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ACT Chief Health Officer’s Report: Burden of Disease
Main causes of the disease burden
Chronic disease and injury cause most of the disease burden
Most of the disease burden in Australia in 2018 was caused by chronic disease or injury rather than acute illness.
The leading types of diseases or conditions contributing to the total burden of disease for people living in the ACT in 2018 were the same as 2011 (Figure 5):
cancer
mental health conditions and substance use disorders
These top contributors to the burden of disease in the ACT in 2018 were consistent with national data.[1]
Musculoskeletal conditions include arthritis, gout, rheumatoid arthritis and back pain and problems.[1] Mental health conditions include depressive disorders, anxiety disorders and schizophrenia.[1] Substance use disorders include alcohol use disorders and drug use disorders.[1]
In the ACT in 2018, the leading types of diseases or conditions contributing to the total fatal burden, or years of life lost (YLL) due to premature death, as shown in Figure 6 were:
Mental health conditions and substance use disorders cause the most years lived with disability
In the ACT in 2018, the leading types of diseases contributing to the total non-fatal burden, or years lived with disability (YLD), as shown in Figure 7 were:
mental health conditions and substance use disorders
These remain the same as 2011 and are consistent with national trends.[1] The non-fatal burden for mental health conditions and substance-use disorders and musculoskeletal conditions increased slightly between 2011 and 2018 (Figure 7).
It is important to note that the other musculoskeletal conditions, which include systemic lupus erythematosus, fibromyalgia and tendonitis, were excluded as a category from the disease rankings in 2018.
Back pain and problems are a leading and rising cause of disease burden
People in both the ACT and Australia lost more years of healthy life due to back pain and problems in 2018 than almost any other specific condition, and this burden seems to be rising (Table 1).
Canberrans lived more years with disability caused by back pain and problems than the average Australian in 2018.[1] Back pain and problems caused an increasing proportion of the disease burden.
People with back problems often live with pain, disability and psychological distress.[2] They are less likely to be employed and often have other chronic diseases and long-term conditions.[3]
Back pain and problems have a range of causes relating to work, lifestyle, injuries or diseases.[2]
Some types of back pain and problems can be prevented through measures that support the community in:
People in the ACT and Australia experienced lower total burden of disease due to coronary heart disease in 2018 than in 2011 (Table 1).
Between 2011 and 2018, Canberrans lived the least number of years with disability caused by coronary heart disease compared to other jurisdictions.[1] The proportion of the disease burden caused by heart disease decreased over this time, both in the ACT and nationally (Table 1).
The ACT had lower than national average rates of heart-related hospitalisations between 2012-2016 and lower rates of heart-related deaths between 2012-2020.[4]
Lower rates of coronary heart disease in the ACT can potentially be partly explained by a lower prevalence of key risk factors compared to the Australian average including:
However, coronary heart disease is still the second leading cause of disease burden in the ACT. Some coronary heart disease can be prevented by measures that support the community in:
maintaining a healthy weight
not smoking
limiting alcohol consumption
exercising regularly
having a healthy diet
reducing stress
good management of risk factors such as high blood pressure, high cholesterol and diabetes.[6]
Canberrans have higher rates of anxiety disorders
Between 2011 and 2018, Canberrans experienced the highest rates of burden of disease due to anxiety than any other state or territory.[1]
While the ACT’s rates of anxiety measured by burden of disease studies are above the national average, they remained consistent between 2011 and 2018.[1] This is despite an increase in the uptake of treatments in recent decades.[7]
The recognition and causes of anxiety are complex and it is therefore hard to determine why rates of anxiety are higher in the ACT than nationally. Risk factors for anxiety include:
family history of mental health conditions
having another mental health disorder
ongoing stressful situations such as problems at work or unstable housing
We have an opportunity to better understand the experiences of Canberrans so we can work to reduce rates of anxiety across our community.
Anxiety diagnoses have increased over time
In the ACT General Health Survey in 2021, 23.2% of females and 11.9% of male respondents reported an anxiety diagnosis.[9] This has increased from 2011 where 7.9% of females and 6.4% of males reported an anxiety diagnosis.
While the impacts of the COVID-19 pandemic were felt from 2020 onwards, between 2019 and 2021 self-reported rates of anxiety for both females and males increased only slightly.[9]
Self-reported rates of anxiety diagnoses over time may reflect an increase in people seeking professional help and getting diagnosed, not necessarily an increase in prevalence.[10]
Disease burden differs for males and females
The leading types of diseases or conditions causing the disease burden differed between ACT males and females in 2018 (Figure 8).
Cancer, cardiovascular disease, and mental and substance use disorders were the 3 leading causes in men. For women the leading causes were musculoskeletal disorders, mental and substance use disorders and cancer.
The more recent 2022 burden of disease study reported that Australian males experienced a higher total burden of disease than females (1.1 times the rate of females).[1]
Men were 1.5 times more likely than women to die prematurely, whereas women were 1.1 times more likely than men to be living with chronic disease or injury.[1] ACT-specific data for 2022 is not available for comparison.
Nationally, COVID-19 caused the eighth highest burden among specific diseases in 2022, contributing 2.7% to the total burden.
The burden of disease from COVID-19 was mostly due to premature death and had the greatest impact on those aged 75-84 years.[11]In 2022, COVID-19 was the fifth specific disease or condition contributing to the fatal burden, or years of life lost.[11]
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