS collected blood and urine samples for tests related to nutritional status and chronic disease.

Scope of the AATSIHS

The 2012–13 AATSIHS surveyed around 12,900 Indigenous Australians (around 9,300 were surveyed in the 2012-13 NATSIHS). The survey included people in remote and non-remote areas and discrete Aboriginal and Torres Strait Islander communities.

The survey excluded non-private dwellings, such as hospitals, nursing homes, hotels, motels and short-stay caravan parks. It also excluded: certain diplomatic personnel of overseas governments; persons whose usual place of residence was outside Australia; members of non-Australian defence forces (and their dependents) stationed in Australia; and visitors to private dwellings.

Data quality

Limitations that need to be considered when interpreting data from the 2012–13 AATSIHS include:

  • Much of the data is self-reported and therefore relies heavily on respondents knowing and providing accurate information.
  • The survey does not include information from people living in nursing homes or otherwise institutionalised.
  • The NATSIHMS component of the AASTIHS had a much lower response rate (40.0%) than the NATSIHS component (80.2%) and the NATSINPAS component (79.2%).

For further details, see the ABS publication Australian Aboriginal and Torres Strait Islander Health Survey: Users' Guide, 2012­­–13 (ABS cat. no. 4727.0.55.002).

Survey of Disability, Ageing and Carers

The Survey of Disability, Ageing and Carers (SDAC) is conducted by the ABS to collect information about people of all ages with a disability, older people (aged 60 and over), and people who provide assistance to older people and people with disabilities. Information was also collected on people who were not in these populations, allowing for comparison of their relative demographic and socioeconomic situations, and is useful in determining the prevalence of certain disease that are very high in older age groups (e.g. stroke) who are more likely to reside in cared-accommodation. There are two components of the SDAC: the household component (people living in private and non-private dwellings with no on-site care facilities) and the cared-accommodation component (people living in cared-accommodation such as hospitals and nursing homes). The most recent SDAC was conducted in 2012; similar surveys were conducted in 2009, 2003, 1998, 1993, 1988 and 1981.

Scope of the SDAC

The SDAC includes people in both private and non-private dwellings (including people in establishments where care is provided) but excludes those in correctional institutions.

Data quality

The data quality declaration for the 2012 SDAC can be found in the ABS publication Disability, Ageing and Carers, Australia: Summary of Findings, 2012 (ABS cat. no. 4430.0).

Reference

ABS (Australian Bureau of Statistics) 2013. Structure of the Australian Health Survey. Canberra: ABS. Viewed 2 March 2016.