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While there are positive signs and progress on many fronts, it is clear that Australia is not healthy in every way, and there are some concerning patterns and trends. These areas pose a challenge to our health system and suggest that there is premature death and disease that might otherwise be avoided.
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Rates of obesity have increased for both adults and children over the past few decades. Comparisons among other developed countries show that Australia has the second highest rate of obesity for males and the fifth highest for females. Many experts are concerned about the effect rising obesity may have on our rates of diabetes, heart disease and other disorders, perhaps even on our life expectancy. Halting and reversing this trend is a national priority.
The rise in the proportion of Australians who are overweight or obese has occurred across virtually all ages. In 2007–08, 1 in 4 adults and 1 in 12 children were obese; this equates to almost 3 million people.
There is a relationship between socioeconomic status and obesity: people who live in the most disadvantaged areas are more likely to be obese than people in less disadvantaged areas.
Find out more: ‘Section 5.6 Obesity’ in Australia’s health 2012
Diabetes is a chronic condition marked by high levels of glucose in the blood. It is caused either by the inability to produce insulin (a hormone produced by the pancreas to control blood glucose levels), or by the body not being able to use insulin effectively, or both. Type 1 diabetes results from the body’s own immune system damaging the pancreas so it can’t produce insulin, and the condition is not preventable. It usually develops in children or young adults, although it can start at any age. Type 2 diabetes—which accounts for 85–90% of all cases—is linked with lifestyle factors such as obesity, physical inactivity and unhealthy diet.
National surveys show that the proportion of the population with diabetes more than doubled in Australia between 1989–90 and 2007–08. The latest estimates suggest that 898,800 people (4.1% of the population) have been diagnosed with diabetes at some time in their lives.
After adjusting for age differences, Aboriginal and Torres Strait Islander people were more than 3 times as likely as non-Indigenous Australians to report some form of diabetes.
Find out more: ‘Section 6.6 Diabetes’ in Australia’s health 2012
There is a high prevalence (level) of mental disorders in the Australian population. A 2007 survey showed that 1 in 5 Australians had experienced a mental disorder in the previous 12 months. Overall, the most common types were anxiety disorders (14%), affective (mood) disorders (6%) and substance use disorders (5%).
The prevalence of anxiety and affective disorders was highest for people aged 35–44, and more common among females. The prevalence of substance use disorders was highest for people aged 16–24, and more common among males.
Find out more: ‘Section 6.3 Mental illness’ & ‘Section 3.2 Functioning and disability’ in Australia’s health 2012
Sexually transmissible infections (STIs) are diseases that are spread through sexual contact. Diagnosis can be difficult as many STIs have no symptoms or have symptoms that are mild, despite serious complications that may develop later.
In 2011, there were about 80,800 chlamydia infections reported in Australia—a sixfold increase since notifications began in 1994. The number of cases is far higher than for any other infectious disease.
Notifications have increased for both males and females, although there were about 40% more notifications for females. More than 3 in 5 reported cases of chlamydia were among people aged 15–24.
Find out more: ‘Section 6.11 Infectious diseases’ in Australia’s health 2012
Chronic kidney disease refers to all conditions of the kidney lasting at least 3 months where there is damage and/or reduced function. It affects 1 in 7 Australian adults to some degree and is often considered preventable because many of its risk factors (such as smoking and excess body weight) are modifiable.
End-stage kidney disease (ESKD) occurs when chronic kidney disease has advanced to the stage where the person’s only chance of survival is dialysis, or a kidney transplant. At the end of 2009, about 18,300 people in Australia were receiving regular dialysis treatment or had a functioning kidney transplant—more than a sevenfold increase since 1977. The rate of new cases of treated ESKD is projected to increase by 80% between 2009 and 2020.
The total incidence rate of ESKD is 6 times as high among Aboriginal and Torres Strait Islander people as it is among non-Indigenous Australians, and Indigenous people are 8 times as likely to begin dialysis or receive a kidney transplant.
