Main languages spoken at home

Of the ten most common languages spoken at home, Italian, English, Arabic, Greek and Spanish language groups had the highest proportion of people reporting one or more long-term health condition(s), multimorbidity, arthritis, heart disease and mental health conditions, while the Punjabi and the Mandarin language groups had the lowest. The proportion of people reporting diabetes was highest for the Italian, Greek, Arabic, Hindi and Vietnamese languages groups and lowest for the Punjabi and Mandarin language groups.

Modelling the odds of selected long-term health conditions from main language used at home

This section reports the results of logistic regression modelling the odds of each long-term health condition based on a person’s main language spoken at home. The commentary in this section focuses on the results for the ten most common languages spoken at home reported in the 2021 Census, including ‘English (only)’ which is used as the reference category. Full output from all regression models is provided in the supplementary tables (Tables S5.1–S5.4).

The results observed from all regression models indicate that after adjusting for the effects of age and social determinants of health, people who speak languages other than English at home were less likely to report long-term health conditions than those who only speak English at home, with the exception of diabetes. Detailed findings from the modelling are presented below.

1. Unadjusted models

The odds ratios for all reported long-term health conditions were generally highest relative to those who spoke English at home for people who spoke mainly Arabic or a European language such as Italian and Greek, and lowest for those who spoke an Asian language such as Punjabi and Mandarin.

2. Adjusting separately for age and social determinants of health

When the results were separately adjusted for age and the social determinants of health, controlling for age substantially changed the odds ratios for reporting the selected long-term health conditions among people who spoke languages other than English at home, with some exceptions. After adjusting only for age, compared with those who spoke ‘English only’ at home, the odds ratios for reporting:

  • one or more long-term health condition(s), multimorbidity, arthritis and heart disease were substantially reduced for the Italian and Greek language groups and did not change significantly for other non-English languages
  • diabetes considerably changed (increased or decreased) for most non-English languages except those who spoke mainly Cantonese at home
  • asthma and mental health conditions did not change considerably for any non-English languages.

Adjusting separately for the effects of the social determinants of health however had only a small impact on the odds ratios for the reported long-term health conditions in all non-English language groups, with the odds ratios generally remaining similar to the corresponding unadjusted odds ratios.

3. Fully adjusted models

In the fully adjusted models, the odds ratios for the reported long-term health conditions remained generally similar to the age-adjusted odds ratios for all of the more commonly spoken non-English languages, relative to those who spoke 'English only' at home. For example, the odds of males who mainly spoke Italian at home reporting one or more long-term health condition(s) was around 1.4 times higher than for those who spoke ‘English only’. This odds ratio dropped to 0.8 after adjusting for age alone. After adjusting for the effects of age, education, labour force status, income, housing suitability, tenure, citizenship status, remoteness and marital status, the odds ratio was 0.9. In the fully adjusted model, compared with those who spoke English (only) at home, the odds of reporting:

  • one or more long-term health condition(s), multimorbidity, arthritis and mental health was higher for those who spoke mainly languages such as Italian and Greek or Arabic at home and lower for those who spoke mainly Punjabi or Mandarin
  • heart disease and diabetes were higher amongst those who spoke mainly Hindi, Punjabi, Arabic, Italian or Greek languages at home and lower for those who spoke mainly Cantonese, Mandarin or Vietnamese.
Table 5: Adjusted odds ratios for the association between main language used at home and reporting long-term health conditions in 2021, adjusted for age and social determinants of health in the fully adjusted model

Health outcome and population size (n)

Odds ratio (95% CI)

Males

Odds ratio (95% CI)

Females

1 or more of any chronic condition

(n=7,700,447 males and 8,010,197 females)

Arabic 0.65 (0.64–0.66)

Cantonese 0.50 (0.49–0.50)

Greek 0.69 (0.68–0.70)

Hindi 0.57 (0.56–0.58)

Italian 0.81 (0.80–0.82)

Mandarin 0.36 (0.36–0.37)

Punjabi 0.29 (0.28–0.29)

Spanish 0.64 (0.62–0.65)

Vietnamese 0.52 (0.52–0.53)

Arabic 0.61 (0.61–0.62)

Cantonese 0.43 (0.42–0.43)

Greek 0.72 (0.71–0.73)

Hindi 0.47 (0.46–0.48)

Italian 0.86 (0.84–0.87)

Mandarin 0.29 (0.29–0.30)

Punjabi 0.25 (0.24–0.25)

Spanish 0.65 (0.64–0.66)

Vietnamese 0.42 (0.41–0.42)

Multimorbidity

(n=7,681,233 males and 7,995,574 females

Arabic 0.70 (0.68–0.71)

Cantonese 0.33 (0.32–0.34)

Greek 0.71 (0.69–0.72)

Hindi 0.65 (0.62–0.68)

Italian 0.87 (0.85–0.89)

Mandarin 0.26 (0.25–0.27)

Punjabi 0.26 (0.25–0.28)

Spanish 0.58 (0.56–0.60)

Vietnamese 0.37 (0.35–0.38)

Arabic 0.65 (0.64–0.67)

Cantonese 0.29 (0.28–0.30)

Greek 0.75 (0.74–0.77)

Hindi 0.49 (0.47–0.51)

Italian 0.92 (0.90–0.93)

Mandarin 0.20 (0.19–0.20)

