Goal 5: Reduce the impact of diabetes among Aboriginal & Torres Strait Islander peoples

Goal 5 focusses on reducing the impact of diabetes among Aboriginal and Torres Strait Islander people.

A number of indicators were identified to measure the progress of Goal 5, some of which were included in Goals 1-4 and, where possible, have been included under the relevant goal above:

The indicators reported specifically for Goal 5 are:

Indicator 5.1 Hospitalisation for diabetes by type of diabetes

Type 1 diabetes

In 2015–16, there were around 860 hospitalisations with a principal diagnosis of type 1 diabetes among Indigenous Australians (Data tables). The type 1 diabetes hospitalisation rate was higher in Indigenous females than males (133 and 96 hospitalisations per 100,000 population, respectively).

Hospitalisation rates for type 1 diabetes among Indigenous Australians were 1.9 times as high among Indigenous Australians living in Major cities as those living in Remote and Very remote areas.

Figure 5.1.1 Hospitalisations for type 1 diabetes (principal diagnosis) in Aboriginal and Torres Strait Islander Australians, by age group and sex, 2015–16

The vertical bar chart displays the rate of hospitalisations for type 1 diabetes, as a principal diagnosis, among ATSI Australians by age group and sex. With the exception of those aged 0–4 years and 55–64 years, the rate was higher among females than males. Among females, the rate of hospitalisations peaked among those aged 45–54 years (211 per 100,000 population). In males, the rate was highest among those aged 25–34 years (154 per 100,000 population).

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 5.1’ for data notes.

Type 2 diabetes

In 2015–16, there were around 2,300 hospitalisations with a principal diagnosis of type 2 diabetes among Indigenous Australians (Data tables). The hospitalisation rate was similar among Indigenous males and Indigenous females (576 and 514 per 100,000 population, respectively) (Figure 5.1.2).

Hospitalisations for type 2 diabetes were 2.1 times as high among Indigenous Australians living in Remote and Very remote areas as those living in Major cities.

Figure 5.1.2 Hospitalisations for type 2 diabetes (principal diagnosis) among Aboriginal and Torres Strait Islander Australians, by age group and sex, 2015–16

The vertical bar chart displays the rate of hospitalisations for type 2 diabetes, as a principal diagnosis among Indigenous Australians, by age group and sex. The hospitalisation rate increased with increasing age and, among those aged 35 years and above, was higher among males than females. The rate peaked in those aged 65 years and above in both males (1,786 per 100,000 population) and females (1,514 per 100,000 population).

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 5.1’ for data notes.

Diabetes during pregnancy

In 2015–16, there were almost 500 hospitalisations with a principal diagnosis of diabetes during pregnancy, including pre-existing and gestational diabetes, among Indigenous women (Data tables). The hospitalisation rates were highest among Indigenous women aged 25–34 (Figure 5.1.3). Hospitalisation rates increased substantially with increasing remoteness. The rate was over 12 times as high among those living in Remote and Very remote areas (739 per 100,000 females) as those living in Major cities (60 per 100,000 females).

Figure 5.1.3 Hospitalisations for diabetes during pregnancy (principal diagnosis) in Aboriginal and Torres Strait Islander females, by age group, 2015–16

The vertical bar chart displays the rate of hospitalisations for diabetes during pregnancy, as a principal diagnosis, among Indigenous women aged 10–44 years. The rate was highest among women aged 25–34 years (526 per 100,000 women).

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 5.1’ for data notes.

Indicator 5.2 Ratio of separations for Aboriginal and Torres Strait Islander people to all Australians, diabetes

In 2015–16, the ratio of hospitalisations for diabetes, as a principal or additional diagnosis, was higher among Indigenous Australians compared with all Australians in all age groups except those aged 0–4. The ratio peaked in those aged 45–54 (6.7 times as high, Figure 5.2.1).

The ratio of diabetes-related hospitalisations for Aboriginal and Torres Strait Islander people compared to all Australians increased with remoteness, from 2.7 times as high in Indigenous Australians living in Major cities to 3.4 times as high among Indigenous Australians living in Remote and Very remote areas. There was some variation in the ratio by state and territory, with the greatest difference in hospitalisation rates being in Western Australia (6 times as high) and the smallest in Tasmania (1.3 times as high, Figure 5.2.2).

Figure 5.2.1 Ratio of hospitalisations for diabetes (principal or additional diagnosis) for Aboriginal and Torres Strait Islander people to all Australians, by age group and sex, 2015–16

The vertical bar chart shows the ratio of hospitalisations for diabetes for Indigenous Australians compared to all Australians, by age group and sex. Among males in the 35–44 year age group, the ratio of hospitalisations were 8 times as high among Indigenous Australians when compared to all Australians. The ratio of hospitalisations was 7.9 times as high among Indigenous women when compared with non-Indigenous women in the 45–54 year age group.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 5.2’ for data notes.

Figure 5.2.2 Ratio of hospitalisations for diabetes (principal or additional diagnosis) for Aboriginal and Torres Strait Islander people to all Australians, by state and territory, 2015–16

The vertical bar chart shows the ratio of hospitalisations for diabetes (principal or additional diagnosis) for Indigenous Australians compared to all Australians, by state and territory. The disparity was greatest among those living in Western Australia, where the rate of hospitalisations was 6 times as high among Indigenous Australian compared with all Australians. The difference was lowest in Tasmania, where Indigenous hospitalisation rates were 1.3 times as high as the rate among all Australians.

