Summary:
- The majority of women report being healthy.
- More women are now surviving breast and cervical cancer than 10 years ago, largely due to improved treatments and early detection through screening.
- Nearly 4 in 5 women suffer from at least one long term ill-health condition.
- The prevalence of injuries, mental and behavioural problems, cancer, diabetes and arthritis is increasing among women.
- Anxiety and mood disorders are the most common forms of mental and behavioural problems experienced by women.
- Women use medication for mental well-being more than men do.
- Australian women do not eat enough fruit and vegetables, nearly half are overweight or obese and about one-third do not exercise.
- The consumption of alcohol at levels that pose a health risk and excess weight are on the rise among women.
- Being overweight or obese, a lack of exercise and daily tobacco use are associated with poorer health.
- Girls are becoming sexually active at earlier ages.
In this part:
How healthy are Australian women?
The Australian Bureau of Statistics regularly conducts the National Health Survey to collect a wide range of information relating to the health and wellbeing of all Australians. Surveys were conducted in 1995, 2001, and 2004–05.
When asked to rate their own general health in 2004–05, 85% of Australian women assessed their health as good, very good or excellent. Only about one in 25 women rated their health as poor. Figure 3.1 shows that women reported slightly better health than men.
Figure 3.1: Self-assessed health of Australian men and women, 2004–05
Source: 2004-05 National Health Survey, ABS Cat. No. 4364.0, Table 3.
Women's self-rated health varied according to age (Figure 3.2). In 2004-05, more young women assessed their health as very good or excellent, compared with women in older age groups. The decline in perceptions of good or excellent health was most noticeable at ages 45–54 years.
Figure 3.2: Women's self-assessed health by age, 2004–05
Source: 2004–05 National Health Survey, ABS Cat. No. 4364.0, Table 3.
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Has women's health improved over time?
Figure 3.3 indicates that women surveyed in 2004-05 reported experiencing better health than women surveyed in 1995. Since 1995, there has been an increase in the proportion of women who perceived their health to be very good or excellent and a commensurate decrease in the proportion of women who rated their health as fair.
Figure 3.3: Trends in women's self-assessed health, 1995–2004–05
Source: 2004–05 National Health Survey, ABS Cat. No. 4364.0, Table 3.
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What illnesses do women suffer?
The National Health Survey also collected information on a range of diseases, illnesses, conditions, and disorders that had lasted for at least six months or were likely to do so. These are collectively referred to as 'long term conditions'.
In 2004–05, 78.4% of women compared to 75% of men reported at least one long term condition. The proportion of women who reported at least one long term condition represents a modest increase over 1995 (76.4%).
Figure 3.4 shows that the prevalence of women's long term conditions increases with age, with sharp increases in the number of women reporting long term conditions occurring between the ages of 0–14 years and 15–24 years and then again after age 44 years. Figure 3.4 also shows that the proportions of women aged 15–44 years with one or more long term condition has increased slightly between 1995 and 2004–05, whereas the proportion of young girls (0–14 years) with a long term condition has decreased over the same period.
Figure 3.4: Women with long term conditions by age, 1995 and 2004–05
Source: 2004-05 National Health Survey, ABS Cat. No. 4364.0, data available on request.
*As a proportion of all women in each age group
Table 3.1 shows the ten most common conditions for women and men in 2004–05. Men and women generally suffered from the same set of common conditions, although the prevalence rates varied by gender. Women were more likely than men to suffer long and short sightedness. Migraine was a top ten condition for women but not for men, and hayfever and allergic rhinitis, asthma, hypertensive disease, chronic sinusitis, and arthritis were more prevalent among women than men.
Table 3.1: Ten most common long term conditions by gender, 2004-05
| MEN |
% |
WOMEN |
% |
| Long-sightedness |
24.3 |
Long-sightedness |
29.9 |
| Short-sightedness |
19.2 |
Short-sightedness |
25.0 |
| Back pain/problems/disc disorders |
16.0 |
Arthritis |
17.8 |
| Hayfever & allergic rhinitis |
15.0 |
Hayfever & allergic rhinitis |
17.2 |
| Complete or partial deafness |
13.3 |
Back pain/problems/disc disorders |
14.7 |
| Arthritis |
12.9 |
Asthma |
11.5 |
| Hypertensive disease |
10.2 |
Hypertensive disease |
11.1 |
| Asthma |
9.0 |
Chronic sinusitis |
10.9 |
| Chronic sinusitis |
7.5 |
Migraine |
9.3 |
| High cholesterol |
7.0 |
Complete or partial deafness |
7.2 |
Source: 2004–05 National Health Survey, Australia, ABS Cat. No. 4364.0, Table 4.
Table 3.2 shows age differences for women with long term conditions. In 2004–05, asthma was the most common condition for young girls. At ages 15–24 years, there was a large increase in the proportion of young women with short sightedness and hayfever and allergic rhinitis. Between the ages of 25–44, back disorders and pain and migraine became more common. At mid-age (45-64), there was a sharp increase in the prevalence of long sightedness and arthritis, and at ages 65 and over, arthritis, hypertensive disease, high cholesterol, and deafness joined the list of common conditions reported by women.
