Australia's health 2018: in brief

Australians are living longer than ever before, but half of us are living with at least one chronic condition, which can affect the quality of our lives, as well as those of our families and carers. Chronic conditions are Australia’s leading cause of ill health and have serious implications for the health system. Many of these chronic conditions are linked to lifestyle factors such as overweight and obesity, insufficient physical activity, tobacco smoking and alcohol use but there are signs of positive behaviour changes, particularly among young Australians.

What is health?

Good health is important—it influences not just how we feel, but how we go about our everyday lives. Health is more than the presence or absence of disease; it incorporates our physical, mental and social wellbeing.

Our health and wellbeing can be influenced by many things, but generally depend on two main aspects:

• determinants—the many, interrelated factors that influence our health
• interventions—things we do to improve our health or to prevent ill health, such as being immunised against diseases or visiting a doctor or hospital when we are unwell.

Determinants of health

Find out more: Chapter 1.1 ‘What is health?’, 4.1 ‘Impacts of the natural environment on health’, 4.2 ‘Social determinants of health’ and 4.3 ‘Health literacy’ in Australia’s health 2018.

We’re living more years in good health

When asked about our own health, most of us think we’re doing well. In 2014–15, more than 4 in 5 Australians aged 15 and over rated their health as ‘excellent’, ‘very good’, or ‘good’.

How we rate our health

Our life expectancy at birth has increased greatly over the last century. We’re expected to live about 33 years longer than people born in 1890. This places us in the top third of OECD countries for life expectancy.

We can also expect to live these extra years in relatively good health; that is, without the health consequences of disease or injury. Males born in 2011 can expect 1.7 more years in full health than males born in 2003, and females can expect an extra 1.2 years. The number of years we can expect to live with the impacts of illness, disease or injury remained steady for males and females between 2003 and 2011.

Find out more: Chapter 1.3 ‘How healthy are Australians?’ in Australia’s health 2018.

How do we die?

Corresponding with our rising life expectancy, age-adjusted death rates in Australia have fallen by around 70% since the early 1900s.

In 2016, there were 158,500 deaths in Australia. The leading causes of death (overall) were similar in 2006 and 2016.

Coronary heart disease was the leading cause of death for males in 2016, accounting for 13% of deaths. Dementia and Alzheimer disease was the leading cause of death for females, accounting for 11% of deaths, closely followed by coronary heart disease.

Leading causes of death

Find out more: Chapter 3.2 ‘Leading causes of death’ in Australia’s health 2018.

What is disease ‘burden’ and what causes it?

Looking at the burden of disease is one way to measure the impact of different diseases or injuries on a population. This is done by measuring how many years of life Australia loses to diseases, either due to people dying early, or living their remaining years affected by ill health.

Coronary heart disease is the leading contributor to the total disease burden in Australia for all ages combined, followed by lung cancer for males, and arthritis and other musculoskeletal conditions (such as back pain and osteoporosis) for females. Chronic conditions are also leading contributors to the disease burden in Australia.

The leading contributors to the disease burden differ across age groups, reflecting that people experience different health problems at different life stages. Disease burden also differs between males and females across the life stages.

Burden of disease focuses on health loss due to disease and injury. It does not account for other broader factors influencing health, such as the social and economic impacts of ill health.

Top disease burdens

Find out more: Chapter 3.1 ‘Burden of disease across the life stages’ in Australia’s health 2018.

Half of us have a chronic condition

Chronic conditions are generally long lasting, require ongoing management and have a substantial effect on individuals, their families and carers, and the health system.

One in 2 (50%) Australians are estimated to have at least 1 of 8 selected common chronic conditions: cancer, cardiovascular disease, mental health conditions, arthritis, back pain and problems, chronic obstructive pulmonary disease, asthma and diabetes. Nearly 1 in 4 (23%) Australians are estimated to have two or more of these conditions.

Collectively, chronic conditions account for:

• 87% of deaths
• 61% of total disease burden
• 37% of hospitalisations

Males and older people experience the highest rate of chronic condition hospitalisations and deaths, although the difference between males and females is decreasing over time.

The three chronic conditions that contribute most to the disease burden in Australia are cancer, coronary heart disease and mental illness.

People with chronic conditions are generally less likely than other Australians to be employed, and are generally more likely to have disability and experience psychological distress, body pain and poor health.

Find out more: Chapter 3.3 ‘Chronic conditions’ in Australia’s health 2018.

Cancer is the leading cause of disease burden

Cancer is a diverse group of several hundred diseases, where some of the body’s cells become abnormal and multiply out of control.

As a disease group, cancer is the greatest contributor to the disease burden in Australia, accounting for one-fifth (19%) of the total burden.

While the number of cancer cases has been rising in Australia, the rate of people being diagnosed with cancer has been falling since 2008.

Breast cancer is the most commonly diagnosed cancer for females, and prostate cancer for males. However, lung cancer is the leading cause of cancer death for males and females.

The relative survival rate of people with cancer, 5 years after diagnosis, has improved (from 49% in 1985–1989 to 69% in 2010–2014). Relative survival measures the average survival experience of people with cancer compared with people of the same age and sex in the general population.

However, this is not the story for all cancers. Mesothelioma—an aggressive form of cancer caused mainly by exposure to asbestos—has no known cure and an average time of 9 months between diagnosis and death. Australia has one of the highest rates of mesothelioma incidence in the world.

Find out more: Chapter 3.2 ‘Leading causes of death’, 3.4 ‘Cancer’ and 3.5 ‘Mesothelioma’ in Australia’s health 2018.

