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. 2023 Aug;8(8):e585-e599.
doi: 10.1016/S2468-2667(23)00123-8.

The burden and trend of diseases and their risk factors in Australia, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

GBD 2019 Australia Collaborators

The burden and trend of diseases and their risk factors in Australia, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

GBD 2019 Australia Collaborators. Lancet Public Health. 2023 Aug.

Erratum in

Abstract

Background: A comprehensive understanding of temporal trends in the disease burden in Australia is lacking, and these trends are required to inform health service planning and improve population health. We explored the burden and trends of diseases and their risk factors in Australia from 1990 to 2019 through a comprehensive analysis of the Global Burden of Disease Study (GBD) 2019.

Methods: In this systematic analysis for GBD 2019, we estimated all-cause mortality using the standardised GBD methodology. Data sources included primarily vital registration systems with additional data from sample registrations, censuses, surveys, surveillance, registries, and verbal autopsies. A composite measure of health loss caused by fatal and non-fatal disease burden (disability-adjusted life-years [DALYs]) was calculated as the sum of years of life lost (YLLs) and years of life lived with disability (YLDs). Comparisons between Australia and 14 other high-income countries were made.

Findings: Life expectancy at birth in Australia improved from 77·0 years (95% uncertainty interval [UI] 76·9-77·1) in 1990 to 82·9 years (82·7-83·1) in 2019. Between 1990 and 2019, the age-standardised death rate decreased from 637·7 deaths (95% UI 634·1-641·3) to 389·2 deaths (381·4-397·6) per 100 000 population. In 2019, non-communicable diseases remained the major cause of mortality in Australia, accounting for 90·9% (95% UI 90·4-91·9) of total deaths, followed by injuries (5·7%, 5·3-6·1) and communicable, maternal, neonatal, and nutritional diseases (3·3%, 2·9-3·7). Ischaemic heart disease, self-harm, tracheal, bronchus, and lung cancer, stroke, and colorectal cancer were the leading causes of YLLs. The leading causes of YLDs were low back pain, depressive disorders, other musculoskeletal diseases, falls, and anxiety disorders. The leading risk factors for DALYs were high BMI, smoking, high blood pressure, high fasting plasma glucose, and drug use. Between 1990 and 2019, all-cause DALYs decreased by 24·6% (95% UI 21·5-28·1). Relative to similar countries, Australia's ranking improved for age-standardised death rates and life expectancy at birth but not for YLDs and YLLs between 1990 and 2019.

Interpretation: An important challenge for Australia is to address the health needs of people with non-communicable diseases. The health systems must be prepared to address the increasing demands of non-communicable diseases and ageing.

Funding: Bill & Melinda Gates Foundation.

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Conflict of interest statement