Note:

  1. Age-standardised to the 2001 Australian Population. See data table ‘Indicator 5.2’ for data notes.

Source: AIHW National Hospital Morbidity Database.

Indicator 5.3 Hospitalisation for principal diagnosis of diabetes by additional diagnosis

In 2015–16, the most common additional diagnosis for hospitalisations with a principal diagnosis of diabetes were related to Factors influencing health status and contact with health services. These include care or services for an ongoing condition, such as dialysis, and a problem or situation that influences a person’s health status (e.g. problems related to lifestyle).

Diseases of the genitourinary system, and Certain infections and parasitic diseases were identified in over a third of hospitalisations with a principal diagnosis of type 2 diabetes. Endocrine, nutritional and metabolic disease was the most commonly identified additional diagnosis associated with a principal diagnosis of type 1 diabetes.

Figure 5.3.1 Hospitalisations of Indigenous persons for a principal diagnosis of diabetes mellitus, by additional diagnosis of hospitalisation, 2014–16

The horizontal bar chart displays the percentage of hospitalisations with a principal diagnosis of diabetes by the additional diagnoses. The most common additional diagnosis were related to Factors influencing health status and contact with health services which were identified in 61%25 hospitalisations with a primary diagnosis of type 1 diabetes, 80%25 hospitalisations with a primary diagnosis of type 2 diabetes, and 57%25 hospitalisations with a primary diagnosis of diabetes during pregnancy.

 Note:

  1. A single hospital separation can have multiple additional diagnoses.

Source: AIHW National Hospital Morbidity Database. See data table ‘Indicator 5.3’ for data notes.

Indicator 5.4 Age-standardised death rate for diabetes by Indigenous status

Over the period 2012–2016, the age-standardised death rate for diabetes (underlying and/or associated cause) was more than 4 times as high among Indigenous Australians as non-Indigenous Australians (228 and 55 deaths per 100,000 population, respectively) (Data tables). The disparity in rates between the Indigenous and non-Indigenous populations was greater among females (5.3 times as high) than males (3.3 times as high). The death rate for diabetes increased with age for both Indigenous Australians and non-Indigenous Australians, and was higher in Indigenous than non-Indigenous Australians in each age group (Figure 5.4.1).

The difference between Indigenous and non-Indigenous death rates for diabetes was greatest in South Australia where the rate was 6.4 times as high. The disparity was lowest in New South Wales where the Indigenous diabetes-related death rate was 2.5 times that of the non-Indigenous rate (Figure 5.4.2).

Figure 5.4.1: Death rate for diabetes, by Indigenous status and age group, 2012–2016

The vertical bar chart displays the death rate for diabetes by Indigenous status and age group. The disparity in death rates was greatest among those aged 85+ years, where the death rate was 2,872 per 100,000 population among Indigenous Australians and 1,258 per 100,000 population among non-Indigenous Australians.

Note:

  1. Data are reported for 5 jurisdictions—New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. Other jurisdictions have a small number of Indigenous deaths, and identification of Indigenous deaths in their death registration systems is relatively poor, making the data less reliable.

Source: AIHW analysis of National Mortality Database. See data table ‘Indicator 5.4’ for data notes.

Figure 5.4.2: Age-standardised death rate for diabetes, by Indigenous status and state and territory, 2012–2016

The vertical bar chart displays the age-standardised death rate for diabetes by Indigenous status and state and territory. The disparity between Indigenous and non-Indigenous rates was highest among those living in South Australia, where the rate was 6.4 times as high among Indigenous Australians and lowest among those living in New South Wales (2.5 times as high among Indigenous Australians).

Notes:

  1. Data are reported for 5 jurisdictions—New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. Other jurisdictions have a small number of Indigenous deaths, and identification of Indigenous deaths in their death registration systems is relatively poor, making the data less reliable.
  2. Age-standardised to the 2001 Australian Population.

Source: AIHW analysis of National Mortality Database. See data table ‘Indicator 5.4’ for data notes.

Indicator 5.5 Avoidable and preventable deaths from diabetes

Avoidable and preventable deaths refer to deaths from conditions which, given timely and effective medical care, are considered preventable. Between 2012 and 2016, the age-standardised rate of avoidable and preventable deaths from diabetes was 48 per 100,000 population among Indigenous Australians (Data tables). Overall, the rate was similar among males and females (47 per 100,000 population and 49 per 100,000 population respectively). The rate of avoidable and preventable deaths from diabetes increased with age for both Indigenous males and females (Figure 5.5.1).

There was variation in the rate of avoidable and preventable deaths from diabetes by state and territory. The Northern Territory had the highest rate (120 per 100,000 population), which was almost 6 times as high as the rate in New South Wales (21 per 100,000 population, Figure 5.5.2).

Figure 5.5.1 Avoidable and preventable deaths from diabetes among Indigenous Australians, by age group and sex, 2012–2016

The vertical bar chart shows the rate of avoidable and preventable deaths from diabetes by age group and sex among Indigenous Australians aged less than 75 years. The rate increased with increasing age and peaked in those aged 65–74 years in both males (272 per 100,000 population) and females (312 per 100,000 population).

Note:

  1. Data are reported for five jurisdictions—New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. Other jurisdictions have a small number of Indigenous deaths, and identification of Indigenous deaths in their death registration systems is relatively poor, making the data less reliable.

