Multimorbidity
Citation
AIHW
Australian Institute of Health and Welfare (2024) Multimorbidity, AIHW, Australian Government, accessed 22 October 2024.
APA
Australian Institute of Health and Welfare. (2024). Multimorbidity. Retrieved from https://www.aihw.gov.au/reports/australias-health/multimorbidity
MLA
Multimorbidity. Australian Institute of Health and Welfare, 17 June 2024, https://www.aihw.gov.au/reports/australias-health/multimorbidity
Vancouver
Australian Institute of Health and Welfare. Multimorbidity [Internet]. Canberra: Australian Institute of Health and Welfare, 2024 [cited 2024 Oct. 22]. Available from: https://www.aihw.gov.au/reports/australias-health/multimorbidity
Harvard
Australian Institute of Health and Welfare (AIHW) 2024, Multimorbidity, viewed 22 October 2024, https://www.aihw.gov.au/reports/australias-health/multimorbidity
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Having a chronic condition becomes more common with increasing age. At the same time, Australia’s ageing population and improvements in medical care mean more people are living for longer with chronic conditions. This increases the likelihood of a person living with multiple chronic conditions, a state of health known as multimorbidity.
People living with multiple chronic conditions often have complex health needs and report poorer overall quality of life than those without multimorbidity. This makes managing multimorbidity an important health concern for all Australians.
This page highlights how common living with multiple conditions is and shows how the chronic conditions that occur together vary by age and sex. The impact of living with multiple conditions is described, as well as how care is co-ordinated for people with multimorbidity.
Estimates of multimorbidity on this page are from AIHW analysis of the Australian Bureau of Statistics (ABS) 2022 National Health Survey (NHS) (ABS 2023a), unless otherwise stated. Estimates are based on analysis of 72 long-term health conditions self-reported to the NHS (Table 1) and will differ from estimates based on different data sources and sets of conditions (see Multimorbidity estimates vary).
How common is multimorbidity?
Multimorbidity is common and becomes more common with increasing age.
It is estimated that 38% of Australians (9.7 million people) had 2 or more of the selected long-term health conditions in 2022. This ranged from 11% of people aged 0–14 to 79% of people aged 85 and over (Figure 1).
In 2022, multimorbidity was more common among females than males. An estimated 4.6 million males (37%) and 5.0 million females (39%) were living with multimorbidity.
Of the 5 most common long-term health conditions, females had a higher prevalence (see glossary) than males for:
- anxiety (22% and 15% respectively)
- depression (14% and 11%)
- asthma (12% and 9.4%).
However, females had a lower prevalence than males for:
- back problems (15% and 16%)
- deafness and hearing loss (7.4% and 12%).
The higher prevalence for females for some of the most common conditions contributes to the higher multimorbidity among females.
For more information on the prevalence of chronic conditions see Chronic conditions.
Figure 1: Proportion of people with 0, 1 and 2 or more selected long-term health conditions by age, 2022
This figure shows that 72% of people aged 0–14, compared with 5.8% of those aged 85 and over, did not report living with a long-term health condition.
Variation between population groups
Certain groups of people are more likely to experience multiple conditions than others.
Multimorbidity becomes more common with increasing socioeconomic disadvantage (Figure 2). In 2022, the estimated prevalence of multimorbidity was:
- 31% in the areas of least disadvantage (the highest socioeconomic areas)
- 44% in areas of most disadvantage (the lowest socioeconomic areas).
By remoteness area, the prevalence of multimorbidity was higher in Inner regional (46%) and Outer regional areas (45%) than in Major cities (35%). For more information on the health of these population groups, see Rural and remote health.
These differences remained after adjusting for differences in the age structure of the socioeconomic and remoteness area populations.
Figure 2: Proportion of people with 0, 1 and 2 or more selected long-term health conditions by socioeconomic and remoteness areas, 2022
This figure shows 44% of people living in areas of least disadvantage and 37% in areas of most disadvantage did not report living with a long-term health condition.