Punjabi 0.20 (0.19–0.21)

Spanish 0.61 (0.60–0.63)

Vietnamese 0.29 (0.29–0.30)

Arthritis

(n=7,676,283 males and 7,997,120 females)

Arabic 0.65 (0.64–0.67)

Cantonese 0.27 (0.26–0.29)

Greek 0.66 (0.64–0.67)

Hindi   0.42 (0.40–0.45)

Italian 0.83 (0.81–0.85)

Mandarin 0.21 (0.20–0.22)

Punjabi 0.22 (0.20–0.24)

Spanish 0.65 (0.62–0.68)

Vietnamese 0.29 (0.27–0.30)

Arabic 0.96 (0.94–0.98)

Cantonese 0.31 (0.30–0.31)

Greek 0.85 (0.83–0.86)

Hindi 0.64 (0.62–0.67)

Italian 0.97 (0.96–0.99)

Mandarin 0.23 (0.22–0.23)

Punjabi 0.43 (0.40–0.45)

Spanish 0.84 (0.82–0.87)

Vietnamese 0.32 (0.31–0.33)

Asthma

(n=7,687,447 males and 7,999,113 females)

Arabic 0.56 (0.54–0.57)

Cantonese 0.51 (0.50–0.53)

Greek 0.63 (0.61–0.65)

Hindi   0.34 (0.33–0.36)

Italian 0.69 (0.67–0.71)

Mandarin 0.25 (0.24–0.26)

Punjabi 0.16 (0.15–0.17)

Spanish 0.66 (0.64–0.68)

Vietnamese 0.72 (0.70–0.73)

Arabic 0.55 (0.54–0.56)

Cantonese 0.34 (0.33–0.35)

Greek 0.61 (0.60–0.63)

Hindi 0.37 (0.35–0.38)

Italian 0.65 (0.63–0.66)

Mandarin 0.17 (0.17–0.18)

Punjabi 0.17 (0.16–0.17)

Spanish 0.63 (0.61–0.64)

Vietnamese 0.45 (0.44–0.46)

Diabetes

(n=7,692,473 males and 7,999,929 females)

Arabic 1.87 (1.83–1.91)

Cantonese 1.07 (1.05–1.10)

Greek 1.14 (1.12–1.17)

Hindi 3.21 (3.12–3.31)

Italian 1.33 (1.30–1.36)

Mandarin 1.04 (1.02–1.06)

Punjabi 1.82 (1.76–1.89)

Spanish 1.11 (1.07–1.15)

Vietnamese 1.15 (1.12–1.18)

Arabic 1.78 (1.74–1.82)

Cantonese 1.11 (1.08–1.13)

Greek 1.23 (1.20–1.26)

Hindi 2.89 (2.80–2.99)

Italian 1.52 (1.49–1.56)

Mandarin 0.90 (0.87–0.92)

Punjabi 1.44 (1.37–1.50)

Spanish 1.20 (1.16–1.25)

Vietnamese 1.20 (1.17–1.23)

Heart disease

(n=7,676,408 males and 7,977,007 females)

Arabic 0.99 (0.97–1.02)

Cantonese 0.49 (0.47–0.51)

Greek 0.87 (0.85–0.89)

Hindi 1.36 (1.30–1.42)

Italian 0.90 (0.88–0.92)

Mandarin 0.49 (0.48–0.51)

Punjabi 0.76 (0.71–0.80)

Spanish 0.60 (0.57–0.63)

Vietnamese 0.46 (0.44–0.48)

Arabic 0.97 (0.93–1.00)

Cantonese 0.53 (0.51–0.56)

Greek 0.79 (0.76–0.81)

Hindi 0.94 (0.88–1.00)

Italian 0.96 (0.93–0.98)

Mandarin 0.64 (0.61–0.66)

Punjabi 0.53 (0.49–0.58)

Spanish 0.63 (0.59–0.66)

Vietnamese 0.51 (0.49–0.54)

Mental health condition 

(n=7,677,552 males and 7,996,244 females)

Arabic 0.35 (0.34–0.36)

Cantonese 0.23 (0.22–0.24)

Greek 0.65 (0.63–0.67)

Hindi 0.18 (0.17–0.19)

Italian 0.74 (0.72–0.76)

Mandarin 0.15 (0.15–0.16)

Punjabi 0.10 (0.09–0.10)

Spanish 0.51 (0.49–0.53)

Vietnamese 0.24 (0.23–0.25)

Arabic 0.35 (0.34–0.36)

Cantonese 0.25 (0.25–0.26)

Greek 0.75 (0.74–0.77)

Hindi   0.19 (0.19–0.20)

Italian 0.86 (0.84–0.88)

Mandarin 0.16 (0.16–0.17)

Punjabi 0.10 (0.09–0.11)

Spanish 0.54 (0.52–0.55)

Vietnamese 0.23 (0.23–0.24)

Notes

  1. Results are from the fully-adjusted model which included the covariates, main languages spoken at home, 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. 
  2. 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 main languages spoken at home, age, the selected social determinants of health, and the long-term health conditions. 
  3.   ‘English (only)’ was selected as the reference category, when calculating the odds ratios for main languages spoken at home. 
  4. OR (95% CI) refers to odds ratio and the 95% confidence interval. 
  5. All odds ratios are rounded to two decimal places.

Source: AIHW analysis of PLIDA, 2021.

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