Adults aged 25–44

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Key findings Disease group burden How does burden differ by sex? Top specific causes of burden Changes over time How big is the gap, and what causes it?

Key findings

  • Adults aged 25–44 accounted for 26% (or 261,618 people) of the First Nations population and 27% (85,433 DALY) of the total burden experienced by First Nations people in 2022. 
  • In 2022, First Nations adults aged 25–44 lost 85,433 years of healthy life (total burden, DALY) due to premature death or living with disease or injury, or 327 DALY per 1,000 people of this age.
  • Among First Nations adults aged 25–44 there was more non-fatal than fatal burden (61% or 51,928 YLD and 39% or 33,505 YLL, respectively).
  • Mental health conditions & substance use disorders was the main cause of burden among First Nations adults aged 25–44.
  • Overall, the health of First Nations adults aged 25–44 improved slightly over the period 2011 to 2022. There was a 3.7% decline in the age-specific rate of total burden between 2011 and 2022 (from 339 to 327 DALY per 1,000 people).
  • For adults aged 25–44, mental health conditions & substance use disorders and injuries were the leading disease group contributors to the gap between First Nations people and non-Indigenous Australians (representing 33% and 25% of the gap among adults aged 25–44, respectively).

In 2022, First Nations adults aged 25–44 lost 85,433 years of healthy life (total burden, DALY) due to premature death or living with disease or injury, or 327 DALY per 1,000 people of this age.

Adults aged 25–44 accounted for 26% (or 261,618 people) of the First Nations population and 27% (85,433 DALY) of the total burden (DALY) experienced by First Nations people in 2022.

Table 1: Total (DALY), non-fatal (YLD) and fatal (YLL) burden rates (per 1,000 people) among First Nations adults aged 25–44, by sex, 2022

Sex

DALY

YLD

YLL

Males

356.0

191.8

164.1

Females

297.2

205.1

92.0

Persons

326.6

198.5

128.1

Source: AIHW First Nations Burden of Disease Database

Disease group burden

The leading disease groups that contributed to the total burden in First Nations adults aged 25–44 were:

  • mental health conditions & substance use disorders (34% of total burden, or 28,669 DALY)
  • injuries (21%, 17,712)
  • cardiovascular diseases (7.8%, 6,662)
  • musculoskeletal conditions (6.3%, 5,366) (Figure 1).

Figure 1: Contribution of disease groups to total (DALY), non-fatal (YLD) and fatal (YLL) burden, First Nations adults aged 25–44, 2022

Stacked bar chart showing proportions of burden by disease group. For this age group, most YLL comes from injuries, while most YLD comes from mental health conditions and substance use disorders.

Stacked bar chart showing proportions of burden by disease group. For this age group, most YLL comes from injuries, while most YLD comes from mental health conditions and substance use disorders.

Note: Disease groups that contribute less than 2% of burden may be based on small numbers and should be treated with caution.

Source: AIHW First Nations Burden of Disease Database

Most of the burden (61% or 51,928 YLD) among First Nations adults aged 25–44 was due to living with disease or injury (non-fatal burden) (figures 2 and 5). Mental health conditions & substance use disorders contributed more than half of the non-fatal burden in this age group (54%), followed by musculoskeletal conditions (10%) and respiratory diseases (6.9%) (Figure 1). 

The remaining burden (39% or 33,505 YLL) was due to premature death (fatal burden) (figures 2 and 5), with injuries (47%) and cardiovascular diseases (18%) the main contributors. Mental health conditions & substance use disorders accounted for only 1.2% of fatal burden for First Nations adults aged 25–44 (Figure 1). 

Among First Nations adults aged 25–44, the contribution of fatal burden and non-fatal burden to total burden differed greatly for each disease group (Figure 2). Among the highest burden disease groups:

  • The burden from mental health conditions & substance use disorders, musculoskeletal conditions and respiratory diseases was mostly non-fatal.
  • The burden from injuries and cardiovascular diseases was mostly fatal.

Figure 2: Fatal (YLL) and non-fatal (YLD) burden as a proportion (%) of total burden (DALY), leading 10 disease groups, First Nations adults aged 25–44, 2022

Stacked bar chart showing burden splits by disease group. Mental health conditions and substance use disorders was predominately non-fatal (99%) and injuries was fatal (90%) and contributed the most burden to this age group.

Source: AIHW First Nations Burden of Disease Database

How does burden differ by sex?

Among First Nations adults aged 25–44, males experienced a higher proportion of the total burden (55% compared with 45%) and fatal burden (64% compared with 36%) than females. First Nations females in this age group experienced a slightly higher proportion of the non-fatal burden than males (52% compared with 48%).

In this age group, mental health conditions & substance use disorders was the leading disease group contributor to total and non-fatal burden for First Nations males and females (Figure 3). Injuries was the leading disease group contributor to fatal burden for males and females, but was responsible for a much higher proportion of the fatal burden in males (54%) than in females (35%) (Figure 3).

Figure 3: Contribution of disease groups to total (DALY), non-fatal (YLD) and fatal (YLL) burden, by sex, First Nations adults aged 25–44, 2022

Stacked bar chart showing proportional burden splits by sex. For both males and females, mental health conditions and substance use disorders use was the leading contributor to DALY, followed by injuries.

Stacked bar chart showing proportional burden splits by sex. For both males and females, mental health conditions and substance use disorders use was the leading contributor to DALY, followed by injuries.

