Chronic conditions and multimorbidity

Chronic conditions are an important global, national and individual health concern. Worldwide, they caused almost 3 in 4 (or 42 million) deaths in 2019 (Global Burden of Disease Collaborative Network 2020). This proportion has increased over time, from 67% of deaths worldwide in 2010 to 74% in 2019 (Global Burden of Disease Collaborative Network 2020). Although 2020 saw a large number of deaths from communicable disease due to the COVID-19 pandemic (WHO 2020), chronic conditions remain an ongoing cause of substantial ill health, disability and premature death.

Chronic conditions generally have long-lasting and persistent effects, and are also referred to as chronic diseases, long-term health conditions or non-communicable diseases. They include conditions such as arthritis, cancer and diabetes. In this report, a ‘chronic condition’ is defined as one of 10 major chronic condition groups: arthritis, asthma, back problems, cancer, selected cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, mental and behavioural conditions and osteoporosis.

The prevalence of these chronic conditions is increasing in Australia. Just under half (47%) of Australians had 1 or more chronic conditions in 2017–18, an increase from 42% of people in 2007–08 (ABS 2018). This is associated with a number of factors, including:

  • Australia’s ageing population
  • improvements in the treatment and management of chronic conditions which extends life expectancy
  • social and behavioural risk factors such as poor diet and physical inactivity (ABS 2018).

As the prevalence of chronic conditions increases, it is expected that multimorbidity – the presence of 2 or more chronic conditions in a person at the same time – will also become more common.

People living with multimorbidity can experience difficulties with everyday activities, poorer overall quality of life and more complex health needs (Fortin et al. 2007; Jackson et al. 2015; Makovski et al. 2019; Marengoni et al. 2011). These outcomes will vary, depending on the number and type of conditions a person has (Fortin et al. 2007; Jackson et al. 2015).

A challenge for health service providers managing multimorbidity is to focus on the person, and all of the conditions they experience, rather than on a single disease (Ording & Sørensen 2013; Starfield 2006).

Multimorbidity can make treatment more complex (Harrison & Siriwardena 2018) and requires ongoing management and coordination of specialised care across multiple parts of the health system (Department of Health 2020a). This places a heavy demand on Australia’s health care system. A key focus of the Australian health system, therefore, is the prevention and better management of chronic conditions to improve health outcomes (Department of Health 2020b). A better understanding of multimorbidity, and of which chronic conditions commonly occur together, can help to inform guidelines for treatment and management.

This work provides baseline information on chronic condition multimorbidity in Australia, before the COVID-19 pandemic. The interaction between pre-existing chronic conditions and COVID-19 infection, as well as any indirect effects on chronic conditions from changes within the health system and wider society due to interventions to manage the spread and impact of COVID-19, may be explored in future work.