Summary

Burden of disease measures the impact of diseases and injuries on a population. It combines the years of healthy life lost due to living with ill health (non-fatal burden) with the years of life lost due to dying prematurely (fatal burden). A significant proportion of this burden is preventable, being due to modifiable risk factors. The First Nations Burden of Disease Study (FNBDS) 2022 includes estimates of disease burden due to 220 diseases and injuries in Australia in 2022.

This report presents a summary of the main findings from the FNBDS 2022, with estimates for previous years (2011, 2018) for comparison. The June 2026 update adds pages focused on certain key disease groups and life stages, as well as estimates of the gap in burden between First Nations people and non-Indigenous Australians. Content covering the geographic differences in burden, health-adjusted life expectancy and the burden attributable to risk factors will be added gradually during 2026.

Estimates from the FNBDS 2022 supersede those produced for the Aboriginal and Torres Strait Islander component of ABDS 2018. The latest results for the whole Australian population are presented in Australian Burden of Disease Study 2024.

To explore burden of disease estimates in more detail see the Interactive data on disease burden. See technical notes for methodological changes for FNBDS 2022 and the Australian Burden of Disease Study: methods and supplementary material 2018 for more detailed information.

Living with disease or injury and dying prematurely contribute equally to the burden of disease

In 2022, First Nations people lost 317,333 years of healthy life (total burden, DALY), with 158,944 years lost to non-fatal burden (YLD) and 158,389 years lost to fatal burden (YLL).

Living with illness or injury (non-fatal): 50% of total burden

Dying prematurely (fatal): 50% of total burden

Chronic diseases and injuries cause most of the burden

Out of the 17 disease groups, the disease groups that caused most of the total burden in 2022 were mental health conditions & substance use disorders, injuries, cardiovascular diseases, cancer & other neoplasms and respiratory diseases; together, these accounted for 62% of the total burden among First Nations people (Figure 1).

Figure 1: Proportion (%) of total burden, and fatal and non-fatal composition of total burden, by top 5 disease groups, First Nations people, 2022

Column chart showing that mental & substance use disorders was the highest contributor to the overall burden. It was mostly non-fatal burden, whereas for the other groups, it was mostly fatal burden.

Source: AIHW First Nations Burden of Disease Database

Higher burden for males, particularly fatal burden

In 2022, dying from disease and injury accounted for more of the burden in males (54%), while living with illness accounted for more of the burden in females (55%) (Figure 2).

Figure 2: Proportion (%) of total burden due to fatal and non-fatal burden by sex, First Nations people, 2022

Stacked bar chart showing proportion of total burden, split by sex and fatal/non-fatal burden. Non-fatal burden was a larger proportion of the total in females, and fatal burden was larger for males.

Source: AIHW First Nations Burden of Disease Database

First Nations males experienced a greater rate of total burden than First Nations females, particularly in people aged 45–64 and 65–74 (Figure 3).

Figure 3: Rate of total burden (DALY per 1,000 people), by sex and age group, First Nations people, 2022

Grouped column chart that shows that total burden for both males and females increased with age (from age 5–14). Burden was higher for males in all age groups.

Source: AIHW First Nations Burden of Disease Database

Top specific causes of the burden

The top 5 specific causes of burden for First Nations people in 2022 were:

  • Coronary heart disease (6.0%)
  • Anxiety disorders (5.0%)
  • Suicide & self-inflicted injuries (4.5%)
  • Chronic obstructive pulmonary disease (COPD) (4.0%)
  • Depressive disorders (3.4%) 

These 5 causes together accounted for 23% of the total burden.

Coronary heart disease, anxiety disorders and COPD were ranked in the top 5 diseases for both sexes; however, the proportion of burden that each contributed was different (Figure 4).

Figure 4: Leading causes of total burden and proportion (%) of total burden by sex, 2022

Bar chart showing the top causes of total burden split by sex. Coronary heart disease was the highest cause for males and anxiety disorders was the highest for females.

Source: AIHW First Nations Burden of Disease Database

Decline in premature deaths, but levels of illness and injury remain stable

Overall, the health of First Nations people has improved over the period from 2011 to 2022. After adjusting for population growth and ageing, there was a 6.3% decline in total burden – this decrease was driven by an 11% decline in fatal burden (Figure 5). Over the same period there was no substantial change in non-fatal burden.

Figure 5: Change between 2011 and 2022 in rates of total (DALY), fatal (YLL) and non-fatal (YLD) burden rate (per 1,000 people), First Nations people

Line chart showing changes in age-standardised rates for burden types between 2011 and 2022. There are decreases for total and fatal burden, although non-fatal burden remains steady.

Note: Rates were age-standardised to the 2001 Australian Standard population.

Source: AIHW First Nations Burden of Disease Database

Gap in burden has narrowed over time

After adjusting for differences in population size and age structure, the absolute gap in burden (DALY rate difference) between First Nations people and non-Indigenous Australians decreased by 8.8% between 2011 and 2022, from 249 to 227 per 1,000 people. There was also a small drop in the relative gap, from a rate ratio of 2.2 in 2011 to 2.1 in 2022. This was largely driven by a narrowing of the gap for fatal burden, which decreased by 9.8% between 2011 and 2022. The gap in non-fatal burden also decreased during this period, by 7.4%. There was no change in the relative gap for fatal burden (a rate ratio of 2.4 in 2011 and 2022), while there was a slight drop for non-fatal burden (from a rate ratio of 2.0 in 2011 to 1.9 in 2022).

The decrease in the gap in non-fatal burden was driven by an increase in the rate of non-fatal burden among non-Indigenous Australians between 2011 and 2022 (7.3% increase, from 98 to 105 YLD per 1,000 people).

Figure 6: Change between 2011 and 2022 in the gap in age-standardised total (DALY), fatal (YLL), and non-fatal (YLD) burden rate (per 1,000 people) between First Nations people and non-Indigenous Australians

Line chart showing changes in burden types between 2011 and 2022. There were decreases for total and fatal burden (6.3% and 11%, respectively), although non-fatal burden remains steady.

Note: Rates were age-standardised to the 2001 Australian Standard population.

Source: AIHW First Nations Burden of Disease Database

A large proportion of the burden occurs in mid-life

Disease burden is not evenly distributed over the different stages of life.

  • Infants, children and young adults aged under 25 comprised around half (51%) of the First Nations population but accounted for just under a quarter (23%) of the total burden in 2022.
  • Adults aged 25–64 comprised 43% of the First Nations population and more than half (58%) of the total burden.
  • Adults aged 65 and over comprised 5.6% of the population but accounted for 19% of the total burden.

Figure 7: Proportion of First Nations population and total burden (DALY), by age group, First Nations people, 2022

Grouped column chart comparing population by age group, to DALY. More than half of the total burden was for adults aged 25–64. Older age groups experienced a greater contribution of burden compared to population.

Source: AIHW First Nations Burden of Disease Database

Previous page
Next page