Burden of Disease

ACT Chief Health Officer’s Report: Burden of Disease

From the Chief Health Officer…

This report on the burden of disease in the ACT, along with the Healthy Weight report, are the first since the ending of the COVID-19 public health emergency declaration in the ACT. The main purpose of these reports is to refocus our attention on key public health issues impacting on the health and well-being of our community at this time.

This information seeks to inform future policy, planning and research, developed both within Government and by external stakeholders.

All Canberrans should have the opportunity to live a long life in the best possible health.

When people experience chronic disease or injury, it can significantly impact their quality of life and take away years of what would otherwise be healthy life. This loss of healthy life is represented by the ‘burden of disease’.

Burden of disease studies tell us that Canberrans live longer lives and spend relatively more of their years in full health compared to the average Australian. However, almost half of all adults in the ACT live with at least one chronic disease.

The top diseases causing the greatest total burden continue to be:

  • cancer
  • mental health conditions and substance use disorders
  • musculoskeletal conditions
  • cardiovascular diseases.

Importantly over one third of the burden of disease in Australia in 2018 could be prevented through action reducing modifiable risk factors.  The top five modifiable risk factors are ones we know well:

  • tobacco use
  • overweight and obesity
  • dietary risks
  • high blood pressure
  • alcohol use.

Finding ways to reduce or eliminate these risk factors can help to prevent the development and impact of health issues and help people enjoy healthier lives.

The ACT Government's Healthy Canberra ACT Preventive Health Plan 2020-2025 and the supporting First Three Year Action Plan (2020-2022) seek to articulate areas for government-led action in a wide range of areas, delivered in partnership with a range of stakeholders. In anticipation of the development of a Second Action Plan, I would encourage everyone to consider how we can reduce the burden of disease across our community.

Data note

This report provides a snapshot of a priority population health issue in the ACT. Statistics on a broad range of population health topics are published and regularly updated on the HealthStats ACT website.

Differences in statistical methods, calculations, data updates and guidelines between the AIHW Burden of Disease Study and other data sources used in this report may result in information varying from previously published results.

COVID-19 has impacted the ability of direct data collection for some of the key statistics, including interruptions to national survey data collection leading to limitations around the availability of up-to-date data for these indicators. This is important to consider when considering the information discussed in this report.

Measuring population burden of disease

Burden of disease is recognised as the best way of measuring the impact of different diseases or injuries on a population.[1] While burden of disease studies quantify the size of health problems they do not consider broader factors such as social, economic or health system impacts.

Understanding the burden of disease for a population involves exploring the estimate of disease burden due to different diseases and injuries, for different population groups, and due to different risk factors.

Therefore, burden of disease studies, alongside measures such as life expectancy, healthy lifestyle indicators and disease risk factors, provide an important snapshot of the health of our community and can tell us where we need to focus our population health efforts.

The main source of information on burden of disease is the Australian Institute of Health and Welfare (AIHW) Burden of Disease Study for 2022, 2018, 2015, and 2011. The 2018 study is most recent analysis containing jurisdictional specific data. A 2022 update release provided information on national estimates and trends.

Other key data sources referred to in this report include:

  • ABS National Health Survey 2018
  • ABS National Aboriginal and Torres Strait Islander Health Survey 2018
  • ABS Life Tables 2019-2021
  • ACT General Health Survey 2021.

Disability-adjusted life years

Disability-adjusted life years (DALYs) expresses the overall disease burden in a population as the number of years lost due to ill-health, disability, or early death.

One DALY equals one year of healthy life lost, either through premature death or from living with disease or injury.[2]

This measure is an approximation, as many people will still enjoy a high quality of life despite living with disease or injury, while others may have reduced wellbeing and quality of life.

Health-adjusted life expectancy

Life expectancy is the average number of years a person can expect to live.[3]

In comparison, health-adjusted life expectancy (HALE) takes into account years lived in less than full health due to disease or injury.

The health-adjusted life expectancy is the average length of time a person can expect to live in full health, or without the impacts of disease or injury.[3]

The ACT context

Canberrans have high life expectancies

People in the ACT have the longest life expectancies in Australia, while Australians have the third highest life expectancies in the world.[4]

Life expectancy at birth in Australia and the ACT increased between 2010 and 2021 (Figure 1).

From 2019 to 2021, Canberrans had the highest life expectancy at birth for both females (86.3 years) and males (82.7 years) compared with other jurisdictions.[5]

Figure 1. Life expectancy at birth, ACT and Australia, 2010-2012 to 2019-2021


Source: Australian Bureau of Statistics (ABS) (2022), Life Tables 2019-2021, ABS website, Australian Government. Note data for life expectancy is based on three year rolling averages.

Canberrans live more years in full health than the average Australian

The number of years Canberrans born in 2018 could expect to live in full health, (or HALE) was 73.1 years, 0.3 years longer than the national average (Figure 2).