Table 3.2: Five most commonly reported long term conditions for women by age, 2004-05
| AGE GROUP |
LONG TERM CONDITION |
% |
| 0–14 |
Asthma
Hayfever & allergic rhinitis
Allergy (undefined)
Short sightedness
Long sightedness |
10.0
6.6
5.8
4.3
3.8 |
| 15–24 |
Short sightedness
Hayfever & allergic rhinitis
Asthma
Long sightedness
Back pain/problems, disc disorders |
21.7
21.3
14.3
13.0
10.5 |
| 25–44 |
Short sightedness
Hayfever & allergic rhinitis
Back pain/problems, disc disorders
Long sightedness
Migraine |
26.0
22.9
17.4
15.0
14.5 |
| 45–64 |
Long sightedness
Short sightedness
Arthritis (all types)
Back pain/problems, disc disorders
Hayfever & allergic rhinitis |
59.7
36.0
31.6
21.5
19.6 |
| 65–84 |
Long sightedness
Arthritis (all types)
Hypertensive disease
Short sightedness
High cholesterol |
62.6
55.8
42.2
35.9
23.4 |
| 85 and over |
Arthritis (all types)
Long sightedness
Deafness (complete/partial)
Short sightedness
Hypertensive disease |
60.7
53.0
47.0
37.3
37.0 |
Source: 2004–05 National Health Survey, ABS Cat. No. 4364.0, data available on request.
Figure 3.5 shows the trends in long term conditions among women between 1995 and 2004–05. Although there were some methodological variations between the 1995 and 2004–05 National Health Surveys, comparable data can be used to identify trends for some selected conditions.
Figure 3.5: Selected long term conditions for women, 1995–2004–05
Source: 2004–05 National Health Survey, ABS Cat. No. 4364.0, data available on request.
Data for 1995 for injury and malignant neoplasms not available.
The prevalence of injuries and mental and behavioural problems is increasing among Australian women. Upward trends were also evident for malignant neoplasms, diabetes, and arthritis and osteoporosis.
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Mental health
The most recent estimate of the prevalence of mental health conditions in the Australian population has been derived from self-report data collected during the Australian Bureau of Statistics 2004–05 National Health Survey. This survey collected self-reports on long term mental or behavioural disorders, the use of medications for mental well-being, and ratings of psychological distress.
Long term mental or behavioural disorders
In 2004–05, 11.4% of women and 10% of men reported having a long term mental or behavioural problem (Table 3.3). Anxiety-related problems and mood (affective) problems were the most commonly reported conditions. Women were 1.5 times more likely than men to report each of these conditions. Men were 2.5 times more likely than women to report alcohol and drug problems.
Table 3.3: Number of reports of mental and behavioural problems by gender, 2004-05
| MENTAL AND BEHAVIOURAL PROBLEM |
MEN |
WOMEN |
| Alcohol and drug problems |
115,900 |
45,400 |
| Mood (affective) problems |
415,300 |
637,300 |
| Anxiety related problems |
384,100 |
583,800 |
| Problems of psychological development |
181,800 |
93,500 |
| Behavioural & emotional problems: usual onset in childhood/adolescence |
124,600 |
52,500 |
| Organic mental problems |
13,300 |
18,600 |
| Other mental & behavioural problems |
109,700 |
58,600 |
| Symptoms & signs involving cognition, perceptions, emotional state & behaviour |
94,400 |
61,300 |
| Total |
982,900 |
1,125,400 |
Source: 2004–05 National Health Survey, ABS Cat. No. 4364.0, Table 4.
The use of medication for mental well-being
Nearly one in four women reported using medication for mental well-being, compared to 14.3% of men. The most commonly used pharmaceutical medications were antidepressants and sleeping tablets for both men and women, but levels of use were highest among women.
Psychological distress
In 2004–05, the majority of men and women reported low levels of psychological distress (Table 3.4). However, low levels of psychological distress were more common among men than women. Just over 15% of women reported high to very high psychological distress, compared to 10.8% of men. About one in four women reported moderate psychological distress.
Table 3.4 also shows trends in self-reports of psychological distress. Between 2001 and 2004–05, the proportions of men and women reporting low levels of psychological distress decreased slightly, although the decrease was larger for men than women. This movement was accompanied by increases in the proportions of men and women reporting moderate levels of psychological distress. For men, there was a concomitant increase in reports of high to very high psychological distress, but the proportions of women reporting these levels of distress remained stable between 2001 and 2004–05.
