While we’re bombarded with claims of an “obesity epidemic” and an “obesity crisis” and Australians being manipulated by the sinister “Big Sugar“, Australians are, inconveniently, living longer and healthier than ever, with some worrying exceptions.
Recent data from the Australian Institute of Health and Welfare on the “fatal burden” — the years of life lost from individual diseases and conditions — shows that in 2015 Years of Life Lost (YLL) per 1000 population for all Australians fell by 5.5% compared to 2011, as part of a nearly 20% fall since 2003. That means that the average numbers of years of life lost to disease every year, as a proportion of the whole population, has dropped by nearly a fifth since the early 2000s.
In terms of age groups, the biggest gains in recent years have been in 75-90-year-olds, but all groups over 55 have noticeably reduced the level of YLL. Coronary heart disease remains the biggest killer and greatest source of YLL, but has reduced 45% since 2003. Stroke has slipped from second to fourth greatest source of YLL, due to a 42% fall. Breast cancer in women has fallen 26.2% in YLL per 1000 population; bowel cancer has fallen by 24.5% and lung cancer by 15%. Motor vehicle accidents have dropped 45%, while the YLL for type two diabetes — another epidemic we are said to be in the grip of — has fallen by 32%, taking it out of the top 10 sources of years of life lost and down to 16th.
However, the YLL to dementia are up nearly 80%, heralding dementia’s arrival in recent years as one of Australia’s biggest killers. And YLL to suicide are up 11%:
In particular, years of life lost to suicide among females has increased alarmingly; they increased 6.7% for males (who remain far more likely to take their lives) but 27.3% among female since 2003. And the age distribution of male suicide has remained broadly the same across the period, but it has changed significantly for women — and particularly for teenage girls — there has been a big spike in YLLs among 15-19 females.
While the internet has often been the subject of moral panics, it’s possible that this may be related to online bullying; the evidence is unclear.
Years lost is also much higher among low-income earners, with years lost averaging 80% more in the lowest income quintile compared to the highest. Years lost to lung cancer among the lowest income quintile are more than double those among the highest; years lost to most other cancers are much more similar between quintiles, except liver cancer. Years lost to homicide are also much higher among low income earners. Average years lost across the lowest quintile have fallen 10.6% since 2011, but that’s not as much as the fall for the wealthiest quintile, where years lost fell 13.5%.
Remoteness is also a major contributor to years lost, obviously reflecting the persistence of poorer health outcome for indigenous communities (although indigenous people in urban areas have poorer outcomes than non-indigenous Australians, and non-indigenous people in remote areas also have poor outcomes). However, the biggest falls in years lost have occurred in remote and very remote communities: for very remote communities, the average of years lost in 2015 adjusted for population was down more than 17% on 2011 levels; in remote communities, down over 15%, compared to a fall of 12% in major cities, showing health outcome in relation to fatal disease improving faster in those communities than in metropolitan areas.
The latest data from AIHW complements that from a study two years ago comparing 2003 and 2011 data, that found that not merely were Australians living longer, but were doing so in better health.
Reach Lifeline on 13 11 14.