Source: AIHW analysis of National Mortality Database. See data table ‘Indicator 5.5’ for data notes.

Figure 5.5.2 Avoidable and preventable from deaths from diabetes among Indigenous Australians, by state/territory, 2012-2016

The vertical bar chart shows the age-standardised rate of avoidable and preventable deaths from diabetes among Indigenous Australians aged less than 75 years by state and territory. The rate varied from 21 deaths per 100,000 population among those living in the New South Wales, to 120 deaths per 100,000 population in the Northern Territory.

Notes:

  1. Data are reported for 5 jurisdictions—New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. Other jurisdictions have a small number of Indigenous deaths, and identification of Indigenous deaths in their death registration systems is relatively poor, making the data less reliable.
  2. Age-standardised to the 2001 Australian Population.

Source: AIHW analysis of National Mortality Database. See data table ‘Indicator 5.5’ for data notes.

Indicator 5.6 Indigenous regular clients with type 2 diabetes who had a blood pressure test

As at June 2016, the majority (63%) of Indigenous regular clients with type 2 diabetes who attended Indigenous primary health care services had a blood pressure result recorded within the previous 6 months (AIHW 2017a). The proportion was lowest in those under 15 years (Figure 5.6.1).

The proportion of Indigenous regular clients with a recorded blood pressure test was highest among those living in Inner regional areas (67%) and lowest in those living in Very remote areas (59%) (Data tables). However, results may be an underestimate, due to June 2016 data for Northern Territory Government services excluding measurements conducted outside an individual service.

By state and territory, the proportion of Indigenous regular clients with type 2 diabetes who had a recorded blood pressure result within the previous 6 months, ranged from 67% in Queensland to 58% in the Northern Territory.

Figure 5.6.1 Percentage of Indigenous regular clients with type 2 diabetes who had a blood pressure result recorded in the primary health organisation in the previous 6 months, by age group and sex, June 2016

The vertical bar chart shows the proportion of Indigenous regular clients with type 2 diabetes who attended a primary health care service and had a blood pressure test in the previous 6 months, by age group and sex. With the exception of those aged less than 15 years, more than half of Indigenous clients had received a blood pressure test in the previous 6 months. Among those aged less than 15 years, 39%25 of males and 49%25 of females had a blood pressure test recorded.

Notes:

  1. Regular client refers to those who visited a particular primary health care provider 3 or more times in the last 2 years.

Source: AIHW 2017a. See data table ‘Indicator 5.6’ for data notes.

Indicator 5.7 Indigenous regular clients with type 2 diabetes who had a kidney function test

As at June 2016, 62% of regular clients of Indigenous primary health care services with type 2 diabetes had a kidney function test recorded within the previous 12 months (AIHW 2017a). Proportions were similar in males and females, with the exception of 15–24 year olds for whom the proportion was higher in females (58%) than males (53%) (Figure 5.7.1).

The proportion with a test recorded in the previous 12 months was similar across remoteness areas (Figure 5.7.2). However, there was some variation across states, with the highest proportion in Victoria/Tasmania (68%) and lowest in the Northern Territory (57%).

Figure 5.7.1 Percentage of Indigenous regular clients with type 2 diabetes who had a kidney function test, by age group and sex, June 2016

The vertical bar chart shows the proportion of Indigenous regular clients, aged 15 years and older, with type 2 diabetes who attended a primary health care service and had a kidney function test in the previous 12 months, by age group and sex. Proportions were similar in males and females, with the exception of 15–24 year olds for whom the proportion was slightly higher in females (58%25) than males (53%25)

Notes:

  1. Regular client refers to those who visited a particular primary health care provider 3 or more times in the last 2 years.

Source: AIHW 2017a. See data table ‘Indicator 5.7’ for data notes.

Figure 5.7.2 Percentage of Indigenous regular clients aged 15 and over with type 2 diabetes who had a kidney function test recorded within the previous 12 months, by jurisdiction and remoteness area, June 2016

The horizontal bar chart shows the percentage of Indigenous regular clients aged 15 and over with type 2 diabetes who had a kidney function test recorded in the past 12 months, by remoteness area and state and territory. The rate did not vary substantially by remoteness area. However, the proportion was lowest in the Northern Territory (57%25) and highest among those in Victoria and Tasmania (68%25).

Note:

  1. Regular client refers to those who visited a particular primary health care provider 3 or more times in the last 2 years.

Source: AIHW 2017a. See data table ‘Indicator 5.7’ for data notes.

Indicator 5.8 Indigenous regular clients with type 2 diabetes who had a kidney function test with results within the specified levels

As at June 2016, 80% of Indigenous regular clients of Indigenous primary health care services aged 15 and over with type 2 diabetes had a kidney function test result within specified levels (eGFR test result ≥60 mL/min/1.73 m2) in the previous 12 months (AIHW 2017a). The proportion within the specified range declined with increasing age (Figure 5.8.1). There was little difference in the proportion whose results were within specified levels by remoteness area or by state and territory (Figure 5.8.2).

Figure 5.8.1 Percentage of Indigenous regular clients aged 15 and over with type 2 diabetes who have had an eGFR recorded within the previous 12 months with a result within specified levels (≥ 60mL/min/1.73 m2), by age group and sex, June 2016

The vertical bar chart shows the percentage of Indigenous regular clients aged 15 and over, with type 2 diabetes, who had an eGFR recorded in the past 12 months that was within specified levels. This data is displayed by age group and sex. The percentage of clients who were within specified levels decreased with increasing age. The percentage was highest among those aged 15–24 years, with 99%25 of females and 97%25 of males identified to have a result within specified levels. In contrast, among those 65 years and older, 61%25 of males and 57%25 of females had a result within specified levels. There was little difference between males and females within age groups.

