Zurich Heart Foundation Heart Health Index - September 2010

Zurich Heart Foundation Heart Health Index - Press Release

As with the two previous surveys (2008 and 2009), the 2010 survey shows there is a

difference between Australian s reported heart health risk behaviours and their perceptions of

meeting the guidelines for these activities.

Close to 60% of people are not getting the recommended amount of physical activity per

week, however 47% of people thought that they were meeting the guidelines.

Close to half the people (46%) who are Overweight thought that their weight met health

guidelines. 13% of people who are Obese thought that their weight met current

guidelines.

Three-quarters of adults wrongly believe that their vegetable consumption meets the

guidelines. More than one in two people that only consume one or two serves of

vegetables per day believe their consumption meets the guidelines.

One in six smokers believe that they have a low or very low risk of heart disease.

Smokers were significantly less likely to have a blood pressure check or cholesterol check

than non-smokers.

Close to three in every four adults rate their health as either good or very good. Only

4% rated their health as poor . Three quarters of Obese people rated their health as

good , very good or excellent .

People who are single were significantly less likely to report having good, very good

or excellent health compared to respondents that are married.

Close to one in five people felt their risk of heart disease is high to very high .

When posed they question of what things increase the risk of heart disease and what can

be done to lower one s risk, the majority of respondents focused on lifestyle factors, such

as diet, exercise (or lack of), weight and smoking. Very few mentioned clinical risk

factors such as high blood pressure, high cholesterol or diabetes.

Lack of time is the most common barrier faced by people that stops them from changing

their behaviour. One in twelve people also feel lack of motivation is a key barrier

holding them back from making changes to their lifestyle.

The Zurich Heart Foundation Heart Health Index (Heart Health Index) survey measures

awareness, knowledge, perceptions and behaviours relating to cardiovascular disease and

associated risk factors.

It specifically seeks to measure heart health related behaviours and compares them with

perceptions of whether they meet current population health guidelines.

A stratified sample design was used to approximate an age, gender and geographically

representative sample of the Australian population aged 20 years and over, while at the same

time, ensuring a sufficiently large sample was achieved in each state and territory to support

analysis and produce reliable survey estimates.

At the end of the sampling and interview process, 1,206 Australian adults aged 20 years or

over were interviewed by computer assisted telephone interviewing (CATI).

The CATI survey was completed by Your Source. The survey was developed jointly by Zurich

Financial Services Australia Limited and the Heart Foundation.

Throughout this report the data from the Heart Health Index survey is presented along with

data from other surveys for comparison and indication of trends over time. Data from the

Australian Bureau of Statistics (ABS) National Health Survey (NHS) 2007/8 data set are

included, along with data from other surveys where available and relevant.

Physical activity behaviour was assessed with the following question:

Now I d like to ask you some questions about various health behaviours. How

By moderate, we mean physical activity that causes small increases in heart rate

and breathing, such as brisk walking, but you can still hold a conversation. By

vigorous, we mean physical activity that causes larger increases in heart rate and

breathing, such as running, aerobics or skiing, and you can t hold a conversation.

Just over forty percent of respondents were meeting the recommended guidelines for

physical activity.

Table 1: Getting Recommended Level of Physical Activity per Week

Close to one in two respondents (47%) doing fewer than 5 sessions of physical activity

each week believed they met the guidelines. This is up on the previous two surveys (35%

in 2009 and 43% in 2008).

Surprisingly, one in six respondents that were meeting or exceeding 5 sessions of

physical activity each week felt they had not done enough physical activity to satisfy the

guidelines.

Males (42%) were slightly more likely to be getting the recommended level of physical

activity than females (40%).

Nearly two in every three respondents (63%) who personally rated their health fair or

poor did not do enough exercise (at least 5 x 30 minute sessions per week).

Close to two-thirds (61%) of individuals that felt they had a high to very high risk of

heart disease did not do enough exercise.

Individuals with tertiary education qualifications (bachelor degree or diploma) were less

likely to do at least 5 physical activity sessions a week than individuals that had finished

high school only.

Smokers were more likely to do or exceed 5 sessions of physical activity a week than

non-smokers.

Obese people (67%) were significantly more likely than those in the ideal or Overweight

categories not to meet the exercise guidelines (56% and 57% respectively).

Body Mass Index (BMI) is calculated using the following formula:

Table 2: NHMRC Body Mass Index Classification

<20.0 20-25 >25-30 >30

Based on self reported height and weight, 41% of the respondents met the guidelines for

ideal weight.

More than half the survey population were either Overweight (37%) or Obese (20%).

Table 3: BMI by Gender

Many people had a distorted view of their weight status:

Close to half the people (46%) who are Overweight thought that their weight met

health guidelines.