The gap between ACT and Australia has narrowed slightly since 2011, when people in the ACT could expect to live 73.3 years in full health, 0.6 years longer than the average Australian.[1]

In 2018, males in the ACT could expect to live the second highest number of years in full health and females the fourth highest compared to other jurisdictions.[1]

Figure 2. Years of life expectancy lived at full health (health-adjusted life expectancy), ACT and Australia, 2011 to 2018


Source: Australian Institute of Health and Welfare (AIHW) (2018) ‘Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018’, Australian Burden of Disease Series no. 23, catalogue number BOD 29, AIHW, Australian Government.

Females live more years in full health than males

For those born in 2018 in the ACT, males can expect to live 71.9 of their 81.2 years (88.6%) in full health, compared to 74.2 of their 85.3 years (86.95%) for females.[1]

Since 2011, this reduced slightly from 72.6 years for males and increased slightly from 73.9 years for females.

Figure 3. Years of life expectancy lived at full health (health-adjusted life expectancy) by sex, ACT, 2011 to 2018


Source: Australian Institute of Health and Welfare (AIHW) (2018) ‘Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018’, Australian Burden of Disease Series no. 23, catalogue number BOD 29, AIHW, Australian Government.

Total burden of disease in the ACT is lower than national averages

In 2018, the ACT had the second lowest rate of total burden of disease after Victoria (Figure 4).

The overall burden of disease measured using DALY was 177.9 years per 1,000 people in the ACT.[1] This has increased slightly since 2011 where people in the ACT lost 175.0 years of healthy life per 1,000 people which was the lowest rate nationally at the time.[1]

While fewer people are dying prematurely in the ACT, compared to the national average, the number of people living with disease or injury is similar to the national average.

In 2018, people in the ACT lost 98.5 years of healthy life per 1,000 people due to living with disease or injury, slightly more than the national average of 98.1 years.[1] This has increased slightly from 96.1 years of healthy life lost per 1,000 people in the ACT in 2011.[1]

In 2018, ACT had the second lowest fatal burden, or years of life lost due to premature death, at 79.4 years per 1,000 people (Figure 4). The total fatal burden in the ACT remained relatively unchanged between 2011 and 2018.[1]

Figure 4. Total burden of disease (disability-adjusted life years, years of life lost and years lived with disability) by state and territory, ACT, 2018


Source: Australian Institute of Health and Welfare (AIHW) (2018) ‘Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018’, Australian Burden of Disease Series no. 23, catalogue number BOD 29, AIHW, Australian Government.

Click here to explore the main causes of the burden of disease in the ACT.

Almost half of Canberran adults live with a chronic condition

In the 2017–18 ABS National Health Survey, 48.7% of Canberrans reported having at least one chronic health condition, slightly above the Australian average of 47.2%.[4]

The most common conditions people reported experiencing were:

  • hayfever and allergic rhinitis
  • mental health and behavioural conditions
  • back problems
  • arthritis
  • asthma.[4]

One fifth of Canberrans live with 2 or more chronic conditions

In 2017–18, 11.6% of Canberrans reported having 2 chronic conditions and 8.7% reported having 3 or more chronic conditions in the National Health Survey.[4] This is also known as multimorbidity.[6]

The overlap in risk factors for many chronic diseases means it is common for people to develop multiple chronic conditions.

For example, people who smoke tobacco are at higher risk of developing cancer, respiratory diseases and cardiovascular diseases.[1]

Modifiable Risk Factors

Approximately 38% of the total burden of disease in Australia in 2018 could be prevented by addressing modifiable risk factors.[1]

Modifiable risk factors are factors (behaviours or exposures) which can lead to disease, injury and early death that can potentially be changed. Examples include tobacco use, alcohol intake or physical activity.

Non-modifiable risk factors are factors that can lead to disease, injury or early death that cannot be changed. Examples include gender at birth, age and genetics (sometimes called family history).

The top 5 risk factors contributing to burden of disease nationally in 2018 were all considered modifiable:

  • tobacco use
  • overweight (including obesity)
  • dietary risks
  • high blood pressure
  • alcohol use.[1]

Click here to learn about the contribution of modifiable risk factors to burden of disease in different population groups in the ACT.

Please take a moment to provide feedback on the Chief Health Officer’s Report by completing our short online survey.

References

[1] Australian Institute of Health and Welfare, ‘Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018’, Australian Burden of Disease Series no. 23, catalogue number BOD 29, AIHW, Australian Government, 2018, accessed 24 February 2023.

[2] Australian Institute of Health and Welfare, Deaths in Australia, AIHW, Australian Government, 2022, accessed 24 February 2023.

[3] Australian Institute of Health and Welfare, ‘Health-adjusted life expectancy in Australia: expected years lived in full health 2011, Australian Burden of Disease Study series no.16. BOD 17, AIHW, Australian Government, 2017, accessed 24 February 2023.

[4] Australian Bureau of Statistics, National Health Survey: First Results, ABS website, 2018, accessed 24 February 2023.

[5] Australian Bureau of Statistics, Life Tables, ABS website, 2022, accessed 24 February 2023.

[6] Australian Institute of Health and Welfare, Chronic conditions and multimorbidity, AIHW website, 2022, accessed 24 February 2023.

Page last updated on: 1 Aug 2023