The health of the Australian population improved markedly during the twentieth century. For example: the toll of infectious disease was reduced sharply, life expectancy at birth continued to increase, death rates from coronary heart disease and stroke have declined since the late 1960s and in more recent years, we have witnessed a downward trend in deaths from lung, colorectal and breast cancer. Despite this, health gains have not been equally shared across all sections of the population. At the end of the twentieth century, there were considerable mortality inequalities between population subgroups in Australia.
This report examines mortality inequalities by sex, geographic region, socioeconomic disadvantage, occupation, and country of birth among infants and children (0–14 years), young adults (15–24 years), working-aged adults (25–64 years), and older persons (65 years or more) for the period 1998–2000, and between 1985–1987 and 1998–2000. Mortality inequalities were examined on the basis of life expectancy, potential years of life lost, potentially avoidable deaths, age-standardised death rates, rate ratios, and a measure of excess mortality.
During 1998–2000, rates of death were substantially higher for males, those living in remote and very remote regions, those living in socioeconomically disadvantaged areas, blue-collar employees, and the Australian-born. While this publication does not focus in detail on Indigenous health, it is also well established that Indigenous peoples have a much poorer mortality profile than non-Indigenous Australians.
The mortality burden in the Australian population attributable to inequality based on sex, geographic region, socioeconomic disadvantage, occupation, and country of birth is large: much of this burden is potentially avoidable. Deaths attributable to inequality constitute a loss of economically productive members of society, and raise health care costs.
Throughout this report we make extensive use of the rate ratio, an internationally accepted measure of inequality that is widely used in health and epidemiological research. However, the reader needs to be aware that the rate ratio must be interpreted carefully when making comparisons between groups and over time: this issue is discussed more fully in Chapter 2 (Section 2.6).