What is the burden of chronic disease?

Chronic diseases are the leading causes of death in Australia

  • 7 out of 10 globally

    According to the World Health Organization, 7 of the 10 leading causes of death globally in 2019 were chronic diseases. 1
  • 9 out of 10 in Australia

    In Australia, chronic diseases cause 9 out of every 10 preventable deaths 2  and account for 85% of years lost due to ill health or early death. 3

This means that although Australians are living longer, we are living more years in ill health – largely due to preventable chronic disease.

The cost of chronic disease to the community

The burden of disease is not equal among all Australians. Lower socioeconomic groups, people living in rural or remote areas, and Aboriginal and Torres Strait Islander peoples are disproportionally affected. If all Australians experienced the same disease burden as the most advantaged Australians do, one fifth of the burden of chronic disease would be reduced. 3

The cost of chronic diseases to the community is considerable, and growing. Treatment of chronic diseases now consumes more than a third of health spending; in 2018–19 about $24 billion was attributable to potentially avoidable risk factors. 4

According to the Global Burden of Disease Study, over a third (38%) of Australia’s disease burden is attributable to risk factors such as tobacco use, obesity, dietary risks, high blood pressure and alcohol use. 3 Additionally, these risk factors cause half (54%) of all chronic disease deaths in Australia.

Aerial view of Finke, Northern Territory, an aboriginal community in the geographical center of Australia. Image by Henrique Félix on Unsplash

What are the trends in chronic disease in Australia?

The prevalence of chronic diseases is increasing in Australia. 5  It is expected that it will become more common for people to have two or more chronic conditions at the same time. 5

Just under half (47%) of Australians had one or more chronic conditions in 2017–18, an increase from 42% of people in 2007–08. This is associated with several factors, including our ageing population and risk factors such as poor diet and physical inactivity. 5

There has been an increase or no decrease in diseases that continue to make a significant number of Australians unwell, such as arthritis, diabetes, asthma, mental ill health and back pain. 6

Deaths from some chronic diseases are decreasing due to better treatments and fewer people smoking. Nevertheless, despite significant reductions in smoking in recent years, tobacco consumption remains the modifiable risk factor with the largest health burden associated. 7

There is continued inequity in the distribution of burden of disease based on socioeconomic group and remoteness. That is, people with different levels of educational attainments, income or housing stability are more or less likely to experience different risk factors for chronic disease. 8

A child enjoying the beach at Gibson Steps, National Park, Great Ocean Road, Port Campbell VIC, Australia. Photo by Colin + Meg on Unsplash

How many Australians have a chronic disease?

  • Nearly half (47%) of Australians (more than 11 million people) are estimated to have one or more chronic diseases. 2
  • 80% of Australians aged 65 and over are estimated to have one or more chronic diseases. 2
  • 20% of Australians (4.9 million people) have two or more chronic diseases. Multimorbidity is more common with age. 2
  • In 2018, the five disease groups that caused the most burden were cancer, musculoskeletal conditions, cardiovascular diseases, mental and substance use disorders and injuries. 6
  • More than half of Australian women enter pregnancy with overweight or obesity – a key determinant of both maternal and childhood obesity. 10
  • One in five Australian children is overweight or obese at age five years. 11

What is the health burden of chronic disease?

Chronic diseases are the major cause of death in Australia and the biggest contributor to premature death and disability. According to the Australian Institute of Health and Welfare, 2 chronic disease caused the following in Australia:

  • In 2015

    66% of the total burden of disease (fatal and non-fatal)
  • In 2017–18

    5 in 10 hospitalisations (51%)
  • In 2018

    9 in 10 preventable deaths (89%)

How does chronic disease impact quality of life?

Chronic conditions cause disability and lives lived in ill health. They reduce people’s ability to enter or remain in the workforce, or to contribute to their families and communities. 2

  • Half of people aged 18 and over who have more than one chronic disease experience disability, restriction or limitation compared with 7.9% of people of the same age with no long-term conditions.
  • Over one third (35%) of people with chronic diseases report they experience high or very high levels of psychological distress (compared with 4.3% of those without chronic disease).
  • Most (88%) people with chronic disease experience recent pain, compared to 55% of those without chronic disease.
  • Compared with people of the same age, people with chronic illnesses are 60% less likely to participate in the labour force, are less likely to be employed full time, and are more likely to be unemployed than people without chronic disease.
Grandfather and grandson going along a sandy path to the beach near Melbourne, Australia. Photo by Johan Mouchet on Unsplash

What is the economic burden of chronic disease?