13% of people who were Obese thought that their weight met current guidelines.

There was a significant difference in BMI for males and females.

Females were significantly more likely to be of ideal weight (49%) compared to

males (31%).

Males (47%) were significantly more likely to be Overweight than females (29%).

Obesity rates were similar for males and females.

Two-thirds of Obese people did not meet the recommended guidelines on physical

activity, significantly higher than people that were of ideal weight.

Couples without kids were significantly more likely to be Overweight than couples

with children at home.

Only one in fourteen people aged 20 to 29 were Obese, compared to one in four

people aged 50 to 59.

Table 4: Obesity by Age Groups

Daily vegetable consumption was assessed with the following question:

Thinking about vegetables, including fresh, dried, frozen and tinned vegetables,

cup of cooked vegetables or 1 cup of salad vegetables?

18% (8% in 2008 and 2009) met the recommended guidelines of five or more serves

each day.

40% (30% in 2008 and 28% in 2009) usually ate three to four serves each day.

Table 5: Daily Vegetable Consumption

Three-quarters of adults wrongly believe that their vegetable consumption meets the

guidelines. Many people incorrectly believe that they are meeting vegetable consumption

recommendations, including:

Just over one in two - 53% - (56% in 2008 and 59% in 2009) of those who had one

to two serves

Just over two-thirds - 70% - (65% in 2008 and 82% in 2009) of those who had three

to four serves

Women (22%) were significantly more likely than men (9%) to consume the

recommended amount of vegetables each day.

57% of men were likely to only consume one to two serves of vegetables, compared to

35% women.

Women were more likely to consume three to four (43%) serves of vegetables a day,

compared to men (3-4 serves - 34%).

82% of those who rate their health as poor or fair did not meet the guidelines for

vegetable consumption.

79% of those who consider their risk for getting heart disease to be very high or high

did not met the guidelines.

Usual fruit consumption was assessed with the following question:

Now I'd like to ask about eating fruit, including fresh, dried, frozen and tinned

medium piece or 2 small pieces of fruit, or a cup of diced pieces.

34% (42% in 2008 and 32% in 2009) only ate one serve each day.

Two thirds of respondents (53% in 2008 and 54% in 2009) ate the recommended two

serves or more.

Table 6: Daily Fruit Consumption

Of those who were eating less than two serves of fruit each day, one third 31% (37% in

2008 and 33% in 2009) thought that they were meeting the recommendations.

Men were significantly more likely to feel they were meeting the recommended guidelines

dispute only eating one serve of fruit than compared to women (39% to 27%).

42% of people who rated their health as either poor or fair consumed less than the

recommended 2 or more serves of fruit a day.

53% of daily smokers do not eat the recommended serves of fruit each day, significantly

higher than those that have never smoked (31%).

58% of individuals who do not do enough exercise also do not eat at least 2 serves of

fruit.

88% of individuals that do not eat sufficient serves of vegetables do not also have the

sufficient number of serves of fruit.

Respondents were asked about their tobacco consumption behaviour with the following

question:

Which of the following best describes your smoking status? This includes

cigarettes, cigars and pipes.

Response options: You smoke daily, You smoke occasionally, You don t smoke

now, but you used to, You ve tried it a few times but never smoked regularly,

Or, you ve never smoked.

55% (55% in 2008 and 56% in 2009) surveyed were non-smokers.

30% (26% in 2008 and 25% in 2009) were ex-smokers

15% (20% in 2008 and 19% in 2009) were current smokers - 13% of the total sample

was daily smokers and 2% were occasional smokers.

Table 7: Smoking Status

27% of smokers rated their health as very good or excellent .

One in six smokers (12% in 2008 and 13% in 2009) of smokers believe they have a low

to very low risk of heart disease.

Men were more likely to be smokers than women (18% v 14%).

Single parents living with their child(ren) were more likely to smoke than couples living

with their child(ren).

Adults that are single (never been married) are significantly more likely to smoke than

adults that are married.

People with a TAFE/trade qualification were more likely to smoke than those with an

undergraduate or postgraduate qualification.

One in 5 Obese individuals smokes daily, compared to 12% of individuals with ideal

weight.

Respondents were asked about their coffee consumption behaviour with the following

question:

Do you drink coffee? If yes to drinking coffee, on average, how many cups per

day? And, what type of milk do you usually have with your coffee?

Slightly more men drink coffee than women, with 69% of men drinking coffee compared

to 65% of women.

The average coffee drinker has 2.2 cups of coffee each day.

There were marginal differences in whether a person drank coffee and their:

educational attainment

marital status

household structure

current activity (i.e. working, studying, unemployed).

