Our challenge: to live long and prosper

There is some good news and bad news about the state of our health in the latest report from the Australian Institute of Health and Welfare (AIHW). 

First, the good news from the biennial review, Australia’s Health 2024: We are living 40% longer than Australians born at the start of the 20th Century. 

Children born today can expect to live 81.2 years for boys and 85.3 years for girls.

Overall life expectancy is now higher than it was before the COVID-19 pandemic, and our longevity is the fourth best among OECD countries. 

The not-so-good news is we are spending more time in poor health, mainly due to chronic disease and mental illness. Chronic conditions contributed to around 90% of all deaths each year from 2002 to 2022.  

This is placing more pressure and demand on the health system. For example, the average number of yearly GP visits per person increased from 3.8 in 1984 to 6.8 in 2022. 

There have also been considerable increases in wait times for planned surgery. In 2022–23, 50% of patients were admitted for planned surgery within 49 days of being placed on the waiting list, up from 40 days in the previous year, and 9.6% of patients waited longer than 365 days, up from 6.3%. 

The report found most Australians – about six in 10 – live with chronic illness. That’s expected to increase, as ageing Australians are likely to have more than one chronic condition. 

Chronic illnesses have contributed to about 90% of deaths in the nation for the years between 2002 to 2022. 

For example, chronic diseases such as cardiovascular diseases and cancer were common causes of death among people over 45, and dementia was the most common cause of death among people over 85. 

Commenting on the report, the Australian Medical Association (AMA) has emphasised the link between chronic disease and mental health. 

It says conditions such as chronic arthritis, diabetes, hypertension, and dementia, are intimately wrapped up in the mental health of the community, and carers are at risk as well.  

“… it's probably no surprise that we have a community where mental health is so important, where people in emotional distress, people under pressure, and that is not only a burden of compassion but it’s also a burden economically,” AMA president Professor Steve Robson said. 

“So, we need to make sure that we deal with these things because they’re just so important for the overall economics of the country. They’re not just a compassionate issue.” 

COVID-19 was responsible for a decline in life expectancy – the first such dip in 50 years. In 2022, it was the third leading cause of death.

From the beginning of the pandemic to March this year, more than 22,000 people in Australia died from or with the virus. 

Life expectancy is also dropping in other developed western countries. 

There have been greater declines in the United States – from 78.9 to 76.4 years – and the United Kingdom – from 81.3 to 80.4.  

Health economist, Martin Hensher, told ABC News, “The continuous trend of life expectancy improvement may be running out of steam a bit. 

“We haven’t seen evidence for that yet in Australia. But that’s the wider trend that we need to keep an eye on.” 

We may be living longer, but the AIHW also looked at the quality of life we can expect in the senior years, before debilitating disease and conditions kick in. 

People aged 65 can expect to live another 15.3 years for men, and 16.7 for women.  

Physical disability is another consideration for ageing people. 

Men who were aged 65 in 2018, could, on average, expect to live a further 9.3 years without disability, and 11 years with some level of disability, including around 3.5 years with severe or profound disability. 

Women aged 65 in 2018 could expect 10 years without disability, 12 years with some level of disability, including around 5.5 years with severe or profound disability. 

Dementia, including Alzheimer’s disease, is the overall leading cause of death among people aged 65-plus, closely followed by coronary heart disease. 

However, there were differences in the leading cause of death across the older age groups. In 2022, the leading cause of death for people aged 65–74 was coronary heart disease followed by lung cancer. 

Coronary heart disease was also the leading cause of death for people aged 75–84. For people aged 85 and over, dementia was the leading cause of death, followed by coronary heart disease. 

Men and women also had different leading causes of death. For men, coronary heart disease was the leading cause across all older age groups. For women aged 65–74 - the leading cause was lung cancer and for all other older age groups, it was dementia.