Many factors can influence how likely it is that an individual will develop a disease or health disorder. These factors are known as determinants of health. Determinants of health include both social determinants and health risk factors.

This page provides an overview of the prevalence of certain health risk factors among Aboriginal and Torres Strait Islander people including overweight and obesity, alcohol consumption and smoking, dietary behaviours, and not meeting physical activity guidelines.

These health risk factors increase the likelihood of a person developing a chronic disease, or interfere with the management of existing conditions.

Many health risk factors are preventable and modifiable and significant reduction is associated with improved health outcomes.

Prevalence of health risk factors

Figure 1 presents prevalence rates of selected health risk factors for Indigenous and non-Indigenous Australians. Although Indigenous Australians have higher rates of health risk factors, the differences are small, except for tobacco smoking.

This chart shows the age standardised prevalence of Indigenous Australians on selected health risk factors and compares it to non-Indigenous prevalence. 97.2% of Indigenous Australians and 94.8% of non-Indigenous Australians had inadequate daily vegetable and fruit consumption, 89.0% of Indigenous Australians and 85.1% of non-Indigenous Australians did not meet physical activity guidelines, 76.8% of Indigenous Australians and 66.3% of non-Indigenous Australians were overweight or obese, 48.5% Indigenous Australians and 41.6% of non-Indigenous Australians consumed alcohol at risk levels on a single occasion and 41.4% of Indigenous Australians and 14.4% of non-Indigenous Australians were current smokers. 

Diet

Diet plays a key role in health and wellbeing and provides the energy and nutrients that the body needs to support tissue maintenance, repair and growth as well as overall health. If diet is poor, energy and nutritional intake can be insufficient or excessive and result in ill health.

Health conditions that are often affected by diet include overweight and obesity, coronary heart disease, stroke, high blood pressure, some forms of cancer and type 2 diabetes.

A range of external factors, including, for example, availability and affordability, may affect levels of fruit and vegetable consumption. In 2018⁠–⁠19, based on estimates from self-reported survey data:

  • 97% (522,100) of Indigenous Australians aged 15 and over had inadequate daily fruit and vegetable consumption, with males more likely to have inadequate consumption than females (99% or 256,500 compared with 96% or 265,800, respectively)
  • similar proportions of Indigenous Australians aged 15 and over in Remote (98% or 100,300) and Non‑remote areas (97% or 421,700) had inadequate daily intake of fruit and vegetables
  • for Indigenous children aged 2⁠–⁠14, 94% (224,000) had inadequate daily intake of fruit and vegetables
  • The age-standardised proportion is not significantly different between Indigenous and non-Indigenous Australians (97.2% compared with 94.8%, respectively) (ABS 2019).

See Diet for more information.

Insufficient physical activity

Regular physical activity provides many benefits for physical and mental health and is an important factor in maintaining a healthy weight. Insufficient physical activity is a key contributor to disease burden in Australia. In 2018⁠–⁠19, based on self-reported data in Non-remote areas:

  • most Indigenous Australians aged 15 and over (89% or 385,900) did not meet the physical activity guidelines
  • there was no significant difference between the proportions of females (90% or 202,100) and males (87% or 183,200) who did not meet the physical activity guidelines (ABS 2019).

See Insufficient physical activity for more information.

Overweight and obesity

Excess weight is a major risk factor for many diseases, such as cardiovascular disease, type 2 diabetes, some musculoskeletal conditions and cancers. There are differences in weight status between Indigenous and non-Indigenous Australians, and these begin in childhood.

A healthy diet, physical activity and accessibility to support from general practitioners and other health services may all result in lower rates of overweight and obesity.

See Indigenous Australians’ use of health services for more information.

Based on Body Mass Index (BMI) (derived from measured height and weight), in 2018-19 around 3.5% (17,000) of Indigenous Australians aged 18 and over were underweight, 22% (108,600) were within normal weight, 29% (141,100) were overweight and 45% (219,500) were obese. Similar proportions of Indigenous males (74% or 172,200) and females (75% or 189,100) were overweight or obese. 

In 2018⁠–⁠19, the majority of Indigenous children aged 2⁠–⁠14 were within normal weight (54% or 129,100). Indigenous girls were slightly more likely to be overweight or obese (40% or 46,400) than boys (34% or 42,000) while Indigenous females aged 15⁠–⁠17 were 4 times as likely to be underweight than males of the same age group (14% or 3,300, compared with 3.1% or 800) (Figure 2) (ABS 2019).
 

This chart shows the proportion of Indigenous Australians in each weight category by age group and sex. The 2–14 age group (54.2%) had a higher proportion of people within the normal weight range compared to the older children aged 15–17 (50.0%) and Indigenous adults (22.3%). Indigenous males (42.5%) aged 18 over were less likely to be obese than females (47.5%). 

See Overweight and obesity for more information.

Alcohol consumption

Regular consumption of alcohol at high levels increases the risk of alcohol-related harm. High intakes can contribute to the development of chronic diseases or alcohol dependence, and premature death. Alcohol consumption can also play a part in excess energy intake, contributing to excess body weight.

Between 2001 and 2018–19, there was an increase in the proportion of Indigenous Australians aged 18 and over reporting that they had not consumed alcohol in the last 12 months or have never consumed alcohol’, from 19% to 26%.

In 2018–19 survey data estimates:

  • a greater number (37%) of Indigenous Australians aged 18 and over in Remote areas reported that they did not consume alcohol in the last 12 months or have never consumed alcohol than did Indigenous adults in the Non-remote areas (23%)
  • similar proportions of Indigenous adults in Non-remote (54%) and Remote (53%) areas reported drinking at risky levels on at least a single occasion (known as short-term risk).

See Alcohol risk and harm for more information.

Tobacco smoking

Tobacco smoking is the leading preventable cause of ill health and death in Australia for both Indigenous and non-Indigenous Australians, contributing to respiratory diseases, cancers, cardiovascular diseases, infections and endocrine disorders.

In 2018–19, based on self-reported data, 43% (210,900) of Indigenous Australians aged 18 and over were current smokers (that is, those who regularly smoke 1 or more cigarettes, pipes, cigars or other tobacco products per day) with the proportion among males (46%) higher than among females (41%). Half of Indigenous Australians aged 18 and over who were current smokers had attempted to quit smoking in the previous 12 months (52% or 109,200).

Prevalence rates of smoking by Indigenous Australians aged 18 and over decreased between 2012–13 (46%) and 2018–19 (43%).  

See Tobacco smoking for more information.

Where do I go for more information?

For more information on health risk factors among Indigenous Australians, see:

Visit Indigenous Australians for more on this topic.

References

ABS (Australian Bureau of Statistics) 2019. National Aboriginal and Torres Strait Islander Health Survey, 2018–19. ABS cat. no. 4715.0. Canberra: ABS.