New data and dashboard reiterate that Australia must do more to accelerate progress on health goals
12 December 2024
Australia’s 2024 Burden of Disease study has again ranked chronic conditions as the leading cause of health burden in Australia.
The report released today by the Australian Institute of Health and Welfare (AIHW) has also revealed that living with overweight and obesity is now the leading risk factor for disease burden, with tobacco use, dietary risks and high blood pressure making up the top five modifiable factors. With nearly one third of disease burden avoidable, it’s essential that prevention be prioritised alongside efforts to strengthen our health system.
To this end, the AIHW has also published a brand-new dashboard to assist with monitoring Australia’s progress against the National Preventive Health Strategy 2021-2030 (NPHS) and National Obesity Strategy 2022-2032 (NOS). The Australian Chronic Disease Prevention Alliance (ACDPA) has welcomed the new user-friendly tool, which provides a synthesis of carefully analysed information ‘at-a-glance’.
Australia's chronic disease burden
Chronic diseases like cancers, dementia and heart disease, are again the leading cause of illness and death in Australia, making up nearly two-thirds of our total disease burden. The new Burden of Disease data reinforces what AIHW’s ‘Australia’s Health 2024’ report revealed earlier this year: that more than one in two Australians live with a chronic disease, (often with more than one), and nearly one third of chronic disease illness and death can be prevented, reduced or delayed. Neurological and mental health conditions are increasingly contributing to our health burden, particularly non-fatal burden or living with illness. People are living longer, but not necessarily healthier.
New accountability tool for preventive health priorities
The new accountability tools provide a mid-point report for two important national health strategies aiming to improve the health of Australians, using the latest data to assess if we are on track towards targets specified in the two strategies, looking especially at trends and inequalities. It also provides a platform to monitor progress on an ongoing basis, to support government, policymakers, and programme implementers to prioritise investments, policies and programs to improve the health of communities.
The new data dashboard utilises a ‘traffic light’ report card, against each NPHS target, to visualise regress (red), no change (amber), progress (green) or unknown change between at least two data points.
This new dashboard is an essential tool – it is also very illuminating.
Inadequate investment throttles progress toward healthier lives for all
For example, four years into the life of the NPHS, it is frustrating to see so little green in the report, showing that progress to date has been underwhelming.
With less than six years until the strategy targets are due to be met, we have a lot of work to do to help all Australians have the healthiest start in life, and to live more of their lives in full health. To get there we must see a meaningful increase public health investment in preventive health particularly with respect to health promotion and preventing chronic disease.
Where there’s political will, there’s often a way
With determined prioritisation and investment in tobacco control, it is perhaps unsurprising that progress towards reducing smoking is going well. In promising news, a greater proportion of babies are being exclusively breastfed for longer in line with international recommendations. Australians have also increased levels of physical activity, although there is insufficient data to assess if young children are enjoying the many benefits of being active, and Australians could be doing more strength-based activity.
Optimism can also be found in the improving metrics for birthweight among Aboriginal and Torres Strait Islander babies, giving them the best start in life. Good progress on HPV vaccination is helping position Australia to be one of the first countries to eliminate cervical cancer, although it will take a little longer to see this evidenced in terms of reduced cervical cancer prevalence. With screening programmes important for early detection and intervention to reduce the progression of conditions, it’s concerning that the report shows little relative change in participation in bowel cancer screening and a decrease in participation in breast cancer screening, which may be explained due to health service disruptions during the height of the COVID-19 pandemic.
Challenges requiring attention
With alcohol a known risk factor in multiple chronic conditions, including several cancers, it is worrying that Australia has barely moved the dial on targets to reduce alcohol use among adults by 10% by 2025, and by 15% by 2030. Adolescents are still not showing significant signs of reducing alcohol use, and Australians are still consuming alcohol in ways that increase their risk of illness and injury. With obesity both a risk factor and condition co-existing with several other chronic conditions including type 2 diabetes and cardiovascular disease, it’s worrying that we are not doing enough to halt the rise in overweight and obesity as we have committed to do by 2030.
Nutrition is one of the top contributors to health in Australia, yet it is alarming that we are not showing progress on core indicators like increasing health-promoting vegetable consumption, and we are going backwards on fruit intake. The Burden of Disease Study has identified dietary risks as one of the leading contributors to disease burden. Without consistent monitoring, we don’t yet have much needed comparable data to assess progress on some specific dietary risks, like reducing intake of free sugars and sodium, this dashboard will help with future monitoring of progress on these indicators.
Similarly, available data doesn't yet give us a sufficient understanding of progress in improving years lived in full health among those experiencing significant socio-demographic challenges such as living in poverty and regional and remote areas of Australia, and First Nations people. Having up to date comparable data is essential, given that baselines from 2018 paint a stark picture of significant health inequities among these priority populations that must be resolved.
Enhancing monitoring can enhance progress
Australia is one of more than 190 countries working towards the global target to reduce early death from chronic disease by 25% by 2025, and by one third by 2030 – targets Australia has adapted to ensure we pursue healthier lives as well as long ones. To get there, we have agreed to reach key milestones along the way, such as voluntary targets like improving nutrition and physical activity, reducing tobacco and alcohol use, reversing hypertension, and halting the rise in obesity – all of which complement targets in the NPHS and NOS.
Time to step up and lead on healthier lives for all
With a United Nations High-Level Meeting on Non-Communicable Disease and Mental Health scheduled for late 2025, it is timely to take stock nationally as we prepare to take a global view to assess what local and global communities can do together to address the barriers and enablers to more people living healthier lives everywhere, including all Australians.
Accountability is an important tool and enabler by identifying what is being done well and where there is room for improvement. The NPHS points to several other enablers that need greater attention to accelerate progress in areas seeing so little – among them increased investment in prevention, better addressing social and commercial factors that influence health, and coordination across government.
Australia has shown great leadership in health promotion and preventive health over several decade. With an election and federal budget in the first half of 2025 these new reports from AIHW reiterates the need for government to step up in 2025 to take strong leadership and make investments that will have a lasting impact by ensuring more Australians enjoy healthier lives for longer.
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