Daily smokers (76%) are significantly more likely to drink coffee than people who have

never smoked (62%).

People that are Overweight or Obese are more likely to drink coffee than people that are

of ideal weight.

Consumption of coffee increases with age, with only 35% of people aged 20 to 29

drinking coffee compared to 71% for people 50 years of age and over.

Close to two-thirds of the women and 60% of men have one or two cups of coffee each

day. However, one in six men and women have four or more cups each day.

Men are more likely to have full cream milk with their coffee than women. 44% of men

that drink coffee have full cream milk, compared to 31% of women. For women, the

majority (59%) have skim/no fat milk, compared to 40% of men. Seven percent of

coffee drinkers have no milk.

People who drink one or two cups of coffee a day are more likely to have skim/no fat

milk, compared to people who drink five or more cups a day are more likely to have full

cream milk.

Participants were asked about blood pressure checks with the following question:

In the last 12 months, have you had the following checked by a doctor or

other health professional?

Close to nine in ten respondents (86%) reported that they had their blood pressure

checked in the last 12 months, compared with 77% in 2008 and 79% in 2009.

Table 8: Blood Pressure Checks

Females (88%) were significantly more likely to have their blood pressure checked in the

last 12 months than males (83%).

Blood pressure checks increased with age. Two thirds of people aged 20 to 29 had a

blood pressure check in the past 12 months, compared to 96% of people aged 60 and

over.

51% of men aged 18-29 had a blood pressure check in the last 12 months, compared to

74% of women aged 20-29.

Smokers (79%) were significantly less likely to have a blood pressure check than non-smokers

(88%).

Obese people (92%) were more likely to have blood pressure check than the other

weight categories - underweight (80%), ideal weight (84%) and over weight (84%).

The respondents were also asked about blood cholesterol checks with the following question:

In the last 12 months, have you had the following checked by a doctor or

other health professional?

Two-thirds of respondents had their blood cholesterol checked by a health professional in

the previous 12 months, compared to 53% in 2008 and 58% in 2009.

Table 9: Cholesterol Checks

As with blood pressure checks, cholesterol checks increased with age.

Smokers (58%) were significantly less likely to have a blood cholesterol check than nonsmokers

(67%).

Respondents that rated their health as very good or excellent were significantly less

likely to have had a blood cholesterol check in the last 12 months than respondents that

rated their health as fair or poor .

Couples living with children were significantly less likely to have a blood cholesterol check

than couples without children.

Obese people (77%) had higher rates of cholesterol checks than other weight categories

- Overweight people (68%), ideal weight people (61%), and underweight people (60%).

Respondents were asked for their perceptions of the three most common causes of death for

women and men in Australia, with the following question:

The most common mention for the highest cause of mortality for women, amongst all

respondents, was breast cancer.

Table 10: First Mention Most Common Cause of Death for Women

For the first time in the three years of the Heart Health Index survey, more respondents

mentioned heart disease as one of the top three causes of death for women than breast

cancer.

Table 11: Top Three Mentions for the Common Cause of Death for Women

The mortality data for Australian females can be used to gauge the accuracy of public

perception. For the purposes of comparison, the female mortality data from the ABS for 2008

is:

Table 12: ABS, Causes of Death, Women 2008

The community seems to underestimate the number of stroke deaths, and overestimates the

number of breast cancer deaths.

Respondents were asked for their perceptions of the three most common causes of death for

women and men in Australia, with the following question:

For the third year in a row, the most common mention for the highest cause of mortality for

men, amongst all respondents, was heart disease.

Table 13: First Mention Most Common Cause of Death for Men

Once again, for the third year in a row, more respondents mentioned heart disease as one of

the top three causes of death for men.

Table 14: Top Three Mentions for the Common Cause of Death for Men

The mortality data for Australian males can be used to gauge the accuracy of public

perception. For the purposes of comparison, the male mortality data from the ABS for 2008

is:

Table 15: ABS, Causes of Death, Men 2008

The community appears to underestimate the number of lung cancer deaths and

overestimate the number of prostate cancer deaths.

The respondents were also asked about their self perceived health status with the following

question:

In general, would you say your health is ? Response options: Excellent , Very

good , Good , Fair , or Poor

Most people believe that their health is good or very good.

Overall, 45% thought that their health is very good or excellent . Only 4% believe their

health is poor .

Table 16: Self Perceived Health Status

Self perceived health ratings are similar across age and sex.

74% of Obese people consider their health to be good , very good or excellent .

People whose fruit consumption met or exceeded the recommended guidelines (85%)

were more likely to rate their own health as good , very good or excellent health

compared with those who did not meet the guidelines (81%).

