International comparisons

It is generally recognised that Australians enjoy good health and that Australia is one of the healthiest countries in the world. The information presented here shows that with respect to selected chronic diseases, Australia compares favourably with some countries, but less so for others. The countries chosen for comparison are members of the Organisation for Economic Cooperation and Development (OECD), a group of countries with broadly similar socio-economic structures and living standards.

The information used here is taken from the OECD health data base using the most recent year for which comparable data are available.

Mortality rates are used to make comparison for those diseases where death is a major outcome:  

• coronary heart disease
• stroke
• lung cancer
• colorectal cancer
• diabetes
• suicide (used as an indicator for depression).
• asthma and chronic obstructive pulmonary disease (which are combined in the OECD mortality data base and are presented in that fashion here)
• chronic kidney disease (the indicator available is the level of kidney replacement therapy (dialysis and transplants))
• oral diseases (the available indicator is the average number of decayed, missing or filled teeth (DMFT) in 12-year-old children).

The OECD data base does not have information on the other diseases covered on this web portal (rheumatoid arthritis, osteoarthritis and osteoporosis). 
However, information on the levels of the three risk factors listed below is available and presented here. 

• smoking
• excess weight
• fruit and vegetable intake (an indicator of nutrition). 

Coronary heart disease 

In 1999, the Coronary heart disease (CHD) (ICD-10 I20-I25) death rates for Australia were about 20% lower than the rates in New Zealand, the UK, and the USA, but were double the rates in France and three times the rates in Japan. While CHD death rates have declined in Australia over the past 40 years, these differences suggest that further reductions are still possible (Figure 1).

Figure 1: Death rates for CHD among OECD countries, 1999

Note:  Rates are age-standardised to the total OECD population for 1980. Source: OECD Health Data 2004.

Stroke

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Australia, the US and France have the lowest death rates from stroke (ICD-10 I60-I69) among the OECD countries (Figure 2). The male rate in Australia is 40% lower than the Japanese male rate and 25% lower than the male rates in the UK, Italy, Germany and Spain. 

Figure 2: Death rates for stroke among OECD countries, 1999

Note:  Rates are age-standardised to the total OECD population for 1980. Source: OECD Health Data 2004.

Lung cancer

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Lung cancer (ICD-10 C33-C34) mortality patterns vary widely between OECD countries. While the rates in Australia are lower than in most OECD countries, they are still higher than in countries such as Sweden (for males) and Spain, France and Italy (for females) (Figure 3). 

Figure 3: Death rates for lung cancer among OECD countries, 1999

Note:  Rates are age-standardised to the total OECD population for 1980. Source: OECD Health Data 2004.

Colorectal cancer

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Death rates for colorectal cancer (ICD-10 C18-C21) are relatively high in Australia, in comparison to other OECD countries (Figure 4). For example, while the Australian male rates are not as high as those in New Zealand and Germany, they are about 25% higher than the rates in the USA and Sweden. 

Figure 4: Death rates for colorectal cancer among OECD countries, 1999

Note:  Rates are age-standardised to the total OECD population for 1980. Source: OECD Health Data 2004.

Depression

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While the major impact of depression is in terms of illness and disability, depression is a factor commonly associated with suicide (ICD-10 X60-X84) and attempted suicide. A majority of people who commit suicide meet the criteria for depressive disorder in the weeks before death.

The suicide rate for males in Australia is high in comparison to other OECD countries, while the female rate is in the middle of the range for these countries (Figure 5).

Figure 5: Death rates for suicide among OECD countries, 1999

Note:  Rates are age-standardised to the total OECD population for 1980. Source: OECD Health Date 2004.

Diabetes

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The death rates for diabetes (ICD-10 E10-E14, which covered both Type 1 and Type 2 diabetes) in Australia in 1999 were in the middle of the range of OECD countries. They were lower than in the USA, Italy and New Zealand, but higher than in Japan, the UK and France (Figure 6). 

Figure 6: Death rates for diabetes among OECD countries, 1999  

Note:  Rates are age-standardised to the total OECD population for 1980. Source: OECD Health Data 2004.

Asthma and chronic obstructive pulmonary disease

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Asthma (ICD-10 J45-J46), bronchitis and emphysema (ICD-10 J41-J44) are grouped together in the OECD data. For this group of respiratory diseases, the Australian death rates are relatively low, in comparison to other OECD countries (see Figure 7).

Figure 7: Death rates for asthma, bronchitis and emphysema among OECD countries, 1999

Notes:  Bronchitis includes chronic bronchitis and bronchitis not specified as acute or chronic, excludes acute bronchitis.  Rates are age-standardised to the total OECD population for 1980. Source: OECD Health Data 2004.

Chronic kidney disease

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The OECD database does not include information on deaths from chronic kidney disease. One measure of the extent of chronic kidney disease is the proportion of the population receiving kidney replacement therapy (having a functional kidney transplant or requiring dialysis), described on this wet site as being people with 'end stage kidney disease' (ESKD). In Australia, the prevalence of ESKD is relatively low in comparison to other OECD countries  (Figure 8).

Figure 8: Proportions of the population using kidney replacement therapy (with a functioning transplant or using dialysis) among OECD countries, 1999

Note:  Rates are not age-standardised. Source: OECD Health Data 2004.

Oral diseases

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An indicator of dental health used by the OECD is the number of decayed, missing and filled permanent teeth (DMFT) in children at age 12 years. Australian 12-year-old children have the lowest average number of DMFT among OECD countries (Figure 9).

Figure 9: Average numbers of DMFT for children at age 12 among OECD countries, 1999

Source: OECD Health Data 2004.

Poor diet and nutrition

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One measure of poor diet and nutrition that is available in the OECD database is fruit and vegetable intake. Adequate amounts of fruit and vegetables in the diet contribute to better health in general, and the fibre content of fruit and vegetables helps to protect against colorectal cancer.

Among OECD countries, Australia has a low per capita level of fruit and vegetable intake. The Australian level is below the minimum recommended by the Cancer Council of Australia. (Figure 10).

Figure 10: Fruit and vegetable intake among OECD countries, 2001

Note: Data are not age-standardised. Source: OECD Health Data 2004.

Tobacco 

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Smoking is a major risk factor for many chronic diseases, including CHD, stroke, lung cancer and COPD. Among OECD countries, Australia, the US and Sweden have the lowest percentages of daily smokers among the population aged 15 and over  (Figure 11).

Figure 11: Percentages of daily smokers aged 15 years and over among OECD countries, 2001

Notes:  A daily smoker refers to a person aged 15 years or over reporting to smoke every day. Rates are not age-standardised. 3. International comparability is limited due to the lack of standardisation in the measurement of smoking habits across OECD countries. Source: OECD Health Data 2004.

Excess weight

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Excess weight, as measured by body mass index, contributes to the development of chronic diseases such as CHD, stroke and diabetes. The OECD data indicate that in Australia, the USA and the UK, a relatively high proportion of the population is overweight or obese.

However, the data for these three countries are from surveys in which height and weight were measured, while the information from the other countries shown in Figure 12 is based on self-reported height and weight. Estimates arising from measured height and weight are generally higher and more reliable than those coming from self-reported height and weight. In spite of this, it is generally agreed that excess weight is a major health concern in Australia.

Figure 12: Percentages of population aged 15+ classified as overweight or obese among OECD countries, 1999

Note:  1. Overweight: BMI 25 and above, but less than 30. Obese: BMI 30 and above. 2. Rates are not age-standardised. Source: OECD Health Data 2004.

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Last reviewed by on 23 June 2005