Declaration of interests SMSI reports support for the present manuscript from a National Health and Medical Research Council (NHMRC) Investigator Grant and from a National Heart Foundation Vanguard Grant. BA reports grants or contracts form Rebecca Cooper Foundation for Investigator-initiated trial grant and a Nat Rem Grant for Investigator-initiated trial biomarkers assessment support, and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Nat Rem and IRACON, all outside the submitted work. PA reports support for the present manuscript from the Australian College of Applied Professions Discipline of Psychological Sciences, Sydney, Australia. BTB reports consulting fees from AstraZeneca, Bristol-Myers Squibb, Janssen, LivaNova, Lundbeck, Novartis, Otsuka, Pfizer, Servier, Wyeth, Biogen, Angelini, Sumitomo Pharma, and Boehringer-Ingelheim, and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Bristol-Myers Squibb, Janssen, LivaNova, Lundbeck, Novartis, Otsuka, Pfizer, Servier, Wyeth, Biogen, Angelini, Sumitomo Pharma, and Boehringer-Ingelheim, all outside the submitted work. AMB reports grants from Australian National Health and Medical Research Council, Bone and Joint Decade Foundation, Arthritis and Osteoporosis Western Australia, Department of Health Government of Western Australia through payments to their institution, consulting fees from WHO, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from American College of Rheumatology, and support for attending meetings or travel from WHO, all outside the submitted work. RB reports grants from the NHMRC, Medical Research Future Fund, Arthritis Australia, HCF Research Foundation, Cabrini Foundation, and Australian Government Department of Health, all as payments to their institution, and royalties from UpToDate for Plantar fasciitis, all outside the submitted work. SRC reports grants or contracts from the Wellcome Trust, Australian Department of Veterans Affairs, National Institutes of Mental Health, Janssen-Cilag Australia, Australian Defense Science and Technology Group, and the Australian National Health and Medical Research Council, consulting fees from Lundbeck-Otsuka Australia, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Lundbeck-Otsuka Australia, support for attending meetings or travel from Janssen-Cilag Australia, participation on a Data Safety Monitoring Board or Advisory Board with Verbatim Trial Orygen Australia, and leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, with executive Committee Member Society for Mental Health Research, all outside the submitted work. KML reports support for the present manuscript from an NHMRC Investigator Grant (APP1173803). PBM reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Janssen (Australia), and Sanofi (Hangzhou), and participation on a Data Safety Monitoring Board or Advisory Board with Janssen (Australia), all outside the submitted work. AEP reports support for the present manuscript from the NHMRC as a grant paid to their institute. JS reports grants or contracts from the National Health and Medical Research Council, the Department of Education, Victoria, and the Medical Research Future Fund, and leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, as President of the Asia Pacific Society for Physical Activity, a not-for-profit professional society. AES reports grants or contracts from the National Health and Medical Research Council of Australia, Leadership Investigator Grant ID2017504, personal payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Servier, Novartis, Omron, Aktiia, and Medtronic, support for attending meetings or travel from Servier, participation on Abbot Advisory Board, and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as Secretary of Australian Cardiovascular Alliance and co-Chair of National Hypertension Taskforce of Australia, all outside the submitted work. HS reports grants to their institute from the Australian Government, Department of Health, Medical Research Future Fund, Western Australian Government Department of Health, Bone and Joint Decade Foundation (Sweden) Curtin University (Australia), Institute for Bone and Joint Research (Australia), and Canadian Memorial Chiropractic College (Canada), all outside the submitted work. SS reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events for an online lecture on Cultural consideration for pain care delivered on Jan 26, 2023, and travel accommodation for delivering a talk on Technologies for pain education in developing countries conducted by the Pain Education SIG of the International Association for the Study of Pain, all outside the submitted work. MAS reports leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, as Vice President of Kidsafe Victoria, Director Council of the Aged Victoria, and Director Australasian Society of Autism Research, outside the submitted work. JS reports stock or stock options in Anagram kommunikation, MinForskning, and Symptoms Europe, outside the submitted work. AGT reports grants or contracts from National Health and Medical Research Council (Australia; grant numbers 1143155, 1171966, and 1182071), and the Medical Research Future Fund (Australian Government; grant number 2015976), as payments to their institution outside the submitted work. MW reports consulting fees from Amgen and Freeline, participation on a Data Safety Monitoring Board or Advisory Board with Staree DSMB, all outside the submitted work. All other authors declare no competing interests.

Figures

Figure 1
Figure 1
Changes in the ranking of age-standardised rate of disability-adjusted life-years between 1990 and 2010 and 2010 and 2019 for the leading causes of diseases, disabilities, and injuries in Australia
Figure 2
Figure 2
Leading level-4 risk factors for deaths associated with non-communicable and communicable diseases and injuries in Australia in 1990, 2010, and 2019 Values in parentheses indicate the percent contribution of the risk factor towards total deaths. Dotted lines indicate no change in the relative ranking between the years. Red lines indicate an increase in the relative ranking and green lines indicate a decrease in the relative ranking. Rankings are based on the percent contribution of the risk factor towards total deaths. Values in parentheses indicate the percent contribution of the risk factor towards total DALYs. Dotted lines indicate no change in the relative ranking between the years. Red lines indicate an increase in the relative ranking and green lines indicate a decrease in the relative ranking. Rankings are based on the percent contribution of the risk factor towards total DALYs. DALYs=disability-adjusted life-years.
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