Patterns of multimorbidity
Chronic conditions can occur together in an individual by chance (because they are common) or because there is an underlying association between them. Associations between conditions may occur where they are commonly diagnosed together, share common risk factors, or where one condition is a risk factor for another.
In 2022, the selected long-term health conditions that most commonly co-occurred varied by age and sex (Figure 3).
Long-term health conditions more commonly diagnosed in childhood (such as ADHD and autism) feature in multimorbidity at younger age groups while conditions that develop over the life-course (such as back problems, osteoarthritis and deafness or hearing loss) feature more with increasing age.
In 2022, an estimated 4.8 million people (19%) were living with anxiety. Anxiety commonly occurred together with other conditions among people aged under 65. For example, anxiety and depression were estimated to co-occur among:
- 197,000 males (4.9%) and 323,000 females (8.5%) aged 0–24
- 311,000 males (8.7%) and 483,000 females (13%) aged 25–44
- 331,000 males (10.9%) and 367,000 females (11.6%) aged 45–64.
An estimated 4.0 million people (16%) were living with back problems (including sciatica, disc disorders and curvature of the spine) in 2022. Back problems commonly occurred with other conditions among people aged 45–64 and those aged 65 and over. For example, in 2022 an estimated:
- 169,000 males aged 45–64 (5.6%) and 289,000 males aged 65 and over (15%) were living with back problems and deafness or hearing loss
- 173,000 females aged 45–64 (5.5%) and 272,000 females aged 65 and over (12%) were living with back problems and osteoarthritis.
Figure 3: Prevalence of the most common pairs of co-occurring conditions by sex and age group, 2022
This figure shows that the co-occurrence of long-term health conditions differs by sex and becomes more common with increasing age.
Impact
Living with multimorbidity can have a substantial impact on an individual’s health, affect their quality of life and have social and economic effects.
In 2022, compared with people with no long-term health conditions of the same age, people aged 18 and over
with multimorbidity reported experiencing higher levels of:
- disability, restriction or limitation (41% of people with multimorbidity experienced this compared with 2.0% of people with no long-term health conditions)
- moderate to very severe bodily pain in the previous 4 weeks (41% compared with 8.2%)
- fair or poor health (28% compared with 3.2%) (Figure 4).
Based on self-reported data from the 2022 NHS, people with multimorbidity were less likely to be in the labour force (working or seeking work) than people with no chronic conditions.
In 2022, the proportion of people aged 18–64 who were working or seeking work was:
- 77% for those with multimorbidity
- 87% for those with no chronic conditions.
These differences remained statistically significant after adjusting for differences in the age structure of the populations being compared.
Figure 4: Impact of long-term health conditions, people aged 18 and over, 2022
This figure shows that among people aged 18 and over, the proportion who reported good or excellent health became less common with the increasing number of long-term health conditions.
Treatment and management
People living with multimorbidity have more frequent and longer medical appointments and more medications to manage than those without multimorbidity (RACGP 2023). This increases the complexity of patient care and can require ongoing management and co-ordination of care across multiple parts of the health system.
Co-ordinated care for people with chronic and complex health conditions and multimorbidity is supported by:
- Medicare-subsidised chronic disease management services – in 2022–23, 16% of the Australian population
(4.1 million people) accessed multidisciplinary care (see glossary) through a general practitioner (GP) chronic disease management plan (AIHW 2024). - medication reviews (see glossary) for people taking 5 or more medications – there were 152,000 medication review services provided in 2022–23 (Services Australia 2023).
- the MyMedicare voluntary patient registration model that gives patients access to greater continuity of care by providing additional funding to their nominated regular care team to manage their care – as at 10 April 2024 there were over 1.0 million patients (3.9% of all patients) and 5,800 practices (91% of all practices) registered with MyMedicare (Department of Health and Aged Care, personal communication, 17 April 2024).
Multimorbidity estimates vary
Estimates of multimorbidity vary depending on the number and type of conditions included in analysis, as well as the source of data used.
