Australians fare well in health report card despite ongoing COVID impact


The Australian Institute of Health and Welfare’s (AIHW) biennial flagship report card of Australians’ health was launched this week by Federal Minister for Health and Aged Care Mark Butler.

The Australia’s health 2024: in brief report reveals boys and girls born in Australia today can expect to live 81.2 years and 85.3 years respectively. This is an increase of about 40% since the start of the 20th century and is the fourth best among OECD countries, after Japan, Korea and Switzerland.

While life expectancy in Australia decreased by 0.1 years likely due to the increase in deaths in 2022, of which close to half were due to COVID-19, much greater declines in life expectancy were seen in the United States (from 78.9 in 2019 to 76.4 in 2021) and the United Kingdom (from 81.3 in 2019 to 80.4 in 2020).

“Even though life expectancy in Australia decreased in 2020–2022, it was still higher than it was in 2017–2019, prior to the pandemic, by 0.3 years for males and females,” AIHW Deputy Chief Executive Officer Matthew James said.

As life expectancy has increased over time, so too has the number of years Australians spend in full health. Between 2003 and 2023, males gained a total of 2.2 years in full health (from 69.4 to 71.6 years) and females gained a total 0.8 years in full health (from 72.8 to 73.6 years).

COVID-19 and the health system

Australia’s last health report card was mid-2022, during the middle of the Omicron wave of the pandemic. The AIHW report found Australia fared well in the Covid-19 pandemic when compared with other OECD countries, with one of the lowest prevalences of Covid-19 infections. However, it still heavily impacted on Australians’ mortality and ongoing morbidity.

“COVID-19 became the third leading cause of death in Australia in 2022, marking the first time in over 50 years that an infectious disease has been in the top 5 causes of death,” said Mr James.

The Australian Medical Association has warned of knock-on health effects as a result of people delaying access to care for health issues during the heights of the Covid-19 pandemic.

Admissions for elective surgeries from public hospital waiting lists were heavily affected by disruptions to hospital services in 2019–20 and subsequent years. In 2022–23, 50% of public patients were admitted for elective surgery within 49 days of being placed on the waiting list, an increase from 40 days in 2021–22 and 41 days in 2018–19.

Large increases in GP attendances and pathology services in 2021 and 2022, returned to pre-pandemic levels in 2023. However, MBS-subsidised telehealth attendances showed no signs of reverting back to pre-pandemic levels of use. In 2023, there was a total of 33.7 million telehealth attendances compared with 176,800- 275,400 total attendances each year in the pre-pandemic years 2017–2019.

Ill-health

Given the aging population, there has also been an increase in the number of years on average Australians spend in ill-health (from 8.7 to 9.7 years for males and from 10.2 to 11.5 years for females). In 2023, Australians lost an estimated 5.6 million years of healthy life due to either ill-health (54% of total burden) or dying prematurely (46% of the total burden).

The leading causes of total burden among males were coronary heart disease, back pain and problems and suicide and self-inflicted injuries. Among females, the leading causes were dementia followed by anxiety disorders and back pain and problems.

Burden of chronic conditions

With greater life expectancy comes a greater burden of chronic conditions. Around three in five Australians were estimated to live with at least one long-term health condition, and two in five with two or more such conditions, in 2022. Chronic conditions contributed to between 89%-92% of all deaths each year in Australia from 2002–2022.

AIHW predicts that the number of Australians with dementia will more than double by 2058 to 849,300 – 533,800 women and 315,500 men. While the age-standardised coronary heart disease death rate fell by more than 80% between 1980 and 2022, CHD remains the leading single cause of death in Australia.

Between 2000 and 2023 the number of new cancer cases increased by 88% and deaths from cancer increased by 41%. “Seven in 10 (71%) people survived at least five years after a cancer diagnosis during 2015–2019, an improvement from five in 10 (53%) in 1990–1994,” Mr James said.

“Since the National Cervical Screening Program was introduced in 1991, the age-standardised death rate for cervical cancer has halved.”

Risk factors

Australia’s health 2024 reveals a decline in tobacco use, along with the number of people aged 14 and over drinking alcohol at risky levels to their health. While tobacco smoking continues trending down, vaping has become more common. In 2022–2023, for people aged 14 and over, 3.5% were using e-cigarettes daily – up from 0.5% in 2016. People aged 18–24 were the age group most likely to use e-cigarettes daily (9.3%) in 2022–2023.

Increasing burden of mental health

Alarmingly but unsurprisingly, the AIHW report shows an increasing burden of mental health, especially in younger Australians. In 2020–2022, an estimated 43% of the population aged 16–85 had experienced a mental disorder at some time in their life while 22% of the population had experienced a mental disorder in the last 12 months.

While the overall proportion of people with a mental disorder in the last 12 months was similar in 2007, there was a notable increase among young people. In 2020–2022, 39% of 16–24-year-olds had a mental illness in the last 12 months, compared with 26% in 2007. This change is almost entirely driven by an increased prevalence among females in this age group (46% in 2020–2022 – up from 30% in 2007).

Health and wellbeing of First Nations people

Significant challenges remain in the health of Aboriginal and Torres Strait Islander peoples. Death rates among First Nations people have fallen in most age groups over the past 10 years – but without any improvement in infant and child death rates over this time.

Cancers are the most common group of diseases causing deaths among First Nations people, overtaking cardiovascular diseases as the most common group in recent years. Between 2006 and 2022, the age-standardised death rate for cardiovascular disease among First Nations people in New South Wales, Queensland, Western Australia, South Australia and the Northern Territory combined fell by 22%, while the cancer death rate rose by 31%.

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