Significant improvement in indigenous disease burden

A new report shows that there has been a decline in the rate of healthy years of life lost due to living with illness or injury and premature death for Aboriginal and Torres Strait Islander people.

The Australian Burden of Disease Study 2018: key findings for Aboriginal and Torres Strait Islander report from the Australian Institute of Health and Welfare (AIHW) shows that Indigenous Australians continue to experience higher rates of ‘disease burden’ than the Australian population as a whole, but the gap is narrowing.

The report measures the impact of diseases and injuries in terms of the number of years of healthy life lost through living with an illness or injury (the non-fatal burden), and the number of years of life lost through dying prematurely from an illness or injury (the fatal burden).

“Over the 15-years from 2003 to 2018, there was a 15% decrease in the total burden. This was mostly driven by a 27% decline in fatal burden, with rates of non-fatal burden remaining stable,” says AIHW spokesperson Dr Fadwa Al-Yaman.

In 2018, the non-fatal burden accounted for 53% of total burden and fatal burden accounted for 47%. Almost half (49%) of the disease burden among Indigenous Australians could have been prevented by avoiding modifiable risk factors such as smoking and an unhealthy diet.

Indigenous males experienced a greater rate of total burden than Indigenous females in all age groups. In 2018, males experienced 1.4 times the rate of fatal burden experienced by females.

The five disease groups that caused the most burden among Indigenous Australians were mental and substance use disorders (23%), injuries (including suicide) (12%), cardiovascular diseases (10%), cancer (9.9%), and musculoskeletal conditions (8%).

Among non-Indigenous Australians, cancer (18%), musculoskeletal (13%), cardiovascular diseases (13%), mental health and substance use disorder (12%) and injuries (including suicide) (8%) were the leading disease groups.

Additionally, the five individual diseases that caused the most disease burden were coronary heart disease (5.8%), anxiety disorders (5.3%), suicide and self-inflicted injuries (4.6%), alcohol use disorders (4.4%) and depressive disorders (4.3%).

When compared with females, males experienced more than three times the amount of burden due to alcohol use disorders and suicide and self-inflicted injuries, and almost twice the burden due to coronary heart disease. When compared with males, females experienced more burden from anxiety and depressive disorders.

“Coronary heart disease continues to be the leading individual cause of disease burden, however, it has also shown the largest reduction over time—declining 48% between 2003 and 2018. Declines have also been seen in type 2 diabetes, stroke, rheumatoid arthritis, hearing loss, and chronic obstructive pulmonary disease (COPD),” says Dr Al-Yaman.

Despite the burden experienced by Indigenous Australians, those born in 2018 can expect to live around 80% of their lives in full health – 56.0 years of the 70.0 years of average life expectancy for males, and 58.8 years of the 74.4 years of average life expectancy for females.

While Indigenous Australians experience disease burden at 2.3 times the rate of non-Indigenous Australians (after adjusting for age), the gap is narrowing.

“The absolute gap in disease burden between Indigenous and non-Indigenous Australians decreased between 2003 and 2018 by 16%. This was largely driven by narrowing of the gap in fatal burden, which decreased by 28%. The gap in non-fatal burden increased slightly during this period, by 6.6%,” says Dr Al-Yaman.

Detailed findings from the Australian Burden of Disease Study 2018, and a report detailing the burden of disease experienced by Aboriginal and Torres Strait Islander people, are planned for release in early 2022.