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Burden of disease is a modelling technique that combines multiple data sources to count and compare the total fatal and non‑fatal health loss from diseases and injuries in a population.
Burden of disease quantifies the gap between a population's actual health and an ideal level of health in the given year. This gap is measured using the disability-adjusted-life-year or DALY. The more DALY associated with a disease or injury, the greater the burden. More than merely counting deaths and disease prevalence, the DALY takes into account age at death and severity of disease to count the years of healthy life lost from death and illness. It also attributes this burden to various risk factors.
The results from burden of disease studies are an important resource for health policy formulation, service planning and to monitor population health, including the gap between Indigenous and non-Indigenous Australians.
The Australian Burden of Disease Study (ABDS) 2011 provides updated estimates for over 200 diseases and injuries in Australia and for the Aboriginal and Torres Strait Islander population for 2011 and 2003.
Most of the burden of disease in 2011 was from chronic diseases. Cancer caused the greatest amount of burden (19%), followed by cardiovascular diseases (15%), mental and substance use disorders (12%), musculoskeletal conditions (12%) and injuries (9%). Together these disease groups accounted for around two-thirds of the total burden of disease in Australia.
The six leading specific causes of burden in Australia in 2011 were: coronary heart disease, other musculoskeletal conditions (which includes chronic pain in joints, muscles and other soft tissue, and systemic lupus erythematosus), back pain & problems, chronic obstructive pulmonary disease, lung cancer and dementia.
After accounting for population increase and ageing between 2003 and 2011, there was a 10% reduction in total burden. The greatest reductions were seen in fatal burden and for total burden due to cardiovascular diseases.
About a third of the burden experienced by the population could be prevented by reducing the exposure to modifiable risk factors. The risk factors causing the most burden were tobacco use, high body mass, alcohol use, physical inactivity and high blood pressure.
The overall burden of disease among Indigenous Australians was 2.3 times that for non-Indigenous Australians in 2011. Rates of fatal and non-fatal burden for Indigenous Australians were 2.7 and 2.0 times those for non-Indigenous Australians, respectively.
Five disease groups accounted for two-thirds of the gap in total disease burden between Indigenous and non-Indigenous Australians (based on age-standardised DALY rate differences): cardiovascular diseases, mental & substance use disorders, injuries, respiratory diseases and cancer.
The disease group causing the most burden among Indigenous Australians in 2011 was mental & substance use disorders. This group includes conditions such as anxiety and depressive disorders, alcohol use disorders, drug use disorders and autism spectrum disorders. Other leading contributors to the total burden among Indigenous Australians were injuries, cardiovascular diseases, cancer and respiratory diseases.
After accounting for population increase and ageing, there was a 5% reduction in the rate of total burden in the Indigenous population between 2003 and 2011. Most of this improvement came from a decrease in the rate of fatal burden (11%). There was, however, a 4% increase in the rate of non-fatal burden, mainly due to increases in people living with chronic diseases such as diabetes, anxiety and depressive disorders, and asthma; and from the non-fatal effects of injuries such as falls.
Just over one-third (37%) of the burden of disease in Indigenous Australians could be prevented by reducing the exposure to the modifiable risk factors included in this study (which does not include the social determinants of health). The risk factors causing the most burden in Indigenous Australians were tobacco use, alcohol use, high body mass, physical inactivity, high blood pressure and high blood plasma glucose. Dietary factors were also important, together accounting for almost 10% of the total burden.
Together, the 29 risk factors included in the study accounted for about one-half (51%) of the overall health gap between Indigenous and non-Indigenous Australians.
These presentations explain information used in Australian Burden of Disease Study: impact and causes of illness and deaths in Australia 2011.
Contact the Australian Burden of Disease Unit