Note: Disease groups that contribute less than 2% of burden may be based on small numbers and should be treated with caution.

Source: AIHW First Nations Burden of Disease Database

To further explore the top disease groups and causes by age group, see the following interactive data visualisation: 

Top specific causes of burden

The 5 leading specific causes of burden accounted for one-third (33%) of the total burden among First Nations adults aged 25–44:

  • suicide & self-inflicted injuries (9.0%, or 7,664 DALY)
  • anxiety disorders (7.4%, 6,338)
  • alcohol use disorders (6.7%, 5,697)
  • depressive disorders (5.5%, 4,721)
  • poisoning (4.6%, 3,905).

The leading specific causes of burden for this age group varied by sex and type of burden, but the overall burden for DALY and YLL was higher in males than females. See Figure 4 for more information. 

Figure 4: Top 5 specific causes of total (DALY), non-fatal (YLD) and fatal (YLL) burden, by sex, First Nations adults aged 25–44, 2022

Tile map showing the top specific causes by sex and burden type. For males suicide & self-inflicted injuries was the largest contributing individual cause of total burden, while for females, it was anxiety disorders.

Tile map showing the top specific causes by sex and burden type. For males suicide & self-inflicted injuries was the largest contributing individual cause of total burden, while for females, it was anxiety disorders.

RTI road traffic injuries.

Source: AIHW First Nations Burden of Disease Database

To further explore the top specific causes across all stages of life, see the following interactive data visualisation: 

Changes over time

Overall, the health of First Nations adults aged 25–44 improved slightly over the period 2011 to 2022 (Figure 5). 

There was a 3.7% decline in the age-specific rate of total burden between 2011 and 2022 (from 339 to 327 DALY per 1,000 people). Most of this decline was observed between 2018 and 2022, while the DALY rate remained relatively stable between 2011 and 2018.

The decrease in total burden was driven by a reduction (of 15%) in the rate of fatal burden between 2011 and 2022, with much of this decrease observed between 2011 and 2018. There was an increase (of 5.6%) in non-fatal burden between 2011 and 2022, with the rate rising between 2011 and 2018 and then decreasing slightly.

Figure 5: Change between 2011 and 2022 in the age-specific total (DALY), non-fatal (YLD) and fatal (YLL) burden rates (per 1,000 people), First Nations adults aged 25–44

Line graph showing the change in age-standardised rates over time for different types of burden. Total and fatal burden rates decreased between 2011 and 2022, while non-fatal burden rates increased slightly.

Source: AIHW First Nations Burden of Disease Database

Changes by disease group

Over the period 2011 to 2022, among First Nations adults aged 25–44, there were decreases in the age-specific total burden rate from:

  • cardiovascular diseases – a decrease of 12 DALY per 1,000 people, or 31%
  • musculoskeletal conditions – a decrease of 5.0 DALY per 1,000, or 20%
  • cancer & other neoplasms – a decrease of 4.6 DALY per 1,000, or 30%.

Increases in burden were observed for mental health conditions & substance use disorders (increase of 12 DALY per 1,000, or 12%) and infectious diseases (increase of 4.6 DALY per 1,000, or 66%). Most of the increase in burden due to infectious diseases was due to the emergence of COVID-19.

Changes by specific causes

In 2011 and 2022, the same 6 diseases were the leading causes of burden among First Nations adults aged 25–44, although there were changes in the rankings and age-specific burden rates for each cause (Figure 6).

There were decreases in the age-specific burden rate and ranking for:

  • coronary heart disease (38% decrease)
  • alcohol use disorders (24% decrease).

There were increases in the burden rate and ranking for:

  • suicide & self-inflicted injuries (27% increase)
  • anxiety disorders (17% increase)
  • poisoning (9.1% increase)
  • depressive disorders (8.0% increase).

Figure 6: Changes in ranking and age-specific DALY rate (DALY per 1,000 people), leading specific causes of burden, First Nations adults aged 25–44, 2011 and 2022

Figure showing the top 6 specific causes of burden in 2011 and 2022. The same 6 diseases were the leading causes of burden among First Nations people aged 25-44 in both years, although there were changes in the rankings and age-specific burden rates among these causes.

Notes 

  1. An increase in rank over time does not always mean the disease or injury has increased in the population, and vice versa. Therefore, changes in ranking of causes of deaths and disease burden over time should be interpreted with caution.
  2. Causes are presented in descending order, from highest age-specific rate to lowest age-specific rate, with arrows indicating either an increase (orange) or decrease (blue) in the age-specific rate over time.
  3. Cause rankings exclude ‘other‘ residual conditions from each disease group; for example, ‘other musculoskeletal conditions’.
  4. For information on colours used for each specific cause, see disease group colours for FNBDS 2022 colour legend.

Source: AIHW First Nations Burden of Disease Database

How big is the gap, and what causes it?

First Nations adults aged 25–44 experienced disease burden at 2.5 times the rate for non-Indigenous adults of this age in 2022 (327 compared with 131 per 1,000 people).

For adults aged 25–44, mental health conditions & substance use disorders and injuries were the main disease group contributors to the gap (representing 33% and 25% of the gap among adults aged 25–44, respectively). Cardiovascular diseases was also an important contributor to the gap in this age group (representing 11% of the gap) (see Figure 5 in Gap in disease burden section).

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