Country of birth
The analyses described below focus on the ten most common countries of birth as reported in the 2021 Census as they account for 54% of overseas born people in Australia and demonstrate the key results. There are 176 countries included in the full results presented in the supplementary tables. For the ten most common countries of birth:
- Italy, England, Australia and New Zealand had the highest proportion of people reporting one or more long-term health condition(s), multimorbidity, arthritis and heart disease, while India and China had the lowest.
- Diabetes was most commonly reported by those born in Italy, the Philippines, England, Vietnam, Malaysia and India. It was least commonly reported for those born in China.
- Asthma and mental health conditions were most commonly reported for people born in Australia, New Zealand or England and least commonly reported for those born in India and China.
Modelling the odds of selected long-term health conditions from country of birth
This section reports the results of logistic regression modelling the odds of reporting each long-term health condition based on a person’s country of birth, including Australia which is used as the reference category. Full output from all regression models is provided in the supplementary tables (Tables S4.1–S4.4).
The results indicate after adjusting for the effects of age, sex and social determinants of health, most overseas born people were less likely to report long-term health conditions compared with Australian-born people. Detailed findings from the modelling are presented below.
1. Unadjusted models
The results from the unadjusted models showed that, among the most common ten countries of birth, compared with people born in Australia, the odds of reporting:
- one or more long-term health condition(s), multimorbidity, arthritis or heart disease were higher only for people born in Italy or England. The odds ratios were lowest for people born in China or India
- diabetes was similar or higher for other countries of birth. The odds ratio was highest for people born in Italy
- asthma or mental health conditions were lower for any country of birth whereas the odds ratios for reporting these conditions were highest for those born in England and New Zealand.
2. Adjusting separately for age and social determinants of health
When the results were adjusted for the effects of age and the social determinants of health, age generally appeared to have the largest effect on the odds of reporting long-term health conditions between some countries of birth and those born in Australia, with some exceptions. For example, after adjusting only for age, the odds ratios for reporting:
- one or more long-term health condition(s), multimorbidity, arthritis and heart disease were substantially reduced for people born in Italy or England, however only slight changes were observed for those born in other overseas countries.
- diabetes decreased for those born in Italy or England and increased for those born in the Philippines.
- asthma or a mental health condition did not change considerably for anyone born in overseas countries.
Adjusting separately for the social determinants of health generally did not affect the associations between country of birth and the reported long-term health conditions, with some exceptions. For example, the odds ratio for reporting one or more long-term health condition(s) was 0.8 for males and females born in New Zealand in the unadjusted models and increased to 1.3 for males and 1.2 for females, after adjusting only for citizenship status.
3. Fully adjusted models
In the fully adjusted models, the odds ratios for the reported long-term health conditions were generally similar to the age adjusted odds ratios for the nine most common overseas countries of birth, with some exceptions. For example, the age adjusted odds ratio for reporting one or more long-term-health condition(s) was 0.78 for both males and females born in New Zealand. After adjusting for the effects of age, education, labour force status, income, housing suitability, tenure, citizenship status, remoteness and marital status in the fully adjusted model, the odds ratios increased by around 30% to 1.1 for males and 1.0 for females born in New Zealand (Table 4 below).
Compared with the Australian-born population, adjusting for the effects of age and the social determinants of health impacts on the odds of people born in different countries reporting diabetes in different ways. For example, the odds ratio of reporting diabetes increased for those born in India and China compared with those born in Australia after adjusting for the effects of age and social determinants of health, while they decreased for those born in Italy. The odds ratios for reporting all other long-term health conditions were similar to, or lower, than those for people born in Australia.