Table 3.4: Trends in self-reports of psychological distress by gender, 2001 and 2004–05
| |
MEN (%) |
WOMEN (%) |
| LEVEL OF PSYCHOLOGICAL DISTRESS |
2001 |
2004–05 |
2001 |
2004–05 |
| Low |
68.9 |
66.6 |
59.9 |
59.1 |
| Moderate |
21.2 |
22.4 |
24.7 |
25.7 |
| High |
7.1 |
7.5 |
10.9 |
10.8 |
| Very High |
2.7 |
3.3 |
4.4 |
4.3 |
Source: 2004–05 National Health Survey, ABS Cat. No. 4364.0, Table 14.
Psychological distress measured by the Kessler Psychological Distress Scale-10 items (K10). The K10 is scored from 10 to 50. Psychological distress scores are grouped as follows: Low=10–15; Moderate=16–21; High=22–29; and Very high=30–50.
Totals may not add to 100% due to rounding.
Table 3.5 shows that ratings of moderate to high psychological distress were more prevalent among younger women and generally decreased with age. Very high psychological distress was more prevalent among women aged between 35–64 years, peaking between the ages of 45–54 years.
Table 3.5: Prevalence of women's psychological distress by age, 2004–05
| |
LEVEL OF PSYCHOLOGICAL DISTRESS (%) |
| AGE GROUP |
LOW |
MODERATE |
HIGH |
VERY HIGH |
| 18–24 years |
49.4 |
31.8 |
15.2 |
3.5 |
| 25–34 years |
55.3 |
30.2 |
10.9 |
3.5 |
| 35–44 years |
57.2 |
26.1 |
11.5 |
5.1 |
| 45–54 years |
59.4 |
24.1 |
10.7 |
5.5 |
| 55–64 years |
69.1 |
17.8 |
8.8 |
4.3 |
| 65 or over |
65.4 |
22.8 |
8.1 |
3.5 |
| Total |
59.1 |
25.7 |
10.8 |
4.3 |
Source: 2004–05 National Health Survey, cited in Australia's Health 2006, AIHW Cat. No. AUS 73, Table 2.31.
Psychological distress and self-assessed health status
Figure 3.6 shows a relationship between self-assessed health status and psychological distress among women in 2004–05. Low levels of psychological distress were related to ratings of excellent/very good health. On the other hand, very high psychological distress was strongly associated with fair/poor health.
Figure 3.6: Women's self-assessed health status by level of psychological distress, 2004–05
Source: 2004–05 National Health Survey, ABS Cat. No. 4364.0, data available on request.
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How many women die each year?
In 2005, there were 67,241 male and 63,473 female deaths.1 A major trend in Australia over the last century has been the steady reduction in death rates. The female death rate fell from 1,691 to 511 deaths per 100,000 women between 1909 and 2004 (See Figure 3.7). The male death rate fell from 2,234 to 770 deaths per 100,000 men over the same period.
Figure 3.7: Age-standardised death rates by gender, 1909–2004
Source: Australian Institute of Health & Welfare National GRIM Books, All causes combined, (ICD10 ), Australia, 1907–2004 & Australia's Health, 2006, AIHW Cat. No. AUS 73 Table S16.
Despite longer life expectancy and lower death rates, Australia's growing and ageing population has resulted in an increase in the total number of deaths over time (Figure 3.8). Between 1909 and 2004, the total number of deaths per year has almost trebled. Each year, there have been more male than female deaths, although the gender gap in the number of deaths is closing.
Figure 3.8: Number of deaths by gender, 1909-2004
Source: Australian Institute of Health & Welfare National GRIM Books, All causes combined, Australia, 1907–2004.
There were 2,141 registered Indigenous deaths in Australia in 2005 and women accounted for 42.7% of those deaths.1 Death rates between 2001 and 2005 across all ages were higher for Indigenous than non-Indigenous women. Between the ages of 15 and 64 years, death rates for Indigenous women were at least three times the rate of other Australian women. The greatest difference occurred among those aged between 35 and 44 years, where death rates for Indigenous women were at least six times those recorded for non-Indigenous women (see Table 3.6).
Table 3.6: Age specific death rates for women by Indigenous status 2001–2005(a)
| DEATHS PER 100,000 POPULATION(b) |
| AGE (YEARS) |
INDIGENOUS |
NON-INDIGENOUS |
INDIGENOUS-
NON-INDIGENOUS RATIO |
| 0 |
10.4 |
4.1 |
2.5 |
| 1–4 |
70.5 |
20.3 |
3.5 |
| 5–14 |
23.0 |
9.7 |
2.4 |
| 15–24 |
96.0 |
28.6 |
3.4 |
| 25–34 |
185.2 |
39.8 |
4.7 |
| 35–44 |
469.0 |
77.4 |
6.1 |
| 45–54 |
850.8 |
173.5 |
4.9 |
| 55–64 |
1,723.2 |
410.1 |
4.2 |
| 65 and over |
4,956.9 |
3,690.6 |
1.3 |
Source: Deaths, Australia, 2005, ABS Cat. No. 3302.0, Table 9.5.
(a) Data for Queensland, South Australia, Western Australia and Northern Territory only. Indigenous rates based on observed Indigenous deaths and are likely to be underestimated.