Note:

  1. Regular client refers to those who visited a particular primary health care provider 3 or more times in the last 2 years.

Source: AIHW 2017a. See data table ‘Indicator 5.8’ for data notes.

Figure 5.8.2 Percentage of Indigenous regular clients aged 15 and over with type 2 diabetes who have had an eGFR recorded within the previous 12 months with a result within specified levels (≥ 60mL/min/1.73 m2), by jurisdiction and remoteness area, June 2016

The horizontal bar chart shows the percentage of Indigenous regular clients aged 15 and over, with type 2 diabetes, who had an eGFR recorded in the past 12 months that was within specified levels, by remonteness area and state and territory. There was little variation by remoteness area with the lowest percentage of clients achieving a result within specified levels was in Remote areas (77%25) and the highest among those living in Inner regional areas (84%25). Simillarly, there was little difference between states and territories with the lowest proportion amogn those living in Western Australia (78%25) and the highest among those in Victoria and Tasmania (84%25).

Note:

  1. Regular client refers to those who visited a particular primary health care provider 3 or more times in the last 2 years.

Source: AIHW 2017a. See data table ‘Indicator 5.8’ for data notes.

Indicator 5.9 Women who smoked during pregnancy

In 2014, a higher proportion of Indigenous women who gave birth had smoked tobacco during their pregnancy than non-Indigenous women (46% and 13%, respectively) (AIHW 2017b). Smoking rates during pregnancy among Indigenous women increased slightly with increasing levels of remoteness, from 40% in Major cities to 52% in Remote and Very remote areas (Figure 5.9.1)

Figure 5.9.1 Women who smoked during pregnancy, by Indigenous status and remoteness area, 2014

The vertical bar chart displays the percentage of women who reported smoking during pregnancy, by Indigenous status and remoteness area. The percentage was consistently higher among Indigenous women compared with non-Indigenous women. The disparity was greatest among women living in Remote and Very remote areas where the rate of smoking during pregnancy was 4 times as high among Indigenous women compared with non-Indigenous women.

Note:

  1. Age-standardised using the 30 June 2001 Australian female Estimated Resident Population (ERP) aged 15–44

Source: AIHW 2017b. See data table ‘Indicator 5.9’ for data notes.

Indicator 5.10 Indigenous children attending preschool

In 2017, almost all (93%) Indigenous children enrolled in a preschool program had attended for at least one hour within the reference week (Data tables). Attendance rates were at least 90% in all states and territories, except the Northern Territory, where the attendance rate was 75% (Figure 5.10.1). Similarly, attendance rates were around 95% in Major cities, Inner regional and Outer regional areas but were below 90% in both Remote and Very remote areas.

While rates of attendance are high among those who are enrolled, additional data are required to determine what proportion of Indigenous children are not enrolled in a preschool program in the year before full time schooling.

Figure 5.10.1 Percentage of Indigenous enrolled children who attended a preschool program in the year before full time schooling, by state and territory, 2017

The vertical bar chart displays the percentage of enrolled Indigenous children who attended a preschool program in the year before full time schooling, by state and territory. The proportion was over 90%25 in all states and territories with the exception of the Northern Territory, where 75%25 of enrolled Indigenous children attended a preschool program.

Note:

  1. 'Year before full time schooling' provision adjusts for school age and preschool age entry provisions with each state/territory.

Source: ABS 2018. See data table ‘Indicator 5.10’ for data notes.

Indicator 5.11 Risk factor status of women who attended an antenatal visit before 13 weeks of pregnancy

In 2010–11, based on self-reported data, over half of women (54%) who gave birth to an Indigenous baby and attended an antenatal visit in the first trimester of pregnancy reported that they smoked tobacco during pregnancy (AIHW 2015b). One in four women reported that they drank alcohol and around 1 in 6 reported that they used illicit drugs during pregnancy.

While a higher proportion of mothers in Very remote areas reported smoking during pregnancy, the proportion reporting alcohol or illicit drug use was lower in Very remote areas compared to those living in less remote areas (Figure 5.11.1)

Figure 5.11.1 Risk factors status of women who gave birth to an Indigenous baby, who attended an antenatal visit before 13 weeks of pregnancy, by remoteness area, 1 July 2010–30 June 2011

The vertical bar chart displays the percentage of Indigenous women who attended an antenatal visit in the first trimester who reported that they smoked tobacco, consumed alcohol or took illicit drugs during their pregnancy. This data is displayed by remoteness area.  The proportion who reported that they smoked tobacco during pregnancy was highest among those living in Very remote areas (64%25) and lowest in Remote areas (46%25). A higher percentage of women in Major cities reported that they consumed alcohol (53%25) or took illicit drugs during pregnancy (38%25) when compared to those living in other areas.

Notes:

  1. Women who were regular clients of the Healthy for Life (HfL) service.
  2. Smoker includes daily smokers, weekly smokers and irregular smokers (people who smoke tobacco less than weekly).
  3. Consumed alcohol during pregnancy.
  4. Illicit drugs user includes daily, weekly and irregular users (a person who uses less than weekly).

