Introduction
Health risk factors and behaviours – such as poor diet, physical inactivity, tobacco smoking and excessive alcohol consumption – can have a detrimental effect on a person’s health (see Health status for information on the general health of people with disability).
Many health problems experienced by the Australian population, including by people with disability, can be prevented or reduced by decreasing exposure to modifiable risk factors where possible.
People with disability generally have higher rates of some modifiable health risk factors and behaviours than people without disability. But there can be particular challenges for people with disability in modifying some risk factors, for example, where extra assistance is needed to achieve a physically active lifestyle, or where medication increases appetite or affects drinking behaviours.
What are health risk factors and behaviours?
Health risk factors are attributes, characteristics or exposures that increase the likelihood of a person developing a disease or health disorder. They can be behavioural or biomedical.
Behavioural risk factors are those that individuals have the most ability to modify – for example, diet, tobacco smoking and alcohol consumption.
Biomedical risk factors are bodily states that pose direct and specific risks for health – for example, overweight and obesity and high blood pressure. They are often influenced by health behaviours, such as diet and physical activity, but can also be influenced by genetic, socioeconomic and psychological factors.
Modifying behavioural and biomedical risk factors can reduce a person's risk of developing chronic conditions and result in large health gains by reducing illness and rates of death.
National Health Survey
The data used in this section are from the Australian Bureau of Statistics’ (ABS) National Health Survey (NHS) 2017–18. The NHS was designed to collect information about the health of people, including:
- prevalence of long-term health conditions
- health risk factors (such as smoking, overweight and obesity, alcohol consumption and physical activity)
- demographic and socioeconomic characteristics (ABS 2018a).
The NHS uses the ABS Short Disability Module to identify disability. This produces an estimate of disability known as ‘disability or restrictive long-term health condition’. In this section, people with disability or restrictive long-term health condition are referred to as ‘people with disability’.
The NHS considers that a person has disability if they have one or more conditions which have lasted, or are likely to last, for at least 6 months and restrict everyday activities. Disability is further classified by whether a person has a specific limitation or restriction and then by whether the limitation or restriction applies to core activities or only to schooling or employment.
The level of disability is defined by whether a person needs help, has difficulty, or uses aids or equipment, with 3 core activities – self-care, mobility, and communication – and is reported for mild, moderate, severe, and profound limitation. People who always or sometimes need help with one or more core activities are referred to in this section as ‘people with severe or profound disability’.
The Short Disability Module is not as effective as the ABS Survey of Disability, Ageing and Carers (SDAC) in identifying disability as it overestimates the number of people with less severe forms of disabilities (ABS 2018b). The module provides useful information about the characteristics of people with disabilities relative to those without but is not recommended for use in estimating disability prevalence.
The NHS collects data from people in private dwellings and not from people living in institutional settings, such as aged care facilities. As such, it may underestimate disability for some groups, such as people aged 65 and over, and those with severe or profound disability.
For more information, see the NHS user guide.
Food and nutrition
Food and beverages (our diet) play an important role in overall health and wellbeing. Good dietary choices:
- contribute to quality of life
- help maintain a healthy body weight
- protect against infection
- reduce the risk of developing chronic conditions.
Health conditions often affected by diet include:
- overweight and obesity
- coronary heart disease
- stroke
- high blood pressure
- some forms of cancer
- type 2 diabetes.
Fruit and vegetables
Australia has national guidelines that provide advice on the amount and types of foods to eat to promote health and wellbeing.
Australian dietary guidelines recommend that adults eat 2 serves of fruit and at least 5 serves of vegetables per day. They recommend, for children and adolescents, depending on age and sex, 1 to 2 serves of fruit and 2½ to 5½ serves of vegetables per day. Guidelines are different for pregnant and breastfeeding women.
The guidelines do not apply to people needing special dietary advice for a medical condition, or to the frail elderly. As such, they should be treated with caution for some people with disability (for example, those with medical conditions requiring a special diet).
See Australian dietary guidelines (NHMRC 2013) for more information.
In the ABS NHS, adequacy of intake (consumption) is based on whether a respondent's reported usual daily fruit or vegetable intake meets or exceeds the NHMRC recommendation. It is collected for people aged 2 and over.
Many people, including those with disability, do not eat enough fruit and vegetables for optimum health and wellbeing. Based on self-reported data, around half (47%) of people aged 2 and over with disability eat less than the recommended serves of fruit and less than the recommended serves of vegetables each day, and are more likely than people without disability (41%) to not meet the guidelines (Figure RISK.1).