(b) Except at age 0.
Indigenous women also die at younger ages than do non-Indigenous women. The median age at death for Indigenous women in 2005 ranged between 48 and 66 years compared to between 71 and 84 years for non-Indigenous women. The lowest median ages at death for Indigenous females in 2005 were observed in South Australia (47.5) and the Northern Territory (50.4). In contrast, non-Indigenous women in South Australia have the highest median age at death (83.7), living 36 years longer than their Indigenous neighbours.1
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What are the causes of female deaths?
The top 10 causes of death in Table 3.7 were responsible for 57% of all male and 61% of all female deaths in 2004. Ischaemic heart disease (commonly called coronary heart disease or heart attack and related disorders) and cerebrovascular disease (stroke) were the two leading causes of death, accounting for nearly 30% of all female deaths and over one-quarter of all male deaths. Strokes were notably more frequent causes of death for women than for men. 'Other heart diseases' (which includes heart failure) was the third leading cause of death for women. Prostate cancer and breast cancer were two prominent sex-specific causes of death. Among women only, dementia and related disorders and pneumonia and influenza were among the ten leading causes of death. Suicide and diabetes were leading causes of death for men, but not for women.
Table 3.7: Ten leading causes of death for men and women, 2004
| |
MEN |
WOMEN |
| RANK |
CAUSE OF DEATH |
NUMBER OF DEATHS |
% |
CAUSE OF DEATH |
NUMBER OF DEATHS |
% |
| 1 |
Ischaemic heart disease |
13,152 |
19.2 |
Ischaemic heart disease |
11,424 |
17.8 |
| 2 |
Cerebrovascular disease |
4,826 |
7.1 |
Cerebrovascular disease |
7,215 |
11.3 |
| 3 |
Lung cancer |
4,733 |
6.9 |
Other heart disease |
4,272 |
6.7 |
| 4 |
Other heart disease |
3,290 |
4.8 |
Dementia and related disorders |
3,253 |
5.1 |
| 5 |
Chronic obstructive |
2,986 |
4.4 |
Breast cancer |
2,641 |
4.1 |
| |
pulmonary disease |
|
|
|
|
|
| 6 |
Prostate cancer |
2,761 |
4.0 |
Lung cancer |
2,531 |
3.9 |
| 7 |
Colorectal cancer |
2,215 |
3.2 |
Chronic obstructive pulmonary disease |
2,213 |
3.5 |
| 8 |
Diabetes |
1,869 |
2.7 |
Colorectal cancer |
1,911 |
3.0 |
| 9 |
Unknown primary site cancers |
1,793 |
2.6 |
Pneumonia and influenza |
1,883 |
2.9 |
| 10 |
Suicide |
1,661 |
2.4 |
Unknown primary site cancers |
1,745 |
2.7 |
| Total (10 leading causes) |
39,286 |
|
Total (10 leading causes) |
39,088 |
|
| All deaths |
68,395 |
57.4 |
All deaths |
64,113 |
61.0 |
Source: Australia's Health, 2006. AIHW Cat. No. AUS73, Table 2.19.
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Breast and cervical cancers
How many women are diagnosed with breast or cervical cancer?
In Australian women, the breast is the most common site for cancer, with 12,027 new cases in 2002.2 The number of breast cancer cases registered between 1996 and 2002 has increased and is projected to increase further in 2006 and 2011 (Table 3.8). The projected increases are due, in part, to population growth and the rapid ageing of the female population, and also reflect increases in incidence rates due to the improved detection of smalldiameter breast cancers through the national mammographic screening program, BreastScreen Australia.3
Table 3.8 also shows that there were 689 new cases of cervical cancer in 2002. The number of new diagnoses and the incidence rate of cervical cancer dropped in 2002 relative to 1996. Further decreases in the number of cases and the incidence rate are projected to continue into the future.
Table 3.8: Incidence of breast and cervical cancer, 1996–2011
| |
1996 |
2002 |
2006(a) |
2011(a) |
| |
Number of cases |
| Breast cancer |
9,742 |
12,027 |
13,261 |
14,818 |
| Cervical cancer |
940 |
689 |
582 |
461 |
| |
Incidence rate(b) |
| Breast cancer |
109.2 |
116.8 |
117.3 |
117.3 |
| Cervical cancer |
10.4 |
6.8 |
5.7 |
3.9 |
Sources: Australia's Health, 2006. AIHW Cat. No. AUS73, Table 2.25, Breast Cancer in Australia: An overview, 2006, AIHW Cat. No. CAN29, Table 1.3, Cervical screening in Australia 2003-04. AIHW, Cat. No. CAN28, Tables 85 & 92.
(a) Projections
(b) Per 100,000 persons age-standardised to the Australian population as at 30 June 2001.