Source: AIHW 2015b. See data table ‘Indicator 5.11’ for data notes.

Indicator 5.12 Risk factor status of women who attended an antenatal visit in the third trimester of pregnancy

In 2010–11, based on self-reported data, 55% of women who gave birth to an Indigenous baby and attended an antenatal visit in the third trimester smoked during pregnancy (AIHW 2015b). Around 1 in 6 reported that they consumed alcohol during pregnancy and 16% reported the use of illicit drugs. Use of illicit drugs and alcohol was more commonly reported by those living in Major cities than more remote areas (Figure 5.12.1).

Figure 5.12.1 Risk factors status of women who gave birth to an Indigenous baby, who attended an antenatal visit in the third trimester of pregnancy, by remoteness area, 1 July 2010–30 June 2011

The vertical bar chart displays the percentage of Indigenous women who attended an antenatal visit in the third trimester who reported that they smoked tobacco, consumed alcohol or took illicit drugs during their pregnancy, by remoteness area.  The proportion who reported that they smoked tobacco during pregnancy was highest among those living in Very remote areas (60%25) and lowest in Remote areas (48%25). A higher percentage of women in Major cities reported that they consumed alcohol (46%25) or took illicit drugs during pregnancy (41%25) when compared to those living in other areas.

Notes:

  1. Women who were regular clients of the Healthy for Life (HfL) service.
  2. Smoker includes daily smokers, weekly smokers and irregular smokers (people who smoke tobacco less than weekly).
  3. Consumed alcohol during pregnancy.
  4. Illicit drugs user includes daily, weekly and irregular users (a person who uses less than weekly).

Source: AIHW 2015b. See data table ‘Indicator 5.12’ for data notes.

Indicator 5.13 Indigenous regular clients with type 2 diabetes receiving recommended care from Indigenous primary health care services

As at June 2016, almost half (49%) of Indigenous regular clients aged 15 and over with type 2 diabetes had an HbA1c test result recorded, 63% had a blood pressure result recorded in the previous 6 months, and 62% had a kidney function test recorded within the previous 12 months (AIHW 2017a).

The proportion of Indigenous regular clients with type 2 diabetes with a recorded blood pressure test was highest among those living in Inner regional areas (67%) and lowest in those living in Very remote areas (59%) (Figure 5.13.1). However, it should be noted that these results may be an underestimate, due to June 2016 data for Northern Territory Government services excluding measurements conducted outside an individual service.

The proportion of Indigenous regular clients aged 15 and over with type 2 diabetes who had an HbA1c test result recorded in the previous 6 months, or a kidney function test in the previous 12 months, did not vary substantially by remoteness area (Figure 5.13.1).

The proportion of Indigenous regular clients aged 15 and over with type 2 diabetes receiving recommended care as at June 2016 varied by state and territory (Figure 5.13.2). The proportion having an HbA1c test result recorded in the previous 6 months ranged from 46% in New South Wales/Australian Capital Territory to 53% in Western Australia. Two thirds of clients in Queensland had a blood pressure result recorded in the last 6 months compared with 58% of clients in the Northern Territory, while the proportion with a kidney function test recorded in the previous 12 months ranged from 57% in the Northern Territory to 68% in Victoria/Tasmania.

Figure 5.13.1 Proportion of Indigenous regular clients with type 2 diabetes who had an HbA1c, blood pressure, and/or kidney function test result recorded, by remoteness area, June 2016

The vertical bar chart displays the proportion of Indigenous regular clients with type 2 diabetes who had a HbA1c test result, blood pressure result, or a kidney function test recorded, by remoteness area. Almost half (49%25) of Indigenous regular clients aged 15 and over with type 2 diabetes had an HbA1c test result recorded, 63%25 had a blood pressure result recorded in the previous 6 months, and 62%25 had a kidney function test recorded within the previous 12 months. The proportion of Indigenous regular clients with type 2 diabetes with a recorded blood pressure test was highest among those living in Inner regional areas (67%25) and lowest in those living in Very remote areas (59%25). There was little variation in the proportion who had an HbA1c test or kidney test recorded by remoteness area.

Note:

  1. Regular client refers to those who visited a particular primary health care provider 3 or more times in the last 2 years.

Source: AIHW 2017a. See data table ‘Indicator 5.13’ for data notes.

Figure 5.13.2 Proportion of Indigenous regular clients with type 2 diabetes who had an HbA1c, blood pressure, and/or kidney function test result recorded, by state/territory, June 2016

The vertical bar chart displays the proportion of Indigenous regular clients with type 2 diabetes who had a HbA1c test result, blood pressure result, or a kidney function test recorded by state and territory. The proportion having an HbA1c test result recorded in the previous 6 months ranged from 46%25 in New South Wales and the Australian Capital Territory to 53%25 in Western Australia. Two thirds of clients in Queensland had a blood pressure result recorded in the last 6 months compared with 58%25 of clients in the Northern Territory, while the proportion with a kidney function test recorded in the previous 12 months ranged from 57%25 in the Northern Territory to 68%25 in Victoria and Tasmania.

Note:

  1. Regular client refers to those who visited a particular primary health care provider 3 or more times in the last 2 years.

Source: AIHW 2017a. See data table ‘Indicator 5.13’ for data notes.