Coronary heart disease and stroke death rates have fallen

Coronary heart disease (CHD) and stroke are both chronic conditions affecting the heart and blood vessels. CHD is caused by a blockage in the arteries supplying blood to the heart. Stroke is caused by a blockage in, or rupture to and bleeding of an artery supplying blood to the brain.

Coronary heart disease

• Responsible for 8% of the total disease burden in Australia
• Affects about 1 in 30 adults (645,000 people), and 1 in 6 people aged 75 and over

Stroke

• Responsible for 3% of the total disease burden in Australia
• Around 394,000 people are estimated to have had a stroke in their lifetime

Many of the risk factors for CHD and stroke can be modified through lifestyle changes and there are also treatment options available for these conditions. Although CHD is the leading single cause of death in Australia, the rate of deaths due to the disease has fallen by 79% since 1980. The rate of deaths due to stroke has fallen by 74% over the same period.

Coronary heart disease and stroke deaths (per 100,000 population) over time

Find out more: Chapter 3.6 ‘Coronary heart disease’ and 3.7 ‘Stroke’ in Australia’s health 2018.

Nearly half of Australians will experience a mental illness in their life

‘Mental illness’ and ‘mental disorder’ describe a wide range of mental health and behavioural disorders. Around 45% of Australians aged 16–85 will experience a mental illness in their life—most commonly anxiety, substance use disorders (especially alcohol use) and mood disorders (especially depression).

Mental illness and substance use disorders are responsible for 12% of the total disease burden in Australia—the third highest disease group after cancer and cardiovascular diseases.

Mental illness affects individuals, families and carers. It also has a far-reaching influence on society as a whole, through issues such as poverty, unemployment and homelessness.

Some groups of people experience increased rates of mental illness:

• Men who have served in the Australian Defence Force are nearly twice as likely to experience affective disorders (such as depression) (9.4%) than men who have not served (5.7%).
• People who identify as homosexual or bisexual are more likely to experience an anxiety disorder (32%) than heterosexual people (14%).
• Females aged 15–24 account for nearly 3 in 5 community mental health care service contacts for eating disorders (58%) and hospitalisations for eating disorders (57%).

Find out more: Chapter 3.12 ‘Mental health’, 3.13 ‘Eating disorders’, 5.5 ‘Lesbian, gay, bisexual, transgender and intersex people’, and 5.6 ‘Veterans’ in Australia’s health 2018.

These conditions are also affecting our health

In addition to the disease burden contributed by cancer, coronary heart disease and mental illness, an estimated:

• 1 in 3 (7 million) adults and children have chronic respiratory conditions, such as asthma. Asthma affects 1 in 9 children aged 0–14 (480,000).
• 1 in 3 (6.9 million) people have arthritis and other musculoskeletal conditions, such as back pain, arthritis and osteoporosis. Musculoskeletal conditions are the fourth leading contributor to the total disease burden in Australia.
• 1 in 10 (1.7 million) adults show biomedical signs of chronic kidney disease. In 2015–16, dialysis was the most common reason for going to hospital.
• 1 in 20 (1.2 million) adults self-report having diabetes, although data suggest that for every 4 adults diagnosed with diabetes, 1 adult is living with the disease undiagnosed. Diabetes contributed to 10% of all deaths in Australia in 2016.
• 1 in 11 (376,000) people aged 65 and over have dementia, a condition more common among older people, especially those aged 85 and over. In 2016, dementia was listed as a cause in more than 25,000 deaths, and replaced heart disease as the leading cause of death for women (it remained as the third leading cause for men).

Find out more: Chapter 3.8 ‘Diabetes’, 3.9 ‘Chronic kidney disease’, 3.1 ‘Arthritis and other musculoskeletal conditions’, 3.11 ‘Chronic respiratory conditions’ and 3.14 ‘Dementia’ in Australia’s health 2018.

A new generation—more Australian teens saying ‘no’ to smoking, alcohol and illicit drugs

Smoking tobacco and drinking alcohol are two lifestyle factors that contribute to high rates of chronic conditions in Australia.

Smoking rates for the whole population have steadily fallen over time, while alcohol consumption has fluctuated in recent years—daily and weekly drinking rates have fallen, but rates of risky drinking on a single occasion have not changed.

The smoking and drinking patterns of Australia’s teenagers have shown some positive signs in recent years; many young people are deciding not to smoke or drink in the first place, while others are older when they first try.

Age when teenagers first smoked a full cigarette and first tried alcohol

Illicit drug use has also fallen among Australian teenagers—those aged 14–19 were far less likely to use illicit drugs in 2016 than in 2001. Cannabis use halved over the period, use of ecstasy and cocaine fell by one-third, and use of meth/amphetamines fell from 6.2% to 0.8%.

Find out more: Chapter 4.5 ‘Tobacco smoking’, 4.6 ‘Alcohol risk and harm’ and 4.7 ‘Illicit drug use’ in Australia’s health 2018.

How healthy are our mothers?

The care a mother receives while pregnant (antenatal care) is associated with better outcomes for both mother and baby. Almost all mothers (99.9%) who gave birth in 2015 had at least one antenatal visit, 95% had five or more visits and 58% had 10 or more visits.

Health factors and behaviours during pregnancy—such as smoking, drinking alcohol, and being overweight or obese—can lead to negative health outcomes for a mother and her child, during birth and in a child’s early life.

Find out more: Chapter 4.12 ‘Antenatal risk factors’ in Australia’s health 2018.