Breast and cervical cancer survival
Breast cancer is the most common cause of cancer-related deaths among Australian women.2 In 2004, there were 2,641 deaths due to breast cancer, representing small increases of 0.7% and 2.2% over 1996 and 2001 respectively (Table 3.9). However, the mortality rate has decreased substantially by 18.5% from 28.7 deaths per 100,000 people in 1996 to 23.4 deaths per 100,000 people in 2004. This trend in the breast cancer mortality rate is in the opposite direction to the incidence trend. Thus, although the number of diagnosed cases of breast cancer has increased in Australia over recent years, more women are now surviving the illness.
Table 3.9 also shows that the numbers of deaths from cervical cancer and the mortality rate have declined over time. The death rate from cancer of the cervix has dropped by 40.6% between 1996 and 2004.
Table 3.9: Trends in breast and cervical cancer mortality, 1996-2004
| |
1996 |
2001 |
2004 |
| |
Number of deaths |
| Breast cancer |
2,623 |
2,585 |
2,641 |
| Cervical cancer |
302 |
262 |
212 |
| |
Mortality rate |
| Breast cancer |
28.7 |
24.7 |
23.4 |
| Cervical cancer |
3.3 |
2.5 |
1.9 |
Source: Australia's Health, 2006. AIHW Cat. No. AUS73, Table 2.26.
Deaths per 100,000 persons age-standardised to the Australian population as at 30 June 2001.
Why are more women surviving breast and cervical cancer?
Evidence suggests that the risk of illness and death from breast and cervical cancer can be lowered through population-based screening and effective follow-up treatment. The success of BreastScreen Australia and the National Cervical Screening Program has been a major contributing factor to reductions in breast and cervical cancer mortality over recent years.3
The National Cervical Screening Program targets all women aged between 20 and 69 years. BreastScreen Australia is aimed specifically at women aged between 50 and 69 years and its objective is to achieve a 70% participation rate by women in the target group. Figure 3.9 shows that participation rates for breast cancer and cervical screening were fairly high, although participation rates for breast cancer screening were below target. The proportion of women who have participated in the National Cervical Screening Program has fallen in recent years (from 63.4% in 1998–99 to 60.7% in 2002–03). The proportion of women aged between 50 and 69 years screened by BreastScreen Australia increased from 52.3% in 1996–97 to 57.1% in 2001–02, but decreased to 56.1% in 2002–03.
Figure 3.9: Women's participation rates for breast cancer and cervical screening, 1996–97 – 2002–03
Source: BreastScreen Australia Monitoring Report 2002–2003, AIHW Cat. No. CAN 27 & Cervical Screening in Australia 2003–04, AIHW Cat. No. CAN 28.
Participation rates for BreastScreen Australia are for women aged between 50 and 69 years and for women aged between 20 and 69 years for the National Cervical Screening Program.
Rates are age-standardised to the 2001 Australian total population.
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Health risk factors
The 2004–05 National Health Survey collected information on a number of lifestyle behaviours and related factors that are recognised as the major risks to health and longevity. These health risk factors are defined in Table 3.10 and the prevalence of these health risk factors among Australian men and women in 2004–05 is shown in Figure 3.10.
Figure 3.10: Health risk factors by gender, 2004–05
Source: Chronic diseases and associated risk factors in Australia, 2006, AIHW Cat. No. PHE 81, Table 3.7.
Table 3.10: Health risk factor definitions
| RISK FACTOR |
DEFINITION |
| Smoking |
Current daily smoking of tobacco products. |
| Risky alcohol consumption |
Average daily consumption of more than four standard drinks for men and more than two standard drinks for women. |
| Physical inactivity |
Very low levels of leisure-time exercise (less than 100 minutes over the past 2 weeks). |
| Poor diet |
Usual daily intake one serve or less of fruit and four serves or less of vegetables. |
| Excess weight |
Body mass index (BMI) is calculated from reported height and weight information, using the formula kg/m2. BMI of 25.0 to less than 30.0 refers to those who are overweight. 'Obese' refers to those with BMI of 30.0 or more. |
| High blood pressure |
Those with medically diagnosed high blood pressure and currently have the condition or are being treated with medication. |
| High blood cholesterol |
Those with medical diagnosis of high cholesterol and currently have the condition. |
Source: Chronic diseases and associated risk factors in Australia, 2006, AIHW Cat. No. PHE 81, Table 3.6 & 2004–05 National Health Survey, ABS Cat. No. 4364.0, Glossary.
The most common health risk factor for women was inadequate vegetable consumption, affecting 84% of all women aged 18 years or more and 40% of women had inadequate fruit consumption. Nearly half (45%) of all women were classified as overweight or obese and one-third of all women undertook very low levels of physical activity. Nearly one in five women was a current smoker, although more men than women used tobacco daily. Over one in 10 women (11.7%), compared to 15.4% of men, reported drinking alcohol at risky levels. Overall, nearly 96% of all Australian women had at least one of the risk factors reported.
