Long-term health condition variables

In the 2021 Census, a question was included for the first time to capture information on the number of Australians with selected long-term health conditions. The Census included a single, long-term health conditions (LTHP) question which asked people of all ages if they have been told by a doctor or nurse that they have any of these long-term health conditions:

  • arthritis
  • asthma
  • cancer (including remission)
  • dementia (including Alzheimer’s)
  • diabetes (excluding gestational diabetes)
  • heart disease (including heart attack or angina)
  • kidney disease
  • lung condition (including chronic obstructive pulmonary disease (COPD) or emphysema)
  • mental health condition (including depression or anxiety)
  • stroke
  • any other long-term health condition(s).

Respondents were asked to include health conditions that have lasted, or are expected to last, for six months or more and to include health conditions that:

  • may recur from time to time
  • are controlled by medication
  • are in remission.

This report analysed the five most common specific long-term health conditions reported in the 2021 Census and responsible for a significant burden of disease in Australia: mental health conditions, arthritis, asthma, diabetes and heart disease. In addition, analyses included reporting one or more long-term health condition (s) (i.e. one or more of any long-term health condition(s) and multimorbidity (i.e. two or more of the ten long-term health conditions that are included in the Census as listed above).

For more information, see Census dictionary: Health.

Strengths and limitations of long-term health condition data from the 2021 Census

The main advantages of the Census as a source of long-term health conditions data are:

  • it includes the total Australian population, as opposed to ABS health surveys which are based on a sample of the total population. This means the data can be used to look at the proportion of the population reporting long-term health conditions among people in smaller geographic regions or in small population groups, which is not possible from surveys
  • the data can be cross-classified with other data collected in the Census
  • it includes people in non-private dwellings such as hospitals and nursing homes which are out of scope for most ABS health surveys.

The main limitations to the Census as a source of long-term health conditions data are:

  • the data were collected for the first time in the 2021 Census so there is currently no time series data available
  • the long-term health conditions data collected are based on a single question whereas ABS health surveys have a detailed set of questions to capture the proportion of people reporting these conditions more accurately
  • data relies on the respondent reporting long-term health conditions, or in some cases reporting long-term health conditions of other people in the household, in most cases without an interviewer present to help
  • data is only available for the listed conditions above
  • under-reporting and over-reporting may occur for some conditions compared with surveys. This is due to self-reporting and reporting on behalf of other members of the household, as well as potential sensitivities about individual health conditions.

Information based on reported data only is likely to underestimate the rate of long-term health conditions due to respondents either not knowing or not accurately reporting their health condition (Liddell et al. 2021). These factors may be specifically relevant in the migrant populations who may have English as a second language and lack of trust in government due to previous experiences (Liddell et al. 2021). Additionally, there may be cultural sensitivities around reporting certain health conditions such as mental health conditions (Paudyal et al. 2021).

For more information on the purpose, collection method, advantages and limitations of the long-term health conditions in the Census see Comparing ABS long-term health conditions data sources.

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