Trends in deaths

There has been a long and continuing decline in death rates in Australia. Between 1907 and 2020, the overall crude mortality rate decreased by 42% (44% for males and 39% for females) (Table S5.1). When accounting for changes in the populations age structure over this period, the age-standardised death rate for males fell by 74% (from 2,234 deaths to 579 deaths per 100,000) and by 78% for females (from 1,844 deaths to 407 deaths per 100,000) (Figure 5.1).

The leading causes of death at that time were infectious diseases, followed by cardiovascular diseases. Large decreases in deaths rates since the early 1900s have also been driven by the decline of infant and child deaths. As people are now more likely to reach older ages, dementia including Alzheimer’s disease, cardiovascular diseases and other chronic conditions (notably cancers) are becoming more prominent as causes of death.

Death rates have historically been higher for males than for females; however, the gap is closing over time. The difference between male and female age-standardised death rates was largest in 1968, when the rate difference was 642 deaths per 100,000 population. In 2020, the rate difference between males and females was 173 deaths per 100,000. The reduction in rate difference between male and female rates since 1968 has largely been driven by the reduction in deaths due to cardiovascular diseases. This was influenced by several factors, including improvements in surgical techniques, hospital care, diagnosis and pharmaceuticals, as well as modifications to lifestyle factors such as smoking, diet and high blood pressure. See more on Mortality inequalities in Australia.

Figure 5.1: Age-standardised death rates in Australia, by sex, 1907–2020

This figure shows that age-standardised death rates decreased overall from 1907 to 2020. For males, the age-standardised death rate decreased from 2,234 deaths per 100,000 population in 1907 to 579 in 2020. For females, the age-standardised death rate decreased from 1,844 deaths per 100,000 population in 1907 to 407 in 2020. Throughout the entire period, the age-standardised death rate was lower for females than males. Age-standardised death rates peaked in 1919, at 2,418 for males and 1,959 for females.

Source: AIHW National Mortality Database (Table S5.1).

Trends by cause of death since the early 1900's

The decline in deaths in the first half of the last century was associated with factors such as control of infectious disease and better hygiene and nutrition. The decline in the later years was associated with improvements in road safety measures, falls in smoking rates, and improvements in prevention, detection and treatment of disease such as cardiovascular disease and other chronic diseases. See more on Mortality over the twentieth century in Australia and 'Chapter 4 Changing patterns of mortality in Australia since 1900’ in Australia’s health 2022: data insights (AIHW 2022 forthcoming).

Infectious diseases were the leading cause of death in the first decade of the last century, followed by cardiovascular diseases and respiratory diseases (Figure 5.2a). In 1919, mortality due to respiratory diseases increased sharply due to the Spanish influenza pandemic. As infectious diseases declined, there was increased mortality from cardiovascular diseases and cancers from the 1920s and 1930s. In recent years, crude mortality rates from cancer have surpassed those from cardiovascular diseases.

When taking into account differences in the populations age structure over time, cardiovascular diseases have consistently been a leading cause of death for Australians over the last century, but age-standardised death rates have been steadily declining (Figure 5.2b). Deaths from cardiovascular diseases peaked in 1968 at 830 deaths per 100,000 population (age-standardised rate) and have since dropped to 118 deaths per 100,000 in 2020. Cancer (all neoplasms) deaths, after adjusting for differences in age structure, peaked in 1985 (217 deaths per 100,000 population) and have gently declined to 150 deaths per 100,000 in 2020.

Age-standardised rates of deaths due to respiratory diseases, infectious diseases and injury and poisoning declined over the last century.

Figure 5.2a: Crude death rates in Australia, by broad cause of death, 1907–2020

This figure shows that the crude death rates for deaths due to respiratory diseases, injury and poisoning, and infectious diseases decreased overall from 1907 to 2020. The crude death rate for deaths due to cardiovascular diseases generally increased from 1919 onwards, peaked in the 1968, and has declined rapidly to 2020. The crude death rate for cancers (all neoplasms) gently increased from 1907 until the early 2000s. From the early 2000s, up until 2020 crude death rates have overall been relatively stable.

Source: AIHW National Mortality Database (Table S5.2).

Figure 5.2b: Age-standardised death rates in Australia, by broad cause of death, 1907–2020

This figure shows that the age-standardised death rates for deaths due to respiratory diseases, injury and poisoning, and infectious diseases decreased overall from 1907 to 2020. The age-standardised death rate for deaths due to cardiovascular diseases increased from 1919 onwards, peaked in the 1968, and has declined rapidly to 2020. The age-standardised death rate for cancers (all neoplasms) gently increased from 1907 until the 1980s, before gently declining to 2020.

Source: AIHW National Mortality Database (Table S5.2).

Trends by cause of death in the past decade

Over the last decade, the 10 leading causes of death for males and females have generally been the same, albeit with different rankings (Figure 5.3):

  • For males, coronary heart disease was the leading cause of death in both 2010 and 2020, accounting for 16% of deaths in 2010 and 12% in 2020. The largest change in leading causes of death for males from 2010 to 2020 was the rise of dementia including Alzheimer’s disease, from sixth to second place. The rankings for all cancers within the top 10 causes of death (lung, prostate and colorectal) decreased between 2010 and 2020.
  • For females, coronary heart disease and cerebrovascular disease fell in rank from 2010 to 2020. On the other hand, there was a notable increase for dementia including Alzheimer’s disease from third to first place. The rankings for all cancers within the top 10 causes of death (lung, breast and colorectal) remained the same between 2010 and 2020.
  • Kidney failure moved out of the 10 leading causes of death for females after 2010 and was replaced by accidental falls in 2020. Similarly, for males, heart failure and other complications moved out of the top 10 causes of death after 2010 and was replaced by accidental falls in 2020.

Figure 5.3: Change in disease ranking and the proportion of all deaths for the leading 10 underlying causes of death in Australia, by sex, between 2010 and 2020

This figure shows the ranking and the proportion of all deaths for the leading 10 causes of death in 2010 and 2020 in Australia by sex. For both males and females, 9 of the 10 leading causes of death in 2010 were also ranked in the leading 10 causes of death in 2020. For both males and females coronary heart disease was the leading cause of death in 2010. In 2020, coronary heart disease was the leading cause of death for males, however for females it was dementia including Alzheimer’s disease, followed by coronary heart disease. For males, between 2010 and 2020, the following diseases decreased in ranking: lung cancer, cerebrovascular disease, prostate cancer, chronic obstructive pulmonary disease, and colorectal cancer, whereas dementia including Alzheimer’s disease and diabetes increased in ranking. There was no change in the ranking of suicide. For females, between 2010 and 2020, the following diseases decreased in ranking: coronary heart disease, cerebrovascular disease and ‘heart failure and complications and ill-defined heart disease’, whereas dementia including Alzheimer’s disease and diabetes increase in ranking. There was no change in the ranking of lung cancer, breast cancer, chronic obstructive pulmonary disease or colorectal cancer.

Note: Colour lines link the same leading causes of death in 2010 with those in 2020; a black line means the ranking of the cause of death remained the same in 2020 as in 2010; an orange line, that the ranking of the cause of death rose compared with that in 2010; and a green line, that the ranking of the cause of death in 2020 decreased compared with that in 2010.

Source: AIHW National Mortality Database (Table S3.1, Table S5.3).