Health outcome and population size (n) | Odds ratio (95% CI) Males | Odds ratio (95% CI) Females |
|---|---|---|
1 or more of any chronic condition (n= 7,694,494 males and 8,008,772 females) | China 0.33 (0.32–0.33) England 0.93 (0.92–0.94) India 0.42 (0.42–0.43) Italy 0.75 (0.74–0.77) Malaysia 0.57 (0.56–0.58) New Zealand 1.06 (1.05–1.07) Philippines 0.71 (0.70–0.73) South Africa 0.77 (0.75–0.78) Vietnam 0.46 (0.45–0.47) | China 0.28 (0.28–0.29) England 0.94 (0.93–0.94) India 0.34 (0.34–0.34) Italy 0.83 (0.82–0.85) Malaysia 0.49 (0.49–0.50) New Zealand 1.02 (1.01–1.03) Philippines 0.56 (0.56–0.57) South Africa 0.74 (0.73–0.75) Vietnam 0.39 (0.38–0.39) |
Multimorbidity (n=7,684,786 males and 7,999,963 females) | China 0.24 (0.24–0.25) England 0.88 (0.87–0.89) India 0.42 (0.41–0.43) Italy 0.80 (0.79–0.82) Malaysia 0.50 (0.48–0.52) New Zealand 0.91 (0.89–0.93) Philippines 0.61 (0.59–0.64) South Africa 0.66 (0.64–0.68) Vietnam 0.33 (0.32–0.34) | China 0.20 (0.19–0.20) England 0.90 (0.89–0.91) India 0.32 (0.31–0.33) Italy 0.90 (0.88–0.92) Malaysia 0.40 (0.39–0.41) New Zealand 0.91 (0.90–0.93) Philippines 0.48 (0.47–0.49) South Africa 0.59 (0.57–0.61) Vietnam 0.28 (0.27–0.28) |
Arthritis (n=7,680,261 males and 8,000,705 females) | China 0.19 (0.19–0.20) England 0.93 (0.92–0.94) India 0.36 (0.34–0.37) Italy 0.76 (0.75–0.78) Malaysia 0.40 (0.38–0.42) New Zealand 0.97 (0.95–0.99) Philippines 0.64 (0.62–0.67) South Africa 0.64 (0.62–0.66) Vietnam 0.27 (0.26–0.28) | China 0.23 (0.22–0.23) England 1.02 (1.01–1.03) India 0.50 (0.49–0.51) Italy 0.97 (0.95–0.99) Malaysia 0.45 (0.43–0.46) New Zealand 0.95 (0.93–0.96) Philippines 0.53 (0.52–0.54) South Africa 0.68 (0.66–0.70) Vietnam 0.32 (0.31–0.33) |
Asthma (n=7,678,607 males and 7,999,224 females) | China 0.15 (0.14–0.16) England 0.88 (0.87–0.89) India 0.20 (0.20–0.21) Italy 0.52 (0.51–0.55) Malaysia 0.49 (0.47–0.51) New Zealand 1.14 (1.12–1.16) Philippines 0.55 (0.53–0.57) South Africa 0.67 (0.65–0.69) Vietnam 0.44 (0.43–0.46) | China 0.12 (0.11–0.12) England 0.84 (0.83–0.85) India 0.22 (0.21–0.23) Italy 0.53 (0.52–0.55) Malaysia 0.47 (0.46–0.49) New Zealand 1.11 (1.09–1.13) Philippines 0.56 (0.54–0.57) South Africa 0.64 (0.62–0.66) Vietnam 0.31 (0.30–0.32) |
Diabetes (n=7,684,641 males and 7,996,488 females) | China 1.02 (1.00–1.04) England 0.95 (0.94–0.96) India 2.61 (2.57–2.66) Italy 1.43 (1.40–1.46) Malaysia 1.46 (1.41–1.51) New Zealand 0.98 (0.96–1.00) Philippines 2.34 (2.28–2.41) South Africa 1.06 (1.03–1.10) Vietnam 1.15 (1.12–1.18) | China 0.93 (0.91–0.95) England 0.95 (0.94–0.96) India 2.24 (2.20–2.29) Italy 1.66 (1.63–1.70) Malaysia 1.32 (1.27–1.36) New Zealand 1.01 (0.99–1.03) Philippines 2.29 (2.24–2.34) South Africa 0.98 (0.94–1.02) Vietnam 1.19 (1.17–1.22) |
Heart disease (n=7,675,515 males and 7,971,847 females) | China 0.45 (0.44–0.46) England 0.91 (0.89–0.92) India 0.94 (0.92–0.97) Italy 0.87 (0.85–0.89) Malaysia 0.79 (0.75–0.82) New Zealand 0.98 (0.96–1.00) Philippines 0.90 (0.86–0.93) South Africa 0.92 (0.89–0.96) Vietnam 0.43 (0.42–0.45) | China 0.59 (0.58–0.61) England 0.83 (0.82–0.85) India 0.67 (0.65–0.70) Italy 0.92 (0.90–0.95) Malaysia 0.58 (0.54–0.61) New Zealand 0.99 (0.96–1.02) Philippines 0.78 (0.75–0.81) South Africa 0.74 (0.70–0.78) Vietnam 0.48 (0.46–0.50) |
Mental health condition (n=7,680,198 males and 8,002,089 females) | China 0.12 (0.11–0.12) England 1.00 (0.98–1.01) India 0.13 (0.13–0.13) Italy 0.65 (0.63–0.68) Malaysia 0.28 (0.27–0.30) New Zealand 0.89 (0.87–0.90) Philippines 0.23 (0.22–0.24) South Africa 0.71 (0.69–0.73) Vietnam 0.22 (0.21–0.23) | China 0.15 (0.15–0.15) England 0.97 (0.96–0.98) India 0.13 (0.12–0.13) Italy 0.92 (0.89–0.95) Malaysia 0.31 (0.30–0.32) New Zealand 0.86 (0.85–0.88) Philippines 0.22 (0.21–0.22) South Africa 0.73 (0.71–0.75) Vietnam 0.21 (0.21–0.22) |
Notes
- Results are from the fully-adjusted model which included the covariates, country of birth or person, age, education, income, employment, tenure, housing suitability, remoteness, citizenship, marital status. Analysis excluded overseas visitors, people who live in non-private dwellings or Migratory, offshore and shipping SA1s, non-classifiable households or Visitor only households.
- Analyses included people aged 15 and over living in Australia in occupied private dwellings on Census Night, who were not overseas visitors and provided a valid response to the 2021 Census questions on country of birth of persons, age, the selected social determinants of health, and the long-term health conditions.
- ‘Australia’ was selected as the reference category, when calculating the odds ratios for countries of birth, and Australia includes External Territories.
- China excludes Special Administrative Regions (SARs) and Taiwan.
- OR (95% CI) refers to odds ratio and the 95% confidence interval.
- All odds ratios are rounded to two decimal places.
Source: AIHW analysis of PLIDA, 2021.