Health risk factors and age
Women's health risk factors varied with age (Table 3.11). Cigarette smoking and risky alcohol consumption were higher among younger women and decreased with age. Poor diet was common across all ages, but was reported slightly more often by younger women. High blood pressure and high cholesterol were more prevalent among older women. Physical inactivity affected about one-third of all women until age 65, when it became more prevalent. About one in four younger women was overweight and the prevalence of excess weight rose sharply at ages 25-44 years and then again at ages 45–64 years.
Table 3.11: Prevalence of women's risk factors by age, 2004–05
| |
AGE GROUP (%) |
| RISK FACTOR |
18-24 |
25-44 |
45-64 |
65-84 |
85+ |
| Smoking |
23.4 |
23.3 |
17.3 |
5.7 |
7.2 |
| Risky alcohol consumption |
12.5 |
12.0 |
13.2 |
7.7 |
5.4 |
| Physical inactivity |
32.3 |
30.8 |
32.3 |
46.7 |
75.5 |
| Inadequate fruit consumption |
49.9 |
45.2 |
34.7 |
30.6 |
35.4 |
| Inadequate vegetable consumption |
90.8 |
86.0 |
79.2 |
81.6 |
87.8 |
| Excess weight |
27.7 |
40.9 |
53.9 |
51.3 |
33.2 |
| High blood pressure |
0.6 |
2.8 |
18.8 |
42.2 |
37.0 |
| High blood cholesterol |
0.3 |
1.9 |
12.2 |
23.3 |
11.4 |
Source: Chronic diseases and associated risk factors in Australia, 2006, AIHW Cat. No. PHE 81, Table 3.10.
Trends in health risk factors
Comparisons with the 2004–05 National Health Survey and the two previous surveys conducted in 2001 and 1995 give an indication of the degree to which women's health risk behaviours have changed over time. Figure 3.11 shows that the proportion of women who were current smokers remained relatively stable. The proportion of women drinking at risky or high risk levels increased from 6.2% to 11.7%. There was a modest reduction in the proportion of women who did not exercise, from 35.4% in 1995 to 34.4% in 2004–05, but an increase in the proportion of women who were classified as overweight or obese.
Figure 3.11: Trends in selected risk factors among women, 1995 – 2004–05
Source: 2004–05 National Health Survey, Summary of Results, ABS Cat. No. 4364.0, Tables 21, 22, 23, and 25.
Health risk behaviours show associations with self-assessed health (Table 3.12). Women who were classified as overweight/obese, were sedentary and were current daily smokers were more likely than other women to rate their health as fair or poor.
Table 3.12: Women's self-assessed health by health risk factor, 2004–05
| |
SELF-ASSESSED HEALTH (%) |
| RISK FACTOR |
EXCELLENT/ VERY GOOD |
GOOD |
FAIR/POOR |
| BMI |
|
|
|
| – Normal range |
64.7 |
24.1 |
11.1 |
| – Overweight/obese |
50.0 |
30.0 |
20.1 |
| Smoker status |
|
|
|
| – Current daily smoker |
46.6 |
32.8 |
20.6 |
| – Never smoked |
58.2 |
27.0 |
14.8 |
| Alcohol risk |
|
|
|
| – Low risk |
62.0 |
26.3 |
11.8 |
| – Risky/high risk |
63.8 |
25.8 |
10.4 |
| Exercise level |
|
|
|
| – Sedentary |
44.6 |
30.8 |
24.5 |
| – Low |
59.7 |
27.1 |
13.2 |
| – Moderate/high |
67.1 |
24.0 |
8.9 |
Source: National Health Survey, Australia, 2004–05, ABS Cat. No. 4364.0, data available on request.
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Sexual and reproductive health
Sexual experience
In 2005, 97.3% of women aged 16 years and over reported ever having had a sexual experience.4
The 2002 Secondary Students and Sexual Health Survey found that by Year 12, nearly half of all students had engaged in sexual intercourse (Table 3.13). Table 3.13 also shows that between 1997 and 2002, there has been an increase in the proportion of students who had ever had sexual intercourse by Year 10, but the increase was larger for girls than for boys. Thus, the age of girls' initiation of sexual intercourse has declined. For Year 12 students, the proportion of students who had ever had sexual intercourse increased slightly for boys, but decreased marginally for girls.
Table 3.13: Students who had ever had sexual intercourse, 1997 and 2002
| |
1997 (%) |
2002 (%) |
| |
YEAR 10 |
YEAR 12 |
YEAR 10 |
YEAR 12 |
| Boys |
23.4 |
47.4 |
27.8 |
48.3 |
| Girls |
16.6 |
48.1 |
24.2 |
45.7 |
| Total |
19.7 |
47.8 |
25.8 |
46.8 |
Source: Smith, A., Agius, P., Dyson, S., Mitchell, A., & Pitts, M. (2003). Secondary Students and Sexual Health 2002, Results of the 3rd National Survey of Australian Secondary Students, HIV/AIDS and Sexual Health. Australian Research Centre in Sex, Health & Society, La Trobe University.