Indicator 5.14 Indigenous regular clients of Indigenous primary health care services who had type 2 diabetes and a general practitioner management plan or team care arrangements

As at June 2016, over half (54%) of Aboriginal and Torres Strait Islander regular clients with type 2 diabetes had claimed a General Practitioner (GP) Management Plan in the previous 2 years, while 50% had claimed a Team Care Arrangement (AIHW 2017a). Service access generally increased with age and, with the exception of those aged less than 15, was similar for males and females (Figures 5.14.1-5.14.2).

The proportion of regular clients claiming a GP Management Plan or Team Care Arrangement in the previous 24 months did not vary substantially by remoteness area (Figure 5.14.3). However, there were some differences by state and territory. South Australia had the lowest proportion of claims for both GP Management Plans (41%) and Team Care Arrangements (38%). Queensland had the highest proportion of claims for GP Management Plans (58%), while the Northern Territory had the highest proportion of claims for Team Care Arrangements (55%).

Figure 5.14.1 Percentage of Indigenous regular clients with type 2 diabetes who claimed an MBS General Practitioner Management Plan within the previous 24 months, by age group and sex, 2016

The vertical bar chart shows the percentage of Indigenous regular clients with type 2 diabetes who claimed an MBS General Practitioner Management plan in the last two years, by age group and sex. The proportion increased with age. The proportion was similar among males and females with the exception of those aged 15 years and below where more females (44%25) than males (27%25) accessed a General Practitioner Management Plan.

Source: AHIW 2017a. See data table ‘Indicator 5.14’ for data notes.

Figure 5.14.2 Percentage of Indigenous regular clients with type 2 diabetes who claimed an MBS Team Care Arrangement within the previous 24 months, by age group and sex, June 2016

The vertical bar chart shows the percentage of Indigenous regular clients with type 2 diabetes who claimed an MBS Team Care Arrangement in the last two years, by age group and sex. The proportion increased with age and was similar among males and females with the exception of those aged 15 years and below where more females (42%25) than males (29%25) a Team Care Arrangement.

Source: AHIW 2017a. See data table ‘Indicator 5.14’ for data notes.

Figure 5.14.3 Percentage of Indigenous regular clients with type 2 diabetes who claimed an MBS General Practitioner Management Plan or Team Care Arrangement within the previous 24 months, by remoteness area, June 2016

The vertical bar chart shows the percentage of Indigenous regular clients with type 2 diabetes who claimed an MBS Team Care Arrangement or General Practitioner Management Plan in the last two years, by remoteness area. There was little variation in access by remoteness area. However, access to a General Practitioner Management Plan was slightly higher than access to Team Care Arrangements across all remoteness areas.

Source: AHIW 2017a. See data table ‘Indicator 5.14’ for data notes.

Indicator 5.15 Indigenous regular clients with type 2 diabetes who are immunised against influenza

As at June 2016, 35% of Indigenous regular clients of Indigenous primary health care services aged 15–49 years with type 2 diabetes were immunised against influenza (AIHW 2017a). The proportion of immunised females was consistently higher than the proportion of males across each age group (Figure 5.15.1).

There was some variation in immunisation rates by state and territory and by remoteness area. Immunisation rates among regular clients aged 15–49 with type 2 diabetes was highest in the Northern Territory (50%) and the lowest in New South Wales/Australian Capital Territory (24%). Around 45% of those living in Very remote areas were immunised, whereas only 1 in 5 regular clients living in Major cities had been immunised (Figure 5.15.2).

Figure 5.15.1 Indigenous regular clients with type 2 diabetes who are immunised against influenza, by age group and sex, June 2016

The vertical bar chart shows the percentage of Indigenous regular clients with type 2 diabetes, aged 15–49 years, who were immunised against influenza by age group and sex. The percentage increased across age groups and was consistently higher among females than males. The rate peaked in those women aged 45–49 years (38%25) and men aged 35–49 years (33%25).

Source: AHIW 2017a. See data table ‘Indicator 5.15’ for data notes.

Figure 5.15.2 Indigenous regular clients with type 2 diabetes who are immunised against influenza, by state/territory and remoteness area, June 2016

The horizontal bar chart shows the percentage of Indigenous regular clients with type 2 diabetes, aged 15–49 years, who were immunised against influenza by remoteness area and state and territory. The percentage was highest among those living in the Northern Territory (50%25) and the lowest in New South Wales/Australian Capital Territory (24%25). In Major cities, 20%25 of regular clients were immunised. In contrast, around 45%25 of those living in Very remote areas were immunised.

Source: AHIW 2017a. See data table ‘Indicator 5.15’ for data notes.

Indicator 5.16 Types of lifestyle issues discussed with health professional

The 2012–13 ABS Aboriginal and Torres Strait Islander Health Survey included questions on the following lifestyle issues discussed with a health professional:

  • smoking;
  • drinking in moderation;
  • reaching a healthy weight;
  • increasing physical activity; and
  • eating healthy food or improving diet.

In 2012–13, based on self-reported data, 18% of Indigenous adults aged 18 and over discussed smoking with a health professional. The rate was highest in those aged 45–54 (26%, Figure 5.16.1), and was significantly higher among those who lived in non-remote areas compared with those living in remote areas (19% and 13%, respectively) (Data tables).

Almost 7% of Indigenous adults discussed drinking in moderation with a health professional. After adjusting for age, the proportion of men who discussed drinking in moderation was more than double the proportion of women (10% and 4%, respectively), and was highest among people aged 55 to 64 years (12%). There was no significant difference between those living in non-remote or remote areas (Data tables).