Preventable chronic diseases have a significant economic impact on Australia. 12  Total health system spending due to potentially avoidable risk factors in 2018–19 was $24 billion. A third of this was due to overweight and obesity and tobacco use. 4

The burden of chronic diseases affects different parts of the economy.

For the health system, the economic costs of chronic disease include identifying, diagnosing, managing and providing ongoing surveillance of disease.

Chronic diseases and their risk factors are also associated with a range of other costs to government, industry and society beyond the health system. These include increased crime and violence from alcohol consumption, reduced productivity, increased absenteeism and presenteeism (failing to perform at one’s best at work due to illness), premature retirement or mortality.

The economic costs of lower productivity are often estimated to be much larger than healthcare and other costs to government.

The evidence suggests that even small changes in the prevalence of risk factors for chronic disease are likely to lead to significant reductions in the health burden for individuals and the healthcare system, as well as a reduction in economic and societal costs for communities, businesses and governments. 7

A busy modern office full of people at desks. Photo by Alex Kotliarskyi on Unsplash

Find out more

The publications and other resources listed in the references below may be useful to those looking for more detailed and in-depth evidence around the benefits of chronic disease prevention.

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  1. World Health Organization 2020. The top 10 causes of death. Accessed 20 April 2022 https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
  2. Australian Institute of Health and Welfare 2020. Australia’s health 2020 snapshots. Australia’s health series no. 17. Canberra: AIHW. https://www.aihw.gov.au/reports-data/australias-health/australias-health-snapshots
  3. Global Burden of Disease Collaborative Network 2020. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle, United States: IHME. Accessed 20 April 2022.
  4. Australian Institute of Health and Welfare 2022. Health system spending per case of disease and for certain risk factors. https://www.aihw.gov.au/reports/health-welfare-expenditure/health-system-spending-per-case-of-disease/contents/about
  5. Australian Institute of Health and Welfare 2021. Chronic condition multimorbidity. https://www.aihw.gov.au/reports/chronic-disease/chronic-condition-multimorbidity/contents/chronic-conditions-and-multimorbidity
  6. Australian Institute of Health and Welfare. 2021. Australian Burden of Disease Study 2018: key findings. Canberra: AIHW. https://www.aihw.gov.au/getmedia/d2a1886d-c673-44aa-9eb6-857e9696fd83/aihw-bod-30.pdf.aspx?inline=true
  7. Howse, E, Crosland, P, Rychetnik, L, Wilson, A. The value of prevention: An Evidence Check rapid review brokered by the Sax Institute for the Centre for Population Health, NSW Ministry of Health. Sydney, Australia: The Australian Prevention Partnership Centre, 2021.
  8. Australian Bureau of Statistics. 2071.0 – Census of Population and Housing: Reflecting Australia – Stories from the Census, 2016. https://www.abs.gov.au/ausstats/[email protected]/Lookup/by%20Subject/2071.0~2016~Main%20Features~Socio-Economic%20Advantage%20and%20Disadvantage~123
  9. Australian Institute of Health and Welfare. Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Canberra, Australia: Australian Institute of Health and Welfare; 2019. https://www.aihw.gov.au/reports/burden-of-disease/burden-disease-study-illness-death-2015/contents/table-of-contents
  10. Australian Institute of Health and Welfare. 2022. Australia’s mothers and babies. Accessed 23 Aug 22 https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies-data-visualisations/contents/antenatal-period/body-mass-index
  11. Australian Institute of Health and Welfare 2020. Overweight and obesity among Australian children and adolescents. Canberra: AIHW. https://www.aihw.gov.au/reports/overweight-obesity/overweight-obesity-australian-children-adolescents/summary
  12. Crosland P, Ananthapavan J, Davison J, Lambert M, Carter R. The health burden of preventable disease in Australia: a systematic review. Australian & New Zealand Journal of Public Health. 2019;43(2):163-70. doi:10.1111/1753-6405.12882