Sexually transmissible infections
Some sexually transmissible infections are notifiable through the National Notifiable Diseases Surveillance System.5 The two most common sexually transmissible infections are believed to be human papillomavirus and genital herpes. However, these infections are not notifiable and their prevalence is unknown.3
Table 3.14 shows the number of new cases of sexually transmissible infections notified in 1996 and 2005 for women. In 2005, chlamydia was the most frequently reported infection, and showed the biggest increase in the number of infections among women between 1996 and 2005. The number of infections of gonorrhoea is also on the rise among Australian women. Large reductions in the numbers of new cases of hepatitis A and hepatitis C were seen over the same period.
Table 3.14: Number of new cases of sexually transmissible infections among women in 1996 and 2005
| SEXUALLY TRANSMISSIBLE INFECTION |
YEAR |
| |
1996 |
2005 |
| Chlamydia |
5,512 |
24,468 |
| Gonorrhoea |
1,475 |
2,540 |
| Syphilis |
705 |
744 |
| Hepatitis A |
718 |
150 |
| Hepatitis B |
78 |
88 |
| Hepatitis C |
7,030 |
4,707 |
Source: National Centre in HIV Epidemiology and Clinical Research, HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report, 2001 and 2006.
Induced abortions
The total number of induced abortions performed each year in Australia is not recorded, except in South Australia and Western Australia. Medicare claims and hospital data are available, but these are unreliable as neither data set has complete coverage of induced abortion.6
Attempts have been made to extrapolate South Australian findings to national data7 or to combine the Medicare and hospital datasets with adjustments.8 Both methods estimated that the number of induced abortions in Australia in 2003 was about 84,000, at a rate of 19.7 abortions per 1,000 women.
Table 3.15 indicates that the highest estimated number of induced abortions in 2003 was in the 20–24 year age group and the lowest among girls younger than 15 years of age.
Table 3.15: Estimated number of induced abortions by age, 2003
| |
AGE GROUP (YEARS) |
| |
LESS THAN 15 |
15-19 |
20-24 |
25-29 |
30-34 |
35-39 |
40-44 |
44 AND OVER |
TOTAL |
| Number |
306 |
13,549 |
21,826 |
17,654 |
15,407 |
10,350 |
4,628 |
498 |
84,218 |
| % |
0.4 |
16.0 |
25.9 |
21.0 |
18.3 |
12.3 |
5.5 |
0.6 |
100 |
| Rate per 1,000 women aged 15–44 years |
N/A |
20.8 |
32.7 |
26.0 |
20.1 |
14.1 |
6.7 |
N/A |
19.7 |
Source: Grayson, N., Hargreaves, J., & Sullivan, E. A. (2005). Use of routinely collected national data sets for reporting on induced abortion in Australia. AIHW Cat. No. PER 30, Table 3.4. Induced abortions refer to medically induced abortions and exclude spontaneous abortions ('miscarriages').
The estimated induced abortion rate per 1,000 women increased from 17.9 in 1985 to peak at 21.9 in 1995. Since 1996, the abortion rate has steadily declined (See Figure 3.12).
Figure 3.12: Estimated abortion rate per 1,000 women aged 15–44 years, Australia, 1985–2003
Source: Chan, A. & Sage, L. C. (2005). Estimating Australia's abortion rates 1985–2003. Medical Journal of Australia, 182, (9), 447–452.
Teenage births
In 2005, there were 10,744 births to mothers younger than 20 years of age, accounting for 4.1% of all births in 2005.9 As a proportion of all births, teenage pregnancies have shown a modest decline since 1996 (Figure 3.13).
Figure 3.13: Teenage births as a proportion of all births, 1996–2005
Source: Australian Social Trends, 2006, ABS Cat. No. 4102.0, Family and Community: National Summary & Births, Australia, 2005, ABS Cat. No. 3301.0.
Reasons for not using contraception
Protection against pregnancy
The Australian Study of Health and Relationships was conducted between 2001 and 2002 and provided estimates of sexual health behaviours and attitudes in the Australian population. The Australian Longitudinal Study of Health and Relationships is currently underway. The study aims to explore issues of reproductive and sexual health behaviours and attitudes, relationship formation, health status and behaviour, and family demographics, as well as changes to Australians' sexual health behaviours and attitudes over time.10
Of all women aged between 16 and 59 years at risk of unplanned pregnancy in 2001–02, 94.8% used some form of contraception. Women who did not use contraception were asked the main reason for not doing so (Table 3.16). The most common reason related to side-effects and contraindications of contraceptives, affecting nearly one in four women not using contraception. Amongst this group, one in five at-risk women reported leaving it to chance when they had babies and similar numbers of women reported ambivalence towards contraception.