Over 20% of Indigenous adults discussed reaching a health weight. The proportion increased with age to 45–54 years (30%, Figure 5.16.2). The age-standardised proportion of Indigenous women who discussed their weight was significantly higher than the proportion of men (25% and 19%, respectively). There was no significant difference by remoteness (Data tables).

Around one in eight Indigenous adults discussed increasing their level of physical activity with a health professional. Again, the rate was highest among those aged 45–54 (23%, Figure 5.16.3). There were no significant differences by sex; however, those in non-remote areas were more likely to report discussing their level of physical activity compared to those living in remote areas (16% and 9%, respectively) (Data tables).

Almost one in five Indigenous adults discussed healthy eating or diet with a health professional. The rate was highest among those aged 55–64 (30%, Figure 5.16.4). There was no significant difference by remoteness (Data tables).

Figure 5.16.1 Types of lifestyle issues discussed with health professional by Indigenous Australians – smoking, 2012–13

The vertical bar chart displays the percentage of Indigenous adults who reported that they discussed reducing smoking with a health professional, by age group and sex. The proportion was lowest among those aged 65 and over among both men (7%25) and women (5%25). The rate peaked in men and women aged 45–54 years (25%25 and 28%25 respectively).

Source: ABS 2014c. See data table ‘Indicator 5.16’ for data notes.

Figure 5.16.2 Types of lifestyle issues discussed with health professional by Indigenous Australians – reaching a healthy weight, 2012–13

The vertical bar chart displays the percentage of Indigenous adults who reported that they discussed reaching a health weight with a health professional, by age group and sex. The percentage was lowest among those aged 18–24 years where 7%25 of males and 15%25 of women reported speaking to a health professional about reaching a health weight. The percentage peaked among women (33%25) and men (26%25) aged 45–54 years.

Source: ABS 2014c. See data table ‘Indicator 5.16’ for data notes.

Figure 5.16.3 Types of lifestyle issues discussed with health professional by Indigenous Australians – physical activity, 2012–13

The vertical bar chart displays the percentage of Indigenous adults who reported that they discussed physical activity with a health professional, by age group and sex. The percentage was lowest among those aged 18–24 years where 3%25 of men and 6%25 of women reported speaking to a health professional about their level of physical activity. The percentage peaked among women aged 45–54 years (24%25) and men (21%25) aged 45–64 years.

Source: ABS 2014c. See data table ‘Indicator 5.16’ for data notes.

Figure 5.16.4 Types of lifestyle issues discussed with health professional by Indigenous Australians – improving diet, 2012–13

The vertical bar chart displays the percentage of Indigenous adults who reported that they discussed improving their diet with a health professional, by age group and sex. The percentage was lowest among those aged 18–24 years where 7%25 of males and 14%25 of women reported speaking to a health professional about improving their diet. The percentage peaked among women aged 45–64 years (28%25) and men aged 55–64 years (32%25).

Source: ABS 2014c. See data table ‘Indicator 5.16’ for data notes.

Indicator 5.17 Health actions taken by people with diabetes

In 2012–13, 29% of Indigenous Australians aged 15 and over, who were living with diabetes, reported that they currently used insulin. The age-standardised proportion was similar in males and females (27% and 25%, respectively)  (Data tables). The proportion was highest in those aged 45–54 (37%, Figure 5.17.1).

Almost two thirds of Indigenous Australians aged 15 and over living with diabetes reported that they had their feet checked in the previous 12 months. The rate increased with age, from 53% among those aged 15–44 to over 80% in those aged 55 and over (Figure 5.17.2).

Over two thirds of Indigenous Australians reported that they had an HbA1c test in the previous 12 months and over 90% reported that they had their blood glucose checked in the previous year. The proportion having their blood glucose tested was 93% or higher in those aged 35 and over (Figure 5.17.3).

Figure 5.17.1 Health actions taken by Indigenous people with diabetes – currently using insulin, 2012–13

The vertical bar chart shows the percentage of Indigenous people aged 15 and over with diabetes who were currently using insulin, by age group and sex. The percentage was highest among those in the 45–54 year age group with 35%25 of males and 37%25 of females reporting they used insulin. The proportion was lowest among males (23%25) and females (18%25) aged 15–44 years.

Source: ABS 2014c. See data table ‘Indicator 5.17’ for data notes.

Figure 5.17.2 Health actions taken by Indigenous people with diabetes – feet checked in the past 12 months, 2012–13

The vertical bar chart shows the percentage of Indigenous people aged 15 and over with diabetes who had their feet checked in the previous 12 months, by age group and sex. The percentage was highest among females aged in the 55–64 years (89%25) and males aged 65 years and over (82%25). The proportion was lowest among males (55%25) and females (52%25) aged 15–44 years.

Source: ABS 2014c. See data table ‘Indicator 5.17’ for data notes.

Figure 5.17.3 Health actions taken by Indigenous people with diabetes – blood glucose checked in the past 12 months, 2012–13

The vertical bar chart shows the percentage of Indigenous people aged 15 and over with diabetes who had their blood glucose checked in the previous 12 months, by age group and sex. The percentage was greater than 75%25 across all age groups. The lowest proportion was among males (76%25) and females (83%25) aged 15–34 years.

Source: ABS 2014c. See data table ‘Indicator 1.7’ for data notes.