Find out more: ‘Section 6.10 Chronic kidney disease’ in Australia’s health 2012
Australians living today experience relatively good oral health compared with those in the past. However, oral health is linked to socioeconomic status. When the adult population is divided into thirds by household income (adjusted for the size of the household), oral health improves as we move from the lowest income group to middle and highest incomes. For example, 87% of people in the highest income group rate their oral health as good, very good or excellent, compared with 84% in the middle income group and 73% in the lowest income group.
Higher income groups were also less likely to experience complete tooth loss, toothache and food avoidance, and to report discomfort with their appearance.
Find out more: ‘Section 6.13 Oral health’ in Australia’s health 2012
Injury has a major, but often preventable, impact on Australia’s health. In 2009–10, 453,000 people suffered an injury severe enough to be admitted to hospital. The majority (85%) of injuries were unintentional —they were not caused deliberately—however, many could have been prevented. Falls and transportation (mostly motor vehicles) were common external causes of injury (49% of all hospitalised cases). There were about 25,700 hospitalisations where the injury was self-inflicted and about 23,000 where it was inflicted by another person.
For people under 65, males are more likely than females to be hospitalised for injury. This is largely due to transport injury and interpersonal violence. For those aged 65 and over, females are more likely to be hospitalised, due mainly to falls.
Find out more: ‘Section 6.5 Injury’ in Australia’s health 2012
National surveys show that vision and hearing disorders are some of the most common long-term conditions among Australians. In 2007–08, 52% had a long-term vision disorder (such as long- and short-sightedness) and 13% had a long-term hearing disorder (such as complete or partial deafness).
Vision and hearing disorders are often linked to age, with older people more likely to be affected than younger people. Hence the number of people affected is expected to increase as the Australian population ages.
Find out more: ‘Section 6.7 Vision and hearing disorders’ in Australia’s health 2012
Blood, organs and tissues can be donated to improve quality of life, and life expectancy, of people with a range of health conditions.
Organs and tissues are most commonly transplanted from a deceased donor. In 2010, 309 deceased donors gave 987 organs to 931 transplant recipients. Kidneys, lungs and livers were the organs most commonly donated.
While donor and transplant numbers are gradually increasing over time, the number of people on the transplant waiting list continues to exceed the number of available organs. During 2010, there were about 1,770 Australians on the waiting list at any time.
The rate of organ and tissue donation in Australia is also considered low by international standards.
Find out more: ‘Section 7.14 Blood, organ and tissue donation’ in Australia’s health 2012
The amount of time it takes for a patient to see a health professional is important for the patient, the relevant health service, and governments.
Waiting times are estimated for several types of services. A survey in 2009 found that 60% of people making a GP appointment for a matter they felt required urgent medical care were seen within 4 hours of making their appointment.
For elective surgery, the measure used in Australia is the median waiting time, that is, the middle value in the data arranged from lowest to highest number of days waited. In 2010–11, the median waiting time was 36 days (meaning that 50% of patients had received their surgery within 36 days). For patients with cancer, the median waiting time was 20 days.
For emergency department care in 2010–11, 70% of patients were seen within the recommended time for their triage category.
Find out more: ‘Section 7.10 Non-admitted hospital care’ in Australia’s health 2012
Many aspects of health are related to how well-off people are financially: generally, with increasing social disadvantage comes less healthy lifestyles and poorer health.
An example of a health behaviour with a strong relationship to socioeconomic status is tobacco smoking. In 2010, 25% of people living in the most disadvantaged areas smoked tobacco, twice the rate of people living in the least disadvantaged areas.
One interesting exception to this pattern of less healthy lifestyle with lower socioeconomic status is risky or high-risk alcohol use, which shows no particular pattern.
Find out more: Sections ‘1.2 Connecting health and welfare’, ‘1.3 Determinants of health’ & ‘2.5 Disadvantage and inequalities’ in Australia’s health 2012