Table 3.16: Main reason for not using contraception given by women apparently at risk of unplanned pregnancy
| REASONS FOR NOT USING CONTRACEPTION |
WOMEN (%) |
| Have experienced side effects/contraindications |
23.0 |
| Leave it to chance/fate/God when to have babies |
20.2 |
| Don't care/don't worry/forget/have never got pregnant |
18.9 |
| Currently breast feeding |
16.5 |
| Believe it is unnatural or unhealthy |
13.7 |
| Don't know enough about what to do |
1.1 |
| Religious objection |
0.0 |
| Would like to but can't/partner or parent doesn't allow it/no access/no confidential service |
0.0 |
| Reason not specified/missing |
6.6 |
| Total |
100.0 |
Source: Richters, J., Grulich, A. E., de Visser, R. O., Smith, A. M. A., & Rissel, C. E. (2003). Sex in Australia: Contraceptive practices among a representative sample of women. Australian and New Zealand Journal of Public Health, 27, 210–216, Table 2.
Women were defined as at risk of unplanned pregnancy if they had at least one male sexual partner in the last year, had vaginal intercourse, were not past menopause, pregnant, trying to get pregnant or infertile, and their partner was not infertile.
Protection against sexually transmitted infection
The most effective way to reduce the risk of contracting a sexually transmitted infection is by using condoms during sexual activity. The Secondary Students and Sexual Health Survey in 2002 found that 57.8% of girls reported using a condom at the most recent sexual encounter. Year 10 girls (69%) were more likely than Year 12 girls (49.8%) to report using a condom. Both Year 10 and Year 12 girls were less likely to report using a condom at the most recent sexual encounter in 2002 relative to 1997.11
The reasons given by students for not using a condom are shown in Table 3.17. Reported knowledge of a partner's sexual history, trusting one's partner, and sex 'just happening' were the most common reasons given by adolescent girls for not using condoms the last time they had sex.
Table 3.17: Reasons for students not using a condom during most recent sexual encounter
| REASON |
BOYS (%) |
GIRLS (%) |
| I don't like them |
30.5 |
16.5 |
| My partner doesn't like them |
24.6 |
15.3 |
| I trust my partner |
23.3 |
38.4 |
| It just happened |
41.2 |
28.9 |
| We both have been tested for HIV/STIs |
4.5 |
10.4 |
| Too embarrassed |
3.7 |
2.9 |
| I know my partner's sexual history |
26.6 |
39.7 |
| It is not my responsibility |
4.8 |
1.9 |
| Other |
32.1 |
40.2 |
Source: Smith, A., Agius, P, Dyson, S., Mitchell, A., & Pitts, M. (2003). Secondary students and sexual health, 2002: Results of the 3rd National Survey of Australian Secondary Students, HIV/AIDS and Sexual Health, Monograph Series Number 47. Australian Research Centre in Sex, Health & Society, La Trobe University, Table 5.17.
Table 3.18 shows that among adults, condom use is more frequent among casual sexual partners than among regular live-in or non-live in partners. In 2001-02, 69.4% of women and 71.1% of men reported sometimes and always using a condom during sexual activity in the last six months with a casual partner.
Table 3.18: Frequency of condom use during sexual activity in the past six months by partner type, 2001–02
| |
MEN (%) |
WOMEN (%) |
| Regular live-in partner |
|
|
| – Never |
77.4 |
82.3 |
| – Sometimes |
14.4 |
11.7 |
| – Always |
8.2 |
6.0 |
| Regular non-live in partner |
|
|
| – Never |
48.6 |
49.9 |
| – Sometimes |
22.9 |
33.5 |
| – Always |
28.5 |
16.7 |
| Casual partner(s) |
|
|
| – Never |
28.9 |
30.7 |
| – Sometimes |
26.5 |
34.0 |
| – Always |
44.6 |
35.4 |
Source: de Visser, R. O., Smith, A. M. A., Rissel, C. E., Richters, J., & Grulich, A. E. (2003). Sex in Australia: Safer sex and condom use among a representative sample of adults, Australian and New Zealand Journal of Public Health, 27, (2), 223–229, Table 2.
Maternal deaths
Death from pregnancy is rare in Australia. During the three-year period 2000–2002, there were 95 maternal deaths. They are classified into direct deaths (death from pregnancy complications), indirect deaths (deaths from pre-existing diseases complicated by pregnancy), incidental deaths (the pregnancy is unlikely to have contributed significantly to the death) and late deaths (direct or indirect death between 43 days and 365 days after termination of pregnancy).
In 2000–2002, the majority of maternal deaths were due to indirect causes (Table 3.19). The main causes of indirect deaths were cardiac disease, infection, psychiatric causes, haemorrhage, cancers or tumours and asthma. There was also a rise in indirect maternal deaths and a decrease in incidental deaths from the previous triennium. These changes are due, in part, to changes in the classification of some deaths.
Table 3.19: Number of maternal deaths by type of death, 1997–2002
| TYPE OF DEATH |
1997–1999 |
2000–2002 |
| Direct cause |
34 |
32 |
| Indirect cause |
30 |
52 |
| Incidental |
28 |
3 |
| Late |
5 |
8 |
| Total |
97 |
95 |
Source: Maternal deaths in Australia, 2000–2002, AIHW Cat. No. PER32, Table 1.
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References