Using self-reported NHS data, the ABS estimated that 22% of Australians (5.6 million people) had 2 or more of 10 selected chronic conditions in 2022 (ABS 2023b).
A more detailed list of conditions is used in analysis for this report that includes all chronic conditions from the Australian Burden of Disease study (AIHW 2021) that can be reasonably identified in the NHS data (72 conditions). This detailed list captures mental health conditions such as depression, anxiety and drug and alcohol problems individually so that an individual with more than one of these long-term health conditions is counted as having multimorbidity. It also includes conditions commonly diagnosed among younger people, such as attention deficit hyperactivity disorder (ADHD) and migraine to better describe multimorbidity across all ages.
Conditions are self-reported to the NHS and may differ from estimates based on different data sources and sets of conditions. The scope of the NHS will also affect estimates of multimorbidity compared with estimates from other sources. For instance, the NHS captures information on residents living in private dwellings, excluding those in residential aged care facilities, hospitals or prisons. This may exclude people likely to experience long-term health conditions or multimorbidity and lead to the underestimation of certain conditions, such as dementia. The NHS does not capture people living in very remote parts of Australia and discrete Aboriginal and Torres Strait Islander Communities.
For more information see the National Health Survey methodology.
Condition group | Inclusions(a) | Prevalence (%)(b)(c) |
---|---|---|
Cancer | Bowel or colorectal cancer, brain cancer, breast cancer, cancer of female genital organs, cancer of male genital organs, cancer of other digestive organs, cancer of other respiratory and intrathoracic organs, Hodgkin's disease, leukaemia, non-Hodgkin's lymphoma, oesophageal or stomach cancer, skin cancer, lung cancer, cancer site unknown, other malignant tumours, in situ neoplasms, benign neoplasms & neoplasms of uncertain nature | 2.3 |
Cardiovascular diseases | Heart failure, ischaemic heart diseases (including angina, heart attack and other ischaemic heart diseases), stroke, other heart diseases, other heart stroke and vascular diseases (including other cerebrovascular diseases, oedema and diseases of arteries, arterioles and capillaries), other diseases of circulatory system (including rheumatic heart disease) | 5.5 |
Chronic respiratory | Asbestosis, asthma, chronic obstructive pulmonary disease (chronic airflow limitation, chronic bronchitis, emphysema) | 12.3 |
Endocrine disorders | Type 1 diabetes, Type 2 diabetes and diabetes type unknown | 5.3 |
Gastrointestinal | Diseases of the liver, diseases of the oesophagus (including gastro oesophageal reflux disease), inflammatory bowel disease (enteritis and colitis) | 1.7 |
Genitourinary | Chronic kidney disease (including Glomerular diseases, Renal failure or Kidney disease, Renal tubulo-interstitial diseases), non-inflammatory female pelvic conditions (including endometriosis) | 2.7 |
Hearing and vision disorders(d) | Deafness or hearing loss (complete, partial, deaf mutism and other deafness or hearing loss nec.), other hearing and vestibular disorders (including, otosclerosis, Meniere’s disease, tinnitus, other diseases of the middle ear and mastoid, other ear and mastoid) Cataracts, glaucoma, macular degeneration, refractive errors (including long sight or hyperopia, short sight or myopia, astigmatism, presbyopia, other disorders of ocular muscles, binocular movement, accommodation and refraction) and other vision disorders (including complete and partial blindness, colour blindness, retinal disorders or defects, other diseases of the eye and adnexa) | 21.3 |
Infectious diseases | AIDS (Auto Immune Deficiency Syndrome) or HIV (Human Immunodeficiency Virus), post COVID-19 conditions | 0.1 |
Infant and congenital conditions | Birth complications (including respiratory problems related to birth and other conditions originating in the perinatal period), cerebral palsy, congenital brain damage or malformation (including spina bifida), Down syndrome, other chromosomal abnormalities, other congenital conditions (including deformities of joints or limbs, other congenital malformations and deformations) | 0.8 |
