Good health, bad health habits—at a cost

Australia has much to be proud of in many areas of health, but lifestyle-related chronic diseases are taking an increasing toll-and so is the bill, according to the latest 2-yearly national health report card from the Australian Institute of Health and Welfare (AIHW).

The Institute's report, Australia's health 2014, was released in Canberra today by federal Health Minister Peter Dutton.

AIHW Director and CEO David Kalisch said, 'On the positive side our report shows that we have increasingly longer life expectancy, lower death rates for cancer and many other diseases, and a health system that people say they are mostly happy with.

'On the "room for improvement" side, we see that Australians are increasingly living with ongoing or "chronic" diseases and their risk factors-which are related to our ageing population as well as to lifestyles and health habits.

'Chronic diseases are the leading cause of illness, disability and death in Australia, accounting for 90% of all deaths in 2011.

 'Chronic diseases have often been called "Australia's greatest health challenge" - and while not solely related to behavioural factors in all cases, can be heavily linked to smoking, physical inactivity, poor nutrition and the harmful use of alcohol. This can lead to obesity, high blood pressure, and high cholesterol, which in turn can lead to cardiovascular disease, diabetes, cancer and mental health issues.'

Mr Kalisch said that, in Australia, as was happening in many developed nations, the costs of health care kept rising.

'They have risen faster than inflation and the economy as a whole for many years, and in recent years have outpaced government revenues from taxation and other sources.

'We find that health spending is taking up a greater proportion of government revenue than it used to-26% in 2011­-12, or 6 percentage points higher than before the Global Financial Crisis.'

Life expectancy, the 'universal health indicator', places Australia among the top nations in the world-sixth for men and seventh for women-but very close to the first-placed nations in 2011 (Iceland for males, Japan for females).We are living 25 years longer on average than a century ago, so that a boy born today can expect to live to 79.9 years, and a girl to 84.

'An extra piece of good news is that almost all of the extra 4 years gained since the late 1990s have been disability-free years,' Mr Kalisch said.

Most Australians also rate themselves highly in the health stakes. In 2011-12, 85% of people aged 15 and over considered themselves to be in good to excellent health. This perception did not reduce much with age, with an estimated 67%-76% of people aged 65 and over considering themselves to have good to excellent health.

Other positive news includes:

  • smoking rates continuing to fall (16% smoking daily in 2010, 43% in 1964)-quitting can result in a life expectancy increase of 10 years. And from 2001- 2011, the proportion of students aged 12-15 who had never smoked rose from 53% to 77%
  • increased vaccination rates among 5-year-olds (92% in 2012, 79% in 2008)
  • improving cancer survival. Five-year survival from cancers was 66% in 2006-2010, compared with 47% in the mid-1980s. Among people surviving 5 years in 2006-2010, the chance of surviving at least another 5 years was 91%
  • a 20% fall in heart attack rates between 2007 and 2011, and stroke event rates fell 25% between 1997 and 2009
  • falls in injury death rates of about 3%-5% each year for causes such as transport injury, thermal injury (exposure to fire, heat, smoke and hot substances), drowning, suicide and homicide.

'In addition to our successes we also have health worries,' Mr Kalisch said. 'The rise of chronic diseases is the most pervasive.

'We know that across all ages, changes in health behaviours can reduce the impact of chronic diseases-the World Health Organization estimates that, worldwide, up to 80% of heart disease, stroke and type 2 diabetes, and up to one-third of cancers, could be prevented by eliminating smoking, unhealthy diet, physical inactivity and the harmful use of alcohol.

'Although daily smoking rates are low by world standards, at 16% for adults, in some areas of Australia (principally high socioeconomic status areas) the rate is 10%, meaning that further improvements are possible,' Mr Kalisch said.

In Australia over 3 in 5 adults (63%) are overweight or obese. Nearly 3 in 5 (57%) do not exercise enough for good health, and in 2011-12 only 8% of adults were eating enough vegetables and 49% were eating enough fruit for optimum nutrition.

Among young adults, between 2007 and 2010 almost 1 in 2 were at risk from harm (drinking 4 standard drinks or more) from a single drinking occasion at least monthly.

Australia's health 2014 highlights health issues at various life stages, with findings such as:

  • Cancer survival 5 years after diagnosis for 0-14 year olds improved from 68% to 81% between 1983-1989 and 2004-2010.
  • Mental health disorders affect an estimated 26% of young people aged 16-24. Around one-third of people in this age group are overweight or obese.
  • For 25-44 year olds, the top 2 causes of death for men in 2011 were suicide and accidental poisoning, and for women, suicide and breast cancer. For 45-64 year olds, the top 2 causes of death for
    men were coronary heart disease and lung cancer, and for women, breast cancer and lung cancer.
  • The most common long-term health conditions afflicting older Australians (65 and over) are arthritis, high blood pressure and hearing loss.

Indigenous health improvements in recent years have included lower death rates from circulatory and respiratory diseases, falling infant mortality rates and reductions in smoking. But Indigenous Australians have 7 times the rate of end-stage kidney disease compared to non-Indigenous Australians, 3.3 times the rate of diabetes, 3 times the hospitalisation rates for respiratory conditions, 1.5 times the cancer death rate, and 1.5 times the obesity rate.

Mr Kalisch said there was potential to improve national health data to better understand chronic diseases, factors affecting life expectancy, the health effects of major life events, and the efficiency and effectiveness of health services.


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