Trends in deaths
Trends by sex
There has been a long and continuing decline in death rates in Australia. Between 1907 and 2021, the overall crude mortality rate decreased by 38% (41% for males and 34% 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 73% (from 2,234 deaths to 597 deaths per 100,000) and by 77% for females (from 1,844 deaths to 427 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 2021, the rate difference between males and females was 170 deaths per 100,000. The large reduction in rate difference between male and females 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 Changing patterns of mortality in Australia.
Figure 5.1: Age-standardised death rates in Australia, by sex, 1907–2021
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. Large decreases in deaths rates since the early 1900s have also been driven by the decline of infant and child deaths. See more on Mortality over the twentieth century in Australia and Changing patterns of mortality in Australia since 1900 in Australia’s health 2022: data insights.
Infectious diseases were the leading cause of death in the first decade of 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 122 deaths per 100,000 in 2021. Cancer (all neoplasm) deaths, after adjusting for differences in age structure, peaked in 1985 (217 deaths per 100,000 population) and have gently declined to 152 deaths per 100,000 in 2021.
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, 1907–2021
Source: AIHW National Mortality Database; Table S5.2.
Figure 5.2b: Age-standardised death rates in Australia, by broad cause of death, 1907–2021
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 2011 and 2021, accounting for 16% of deaths in 2011 and 12% in 2021. The largest change in leading causes of death for males from 2011 to 2021 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 2011 and 2021.
- For females, coronary heart disease and cerebrovascular disease fell in rank from 2011 to 2021. There was a notable increase for dementia including Alzheimer's disease from third to first place, accounting for 9% of deaths in 2011 and 13% of deaths in 2021. The ranking for breast cancer was the only cancer within the top 10 causes of death to decrease between 2011 and 2021.
- Influenza and pneumonia moved out of the 10 leading causes of death for females after 2011 and was replaced by accidental falls in 2021. Similarly, for males, heart failure and other complications moved out of the top 10 causes of death after 2011 and was replaced by accidental falls in 2021.
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 2011 and 2021
Note: Colour lines link the same leading causes of death in 2011 with those in 2021; a black line means the ranking of the cause of death remained the same in 2021 as in 2011; an orange line, that the ranking of the cause of death rose compared with that in 2011; and a green line, that the ranking of the cause of death in 2021 decreased compared with that in 2011.
While coronary heart disease continues to be the leading cause of death overall, the gap between coronary heart disease and dementia continues to narrow (see Figure 5.4). In 2011 more than twice the number of people died from coronary heart disease than from dementia (21,526 and 9,864 deaths respectively). Over the last decade, coronary heart disease deaths have decreased from 15% of all deaths in 2011 to 10% of all deaths in 2021, while deaths due to dementia have increased from 6.7% of all deaths in 2011 to 9.3% of all deaths in 2021. In 2021 the difference between the two leading causes has continued to narrow (17,331 deaths due to coronary heart disease and 15,940 deaths due to dementia). For more information about dementia, see Dementia in Australia.
When taking into account changes in the age structure of the population, the death rate of coronary heart disease increased slightly for the first time in a decade in 2021 (Figure 5.4). This was due to the increase in the death rate for females between 2020 (32.7 deaths per 100,000 females) and 2021 (33.8 deaths per 100,000 females) (Table S5.4). The age-standardised death rate for males fell slightly between 2020 and 2021.
Lung cancer deaths have generally been declining over the last decade. Male lung cancer deaths had an increase for the first time in a decade in 2021 (32.2 deaths per 100,000 compared to 31.8 in 2020), but still stay well below the 2011 rate (43.8 deaths per 100,000) (Table S5.4).
Figure 5.4: Age-standardised death rates in Australia, leading causes of death, 2011–2021
Source: AIHW National Mortality Database; Table S5.4.