Mental and substance use | ADHD, anxiety disorders (including feeling anxious nervous or tense, obsessive compulsive disorder, panic attack, panic disorder, phobic anxiety disorders, post-traumatic stress disorder), autism spectrum disorders, bipolar affective disorder (including mania), conduct disorders, depression (including feeling depressed and other mood affective disorders), harmful use or dependence on alcohol, harmful use or dependence on drugs (including prescription drugs and other substances), intellectual impairment, schizophrenia (including psychosis), other mental health conditions (including dyslexia, dyslalia, speech impairment, other behavioural, cognitive and emotional problems with usual onset in childhood or adolescence and other mental and behavioural problems) | 25.9 |
Musculoskeletal | Back problems (including sciatica, disc disorders and curvature of the spine), gout, osteoarthritis, rheumatoid arthritis, other musculoskeletal and connective tissue conditions (including acquired deformities of joints and limbs, soft tissue disorders, other arthritis and type unknown, other arthropathies, other diseases of the musculoskeletal system) | 28.7 |
Neurological | Dementia (including Alzheimer’s disease), epilepsy, migraine, motor neurone disease, multiple sclerosis, Parkinson’s disease, other disease of the nervous system (including chronic fatigue syndrome, muscular dystrophy, narcolepsy, Huntington’s disease) | 8.8 |
Skin | Dermatitis and eczema, psoriasis | 4.1 |
- Each inclusion in the condition group is counted separately to determine the number of long-term health conditions a person has.
- Population prevalence estimates are based on information ‘as reported’ by NHS respondents and may differ from those reported from other sources due to differences in the method of data collection (for example, self-report survey compared with diagnostic survey).
- The NHS is not conducted within institutions, such as residential aged care facilities, hospitals or prisons. This may exclude people likely to experience chronic conditions, leading to the underestimation of certain conditions, such as dementia. For more information see the National Health Survey methodology.
- Vision conditions corrected with glasses are excluded from analysis.
Source: AIHW analysis of ABS 2022 (ABS 2023a).
Where do I go for more information?
For further information on chronic conditions and multimorbidity see:
- Australia's health 2024: data insights article The ongoing challenge of chronic conditions in Australia
- Chronic conditions
- Physical health of people with mental illness
- Chronic condition multimorbidity
- ABS National Health Survey, 2022
For more on this topic, visit the Australian Centre for Monitoring Population Health.
ABS (Australian Bureau of Statistics) (2023a) Microdata: National Health Survey, 2022, AIHW analysis of detailed microdata, accessed 15 February 2024.
ABS (2023b) Table 1: Summary health characteristics, 2001 to 2022 (Table 1.3) National Health Survey 2022, ABS website, accessed 1 February 2024.
AIHW (Australian Institute of Health and Welfare) (2021) Australian Burden of Disease Study: Methods and supplementary material 2018, AIHW, Australian Government, accessed 13 February 2024.
Australian Institute of Health and Welfare (2024) Medicare-subsidised GP, allied health and specialist health care across local areas: 2022-23, AIHW, Australian Government, accessed 19 April 2024.
RACGP (Royal Australian College of General Practitioners) (2023) General practice: health of the nation 2023, RACGP, accessed 01 February 2024.
Services Australia (2023) Medicare Item Reports, Services Australia, Australian Government, accessed
8 November 2023
Amendments
15 August 2024:
- In Table 1, the prevalence estimate for Hearing and vision disorders has been updated from 8.9% to 21.3%.
- Under the Patterns of multimorbidity heading, in the 4th paragraph, the sentence “In 2022, an estimated 1.9 million people (15%) were living with anxiety” has been updated to “In 2022, an estimated 4.8 million people (19%) were living with anxiety".
- Under the Patterns of multimorbidity heading, in the 5th paragraph, the sentence “An estimated 2.1 million people (16%) were living with back problems” has been updated to “An estimated 4.0 million people (16%) were living with back problems”.