2.18 Physical activity
This measure reports on the proportions of the Aboriginal and Torres Strait Islander adult and child populations classified as having sedentary, low, moderate or high physical activity levels
Introduction
This is no. 42 of 68 measures in the Aboriginal and Torres Strait Islander Health Performance Framework 2014 report: detailed analyses. This report provides information on a range of
measures of health status, determinants of health and the health system performance relating to Aboriginal and Torres Strait Islander people.
The Framework comprises 3 tiers: Tier 1—Health status and outcomes Tier 2—Determinants of health Tier 3—Health system performance.
The full report, including a comprehensive description of all data sources used in the report, and notes about the data quality is available from
<http://www.aihw.gov.au/publication-detail/?id=60129550779>. Tables referenced are available from
<http://www.aihw.gov.au/indigenous-data/health-performance-framework/>.
Data source
Australian Aboriginal and Torres Strait Islander Health Survey.
For more information, see ‘Data sources and quality’ at the end of this measure.
Data analyses
Current guidelines recommend that children aged 2–4 are physically active for at least 3 hours every day; that children aged 5–17 do at least 60 minutes per day of moderate to vigorous intensity physical activity; that adults aged 18–64 accumulate 150 to 300 minutes (2½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1¼ to 2½ hours) of vigorous intensity physical activity per week; and that adults aged over 65 accumulate at least 30 minutes of moderate intensity physical activity on most days. The guidelines also recommend a maximum time to be spent sitting (sedentary behaviour) for all ages
(Department of Health 2014). The Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) defined ‘sufficient’ activity for adults as at least 150 minutes over 5 or more sessions.
See also ‘Other related information’ at the end of this measure. The following data are presented for this measure:
• Sufficient levels of physical activity, see ABS 4727.0.55.004: tables 1.1, 1.4, 9.3 and 16.3 • Types of physical activity, see ABS 4727.0.55.004: Table 4.1.
Note that all data cited in this measure are drawn from the report Australian Aboriginal and Torres Strait Islander Health Survey: Physical Activity, 2012–13 (ABS 2015) and its associated detailed tables. These tables are not reproduced in this report.
Sufficient levels of physical activity
Current period
In the period 2012–13 in Non-remote areas:
• 38% of Indigenous adults had undertaken a sufficient level of physical activity in the last week. Rates of sufficient activity were higher for Indigenous males (43%) than for
Indigenous females (33%). Of Indigenous Australians aged 18–24, 48% were sufficiently active, compared with 27% of those aged 55 and over (ABS 4727.0.55.004: Table 1.1). • After adjusting for age, the rate for Indigenous adults who met sufficient activity levels
in the last week was 0.8 times as high as for non-Indigenous adults. The gap was 8 percentage points (ABS 4727.0.55.004: Table 1.4, Figure 2.18.1).
• An estimated 82% of Indigenous children aged 2–4 met the recommendations of at least 3 hours of physical activity per day, similar to the proportion (81%) for non-Indigenous children (ABS 4727.0.55.004: Table 16.3). Average time spent in physical activity was
Types of physical activity
Current period
In the period 2012–13 in Non-remote areas:
• After adjusting for age, on average Indigenous adults spent more time walking for transport (ratio of averages of 1.7) and less time walking for fitness, recreation or sport than non-Indigenous adults (ratio of 0.8). Indigenous adults also spent less time doing moderate (0.7 times) or vigorous physical activity (0.8 times) than non-Indigenous adults (ABS 4727.0.55.004: Table 4.1).
• Indigenous adults on average spent more time watching television or videos (1.3 times) and less time using a computer/internet than non-Indigenous adults (0.6 times)
(ABS 4727.0.55.004: Table 4.1).
Source: ABS 4727.0.55.004: Table 1.4.
Figure 1.18.1: Age-standardised proportion of persons aged 18 and over in Non-remote areas with sufficient physical activity, by Indigenous status, 2012–13
0 10 20 30 40 50 60 70 80 90 100 Indigenous Non-Indigenous Per cent
Source: ABS 4727.0.55.004: Table 9.3.
Figure 1.18.2: Proportions of children aged 5–17 in Non-remote areas who met physical and screen-based activity recommendations, by Indigenous status, 2012–13
Data sources and quality
Physical activity data
The information is ‘as reported’ by respondents and reflects their perception of the activity undertaken, the intensity of their participation, their level of fitness, and so on. Information related to physical activity that persons aged 15–17 undertook was reported by an adult within the household, usually a parent. The child may or may not have been consulted. As a result, data for this age group should be interpreted with particular care.
In general, the use of a 2 week reference period was not considered to pose significant recall problems for respondents. For many people, participation in exercise is regular and/or for a set period each session. However, to the extent that persons undertook exercise in less formal circumstances or that the reference period was atypical of usual exercise patterns, the
accuracy of the information provided may have been affected.
Recent developments in the area of statistics on exercise or physical activity have tended to move away from the use of metabolic equivalent level (MET) values in deriving exercise level, and have placed more emphasis on measures of time spent exercising. Retention of the exercise level approach as described above was mainly for the purpose of consistency and comparability with data from the 1995 and 2001 National Health Surveys. However, measures of time exercising are also available as outputs from this survey (ABS 2005). Survey respondents are required to recall recent activity in minutes without being primed and without independent checks. Diary recording (as used in the ABS Time Use Survey) or
0 10 20 30 40 50 60 70 80 90 100
Physical activity Screen-based activity Both
Per cent
Indigenous Non-Indigenous
The difference of intensity between different activities is not always clear for respondents, although explanatory instructions are included. Mutual exclusivity of concepts remains a problem.