People whose level of physical activity met or exceeded the recommended guidelines

(55%) were more likely to rate their own health as very good or excellent health

compared with those who did not meet the guidelines (47%).

Current smokers (30%) were significantly less likely to rate their own health as very

good or excellent health compared with non smokers (49%).

People who are single (70%) were significantly less likely to report having good , very

good or excellent health compared to respondents that are married (89%).

People were also asked to indicate their self perceived risk of heart disease with the following

question:

What would you say is the risk that you ll get heart disease?Would you say it is ?

The supplied response categories were: very high , high , moderate , low and

very low .

Most people felt they were of moderate (42%) or low (29%) risk of having heart

disease.

14% thought they were high risk and 5% believe themselves to be at very high risk.

Table 17: Perceived Risk of Getting Heart Disease

Perception of heart disease risk increases with a person s BMI.

14% of people that were of ideal weight rated their risk of getting coronary heart disease

as high or very high .

32% of people that are Obese thought that they were at a high or very high risk of

coronary heart disease.

More than one third (35%) of daily smokers rated themselves as at a high or very high

risk of getting coronary heart disease, significantly higher than those who have never smoked

(13%).

Respondents were asked to indicate what things can increase the risk of heart disease with

the question:

Based on what you know, what things do you think increase your risk of heart

disease?

Most respondents nominated lifestyle factors as key risks for heart disease. More than

half mentioned poor diet, with one in two also mentioning lack of exercise.

One in nine respondents mentioned high cholesterol as a risk factor, with only one in

twenty mentioning high blood pressure.

Table 18: Heart Disease Risk Factors

Respondents were asked to indicate how people can lower their risk of heart disease with the

following question:

What, if anything, can people do to lower their risk of coronary heart disease?

Around four in five people believe that a healthy diet and exercise can be used to lower

risk of heart disease, significantly higher than for all other mentions.

Just 1% of respondents mentioned regular blood pressure checks/lowering blood

pressure would help reduce the risk of heart disease.

Table 19: Reducing Risk of Heart Disease

Respondents were asked about recent behaviour changes with the following question:

Have you made any changes to your behaviour in the past 6 months to reduce

your risk of heart disease?

37% had made a change to their behaviour to reduce their risk of heart disease in the

past six months.

Table 20: Made a Change to Behaviour in Last 6 Months

Women were significantly more likely to have made a change in the last 6 months than

men.

People over the age of 60 were significantly less likely to have made a change in the last

6 months than people under the age of 60.

People with kids (43%) were significantly more likely to have made a change in the last 6

months than people without children (31%).

People with TAFE/trade qualifications were significantly more likely to have made a

change in the last 6 months than people with high school qualification only.

People who were Obese (52%) were significantly more likely to have made a behaviour

change in last six months than people who were of ideal weight (28%).

Respondents were asked about recent behaviour change with the following question:

What changes have you made? (Only includes respondents that answered

yes to Have you made changes in the past six months? )

The majority of respondents that had made a change in the past six months to reduce

their risk of heart disease made lifestyle changes, with improving diet and increasing

exercise the two main behaviour changes.

Table 21: Changes to Behaviour in Last 6 Months

Of those who have changed their behaviour in the last 6 months;

Only 5% of people that are Obese changed their behaviour by losing weight in the last 6

months. For people that are Overweight, only 1% lost weight in the last 6 months.

One in seven people that are Obese reduced their consumption of fatty/unhealthy foods

in the past six months.

One in five people that are Obese increased their exercise levels in the past six months.

One in six smokers cut down on the number of cigarettes they smoked in the past six

months.

Perceived barriers to behaviour change to reduce risk of heart disease were assessed with

the following question:

What, if anything, makes it difficult for you to change your behaviour to reduce

your risk of heart disease?

Lack of time is the most common barrier faced by people that stops them from changing

their behaviour.

One in eleven people are also hampered by an existing condition or illness that prevents

them from changing their behaviour.

Table 22: Barriers to Changing Behaviour

One in eight people that are Overweight, believe there are no barriers and also believe

they are healthy and they do not need to change.

One in six Obese people believe a barrier to changing their lifestyle is lack of time. Also,

one in five Overweight people believe a barrier to changing their lifestyle is lack of time.

One in six Obese and Overweight people feel the lack of motivation is a barrier to them

changing their behaviour.

Women are significantly more likely to mention lack of time as a barrier to change than

men.

People under the age of 40 are significantly more likely to mention lack of time as a

barrier to change than people over 50 years of age.

Couple with kids are significantly more likely to mention lack of time as a barrier to

change than couples without kids.