Which health conditions are more likely to be reported as underlying, direct or contributory causes?
Health conditions can play different roles in causing death. Some conditions are more likely to be reported as either the underlying, direct or contributory cause of death (Figure 8.2).
Figure 8.2 Cause of death, per cent involvement by cause type, cause groups 2023
The stacked bar graph shows conditions or diseases such as cancer, external causes, infant and congenital conditions and neurological conditions are more likely to be underlying causes of death than to be direct or contributory.
| Cause of death | Underlying | Direct | Contributory |
|---|---|---|---|
| Infectious | 25.5 | 64.2 | 10.3 |
| Infant & congenital | 68.7 | 6.6 | 24.7 |
| Cancer | 71.2 | 14.6 | 14.2 |
| Cardiovascular | 28.2 | 31.1 | 40.7 |
| Respiratory | 25.5 | 47.8 | 26.7 |
| Gastrointestinal | 33.2 | 39.5 | 27.3 |
| Neurological | 49 | 17.9 | 33.1 |
| Mental & behavioural | 3.8 | 23.9 | 72.3 |
| Endocrine | 24.8 | 15.8 | 59.5 |
| Kidney & urinary | 13.8 | 43.8 | 42.4 |
| Reproductive & maternal | 32.6 | 23.6 | 43.8 |
| Musculoskeletal | 14.4 | 14.3 | 71.4 |
| Hearing & vision | 1.9 | 11.1 | 87 |
| Skin | 21.5 | 46.7 | 31.8 |
| Oral | 34.9 | 35.6 | 29.5 |
| Blood & metabolic | 13.4 | 32.1 | 54.5 |
| External | 56.6 | 26.8 | 16.6 |
| Injury | 0 | 88 | 12 |
| Ill-defined | 4.8 | 73.8 | 21.5 |
| Unspecified/undetermined | 100 | 0 | 0 |
| Psychosocial | 0 | 2.8 | 97.2 |
Notes:
- The year refers to year of registration of death. Deaths registered in 2023 are based on the preliminary version and are subject to further revision by the Australian Bureau of Statistics (ABS).
- Cause groups and specific causes are based on the cause list used for reporting on multiple causes of death as described in the Technical notes.
Source: AIHW National Mortality Database; Table S8.4.
Causes which are more likely to be underlying cause of death when mentioned on the death certificate include:
- cancers (71% of mentions are as an underlying cause of death)
- external causes (57% of mentions)
- neurological conditions (49% of mentions).
Direct causes of death often reflect complications of the underlying cause and are experienced at the end of life. Injuries are almost always (88% of the time) direct causes as these reflect the consequences of external causes. Infectious and respiratory diseases can arise as a complication of the underlying cause and often in a medical setting. Other conditions or health events which are more likely to be reported as direct causes of death when mentioned on the death certificate include:
- ill-defined causes (74% of mentions are as a direct cause of death)
- infectious diseases (64%)
- respiratory diseases (48%).
Conditions or health events which are more likely to be contributory causes, that is, conditions which significantly contributed to the death but were not in the chain of events leading to death, include:
- mental and behavioural conditions (72% of mentions were as a contributory cause of death)
- musculoskeletal (71%)
- endocrine (59%).