A well-recognised reporting issue for self-report surveys is the tendency of respondents to report in a socially desirable way. For example, the less active may want to over-report activity to appear healthier.
Survey questions related to duration of exercise differ slightly in the questionnaire for remote areas and may affect the comparability of results.
Despite the limitations of the survey data, users have generally considered the data
produced to be of sufficient quality for the very broad measures of physical activity required (ABS 2005).
A reliable tool for measuring Aboriginal and Torres Strait Islander physical activity levels has not yet been developed. A study to determine the reliability of the Active Australian Survey in measuring Aboriginal and Torres Strait Islander populations revealed that it was not a reliable tool (not culturally appropriate) ( Marshall & Miller 2004). The Active
Australian Survey uses very similar questions to the National Health Survey to determine physical activity levels. For this reason the data should be interpreted cautiously.
Australian Aboriginal and Torres Strait Islander Health Survey
The 2012–13 Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) included a sample of 12,000 Indigenous Australians for the core sample and sub-samples for various components of the survey such as voluntary biomedical data for adults. TheAATSIHS sample was specifically designed to select a representative sample of Indigenous Australians and therefore overcome the problem inherent in most national surveys (that is, small and unrepresentative Indigenous samples).
Survey results are subject to sampling errors as only a small proportion of the population is used to produce estimates that represent the whole population. Non-sampling errors may occur where there is non-response to the survey or questions in the survey,
misunderstanding of questions or errors in recording, coding or processing the survey. Information recorded in this survey is ‘as reported’ by respondents. Responses may be affected by imperfect recall or individual interpretation of survey questions. Any data that are self-reported are also likely to under-estimate circumstances about which the respondent is unaware, or may be reluctant to report (for example, certain health conditions, weight, drug use).
Selected non-Indigenous comparisons are available from the 2011–13 Australian Health Survey (AHS). The AHS was conducted in Major cities, regional and remote areas, but very remote areas were excluded from the sample.
Further information on AATSIHS data quality issues can be found in the user guide for the survey (ABS 2013). Time series comparisons for some indicators are available from the 2004–05 NATSIHS, 2008 NATSISS, 2002 NATSISS, 2001 NHS and the 1994 National Aboriginal and Torres Strait Islander Survey (NATSIS).
Australian Health Survey
The Australian Health Survey (AHS) combines the existing ABS National Health Survey (NHS) and the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) together with 2 new elements: a National Nutrition and Physical Activity Survey (NNPAS) and a National Health Measures Survey (NHMS).
For more information see: • National Health Survey
<http://www.abs.gov.au/AUSSTATS/[email protected]/Lookup/4363.0.55.001Main+Features1 2011-13?OpenDocument>.
• National Aboriginal and Torres Strait Islander Health Survey <http://www.abs.gov.au/ausstats/[email protected]/mf/4715.0/>. • National Nutrition and Physical Activity Survey
<http://www.abs.gov.au/ausstats/[email protected]/Lookup/by%20Subject/4364.0.55.007~201 1-12~Main%20Features~About%20the%20National%20Nutrition%20and%20Physical% 20Activity%20Survey~731>.
• National Health Measures Survey
<http://www.abs.gov.au/ausstats/[email protected]/Lookup/4364.0.55.005Chapter1102011-12>.
List of figures
Figure 1.18.1: Age-standardised proportion of persons aged 18 and over in Non-remote areas with sufficient physical activity, by Indigenous status, 2012–13 ... 3 Figure 1.18.2: Proportions of children aged 5-17 in Non-remote areas who met physical and
screen-based activity recommendations, by Indigenous status, 2012–13 ... 4
References
ABS (Australian Bureau of Statistics) 2005. Physical activity: review of strategic statistical issues for future National Health Surveys. Discussion paper. Canberra: ABS.
ABS 2013. Australian Aboriginal and Torres Strait Islander Health Survey: users’ guide, 2012–13. ABS cat no. 4727.0.55.002. Canberra: ABS.
ABS 2015. Australian Aboriginal and Torres Strait Islander Health Survey: Physical Activity, 2012–13 (4727.0.55.004) Table no. 1.1, 1.4, 4.1, 9.3, 16.3, 17.3, 18.3 and 19.1. Viewed on 31 March 2015,
<http://www.abs.gov.au/AUSSTATS/[email protected]/DetailsPage/4727.0.55.0042012– 13?OpenDocument>.
DoH (Department of Health) 2014. Australia’s Physical Activity and Sedentary Behaviour Guidelines.
Other related information
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White SL, Dunstan DW, Polkinghorne KR, Atkins RC, Cass A & Chadban SJ 2011. Physical inactivity and chronic kidney disease in Australian adults: The AusDiab study. Nutrition, Metabolism and Cardiovascular Diseases 21:104–12.
Wilmot E, Edwardson C, Achana F, Davies M, Gorely T, Gray L et al. 2012. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic
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