Health risk factors are attributes, characteristics or exposures that increase the likelihood of a person developing a disease or health disorder. In many cases, individuals can modify risk factors such as smoking, sun exposure or physical activity. Biomedical risk factors (for example overweight) are bodily states that are often influenced by behavioural risk factors. Together these risk factors are referred to as being either potentially avoidable or modifiable and they are distinct from other types of risk factors, such as genetic pre-dispositions, which are not generally modifiable.
Expenditure due to modifiable risk factors in this report refers to health system spending on a burden of disease condition that can be attributed to people having a particular risk factor e.g. history of smoking. It is not spending on addressing the risk factor itself i.e. not the amount of money spent on trying to reduce tobacco consumption across the Australian population.
In this report 20 risk factors have been identified as contributing to disease burden. These are:
- air pollution
- alcohol use
- bullying victimisation
- child abuse and neglect
- dietary risks
- high blood plasma glucose
- high blood pressure
- high cholesterol
- high sun exposure
- illicit drug use
- impaired kidney function
- intimate partner violence
- iron deficiency
- low birth weight and short gestation
- low bone mineral density
- occupational exposures and hazards
- overweight (including obesity)
- physical inactivity
- tobacco use
- unsafe sex.
Burden (and costs) for risk factors can be reported in two ways
Mediation adjusted burden
Mediation adjusted burden takes into account the overlapping ways in which a risk factor can contribute to disease formation. For example, a risk factor such as tobacco use may contribute to high blood pressure, which is also a risk factor for disease.
Total attributable burden
Total attributable burden sums total burden for all risk factors. This will however overestimate attributable burden due to these overlapping pathways.
Results are presented using both mediation adjusted burden and total attributable burden in this report.
For information on the methods used to derive risk factor spending estimates, refer to the Technical notes of this report and the Australian Burden of Disease Study: Methods and Supplementary material 2018.
The true percentage of spending on conditions that is due to all modifiable risk factors is unknown. For those conditions for which attribution is possible, $38 billion (21%) of the estimated health spending in 2023–24 is attributable to these potentially avoidable risk factors. The risk factor with the highest total attributable spending is overweight (including obesity) at $10.1 billion ($7.0 billion after accounting for mediation).
Key findings
- In 2023–24, the top 5 risk factors contributing to summable health spending were: overweight (including obesity) ($7.0 billion); high blood plasma glucose ($5.6 billion); tobacco use ($4.6 billion); impaired kidney function ($3.4 billion); alcohol use ($3.1 billion).
- Overweight (including obesity) has been the highest total cost risk factor since 2015-16, while high blood plasma glucose overtook tobacco use as the 2nd highest in 2023-24
- The growth rate in real spending since 2015–16 was highest for impaired kidney function (52%), overweight (including obesity, 47%) and UV sun exposure (45%).
- Injuries from falls and osteoarthritis were the two conditions with highest total spending in 2023–24, of which 37% and 29% respectively were attributable to risk factors
- Dietary risks were the leading risk factor driving spending on coronary heart disease, contributing an estimated $842 million.
- Over half (53%) of the estimated spending for bowel cancer can be attributed to modifiable risk factors.
The following interactive data visualisation (Figure 5) shows the mediation adjusted and total attributable health spending due to different risk factors, by year, in current and constant prices. The data used to create the visualisations can also be downloaded as an Excel workbook from the Data section.