Indicator 5.18 People without diabetes tested for high sugar levels/risk of diabetes

In 2012–13, an estimated 47% of Indigenous adults aged 18 and over without diabetes reported that they were tested for high sugar levels in the previous year. The proportion increased with age, from 30% of those aged 18–24 to 72% of those aged 55–64 (Figure 5.18.1). Overall, the age-standardised proportion of Indigenous women tested for diabetes was significantly higher than the proportion of men (57% and 51%, respectively) and this difference was observed for those aged 18–44 (Figure 5.18.1).

The proportion of Indigenous adults tested for high sugar levels was significantly higher in non-remote areas compared with remote areas (55% and 48%, respectively) (Figure 5.18.2). There was some variation in the proportion of people tested by state, with the highest rates identified in South Australia (64%) and the lowest in the Northern Territory (46%).

Figure 5.18.1 Indigenous people without diabetes who were tested for high blood glucose, by age group and sex, 2012–13

The vertical bar chart shows the percentage of Indigenous adults without diabetes who were tested for high blood glucose, by age group and sex. Overall, the proportion increased with age. The percentage was higher among women than men from 18–54 years. The relationship was reversed in those aged 55 years and over. The proportion of women tested was highest among those aged 55–64 years (70%25). Among males, the percentage was highest among those aged 65 and over (79%25)

Source: ABS 2014c. See data table ‘Indicator 5.18’ for data notes.

Figure 5.18.2 Indigenous people without diabetes who were tested for high blood glucose, by state/territory, 2012–13

The vertical bar chart shows the age-standardised percentage of Indigenous adults without diabetes who were tested for high blood glucose, by state and territory. The proportion was highest among those living in South Australia (64%25), and lowest among those in the Northern Territory (46%25)

Note:

  1. Age-standardised to the 2001 Australian Population.

Source: ABS 2014c. See data table ‘Indicator 5.18’ for data notes.

Indicator 5.19 Selected health issues of Indigenous mothers

In 2014–15 the National Aboriginal and Torres Strait Islander Social Survey, collected self-reported information relating to health issues experienced by Indigenous mothers during pregnancy. Mothers with children aged 0–3 years were asked about:

  • incidence of high blood pressure during pregnancy
  • folate use before and/or during pregnancy
  • incidence of diabetes or high blood sugar during pregnancy
  • medication or supplement use during pregnancy, and
  • whether they sought advice regarding their pregnancy.

More than half of Indigenous mothers reported that consumed folate before or during their pregnancy (58%) (Data tables). Around 6,600 (9%) had diabetes or high blood sugar, 18% reported that they had high blood pressure, 47% reported using medication or supplements and almost 40% sought advice (Figure 5.19.1).

Figure 5.19.1 Selected health issues of Indigenous mothers

The horizontal bar chart shows the percentage of Indigenous mothers, with a child aged 0–3 years, who reported they had high blood pressure, took folate before or during pregnancy, had diabetes or higher blood sugar, took medication or supplements, or sought advice during their pregnancy. More than half of Indigenous mothers reported that consumed folate before or during their pregnancy (58%25), 9%25 had diabetes or high blood sugar, 18%25 reported that they had high blood pressure, 47%25 reported using medication or supplements and 39%25 sought advice regarding their pregnancy.

Source: ABS 2016d. See data table ‘Indicator 5.19’ for data notes.

Indicator 5.20 Use of antenatal care by selected health issues

In 2014–15, almost all Indigenous women in the National Aboriginal and Torres Strait Islander Social Survey reported accessing antenatal care while pregnant (Figure 5.20.1). While the proportion of women with health issues who accessed antenatal care was slightly higher than the proportion without health issues, these differences were not statistically significant.

Figure 5.20.1 Proportion of Indigenous mothers who accessed antenatal care by selected health issues by Indigenous women 

The horizontal bar chart shows the percentage of Indigenous mothers who accessed antenatal care by whether they had high blood pressure, had diabetes or higher blood sugar, took medication or supplements, or sought advice during their pregnancy. Almost all mothers accessed antenatal care with little difference between those who did or did not report selected health issues.

Source: ABS 2016d. See data table ‘Indicator 5.20’ for data notes.

Indicator 5.21 Diabetes problems managed by general practitioner

Data from the Bettering the Evaluation and Care of Health (BEACH) study indicate that, in the period from April 2010 to March 2015, 5.5% of problems managed by GPs among Indigenous patients were diabetes related. The majority of diabetes-related problems managed were for non-insulin dependent type 2 diabetes (92%).

The rate of diabetes problems managed by GPs was 3 times as high among Indigenous Australians as among other Australians. The disparity between Indigenous Australians and other Australians in the rate of diabetes problems managed by GPs was greater for non-insulin dependent type 2 diabetes than insulin dependent type 1 diabetes (3 and 2.3 respectively).

Figure 5.21.1 Rate of diabetes problems managed by general practitioners, by Indigenous status and diabetes type, 2010–2015

The vertical bar chart displays the rate of diabetes problems management by General Practitioners, by Indigenous status and diabetes type. The number of problems managed per 100,000 population was substantially higher among Indigenous Australians compared with other Australians. The disparity in rates of diabetes problems managed by General Practitioners was greater for non-Insulin dependent type 2 diabetes than insulin dependent type 1 diabetes (3 and 2.3 respectively).

Note:

  1. Directly age-standardised rate (no. per 1,000 encounters).

Source: AIHW 2017b. See data table ‘Indicator 5.21’ for data notes.