Health Status and Outcomes

Self-assessed health status

Table 15: Self-assessed health status, people 15+, 2014 (ABS General Survey)

 

MC

IR

OR/rem

Excellent/v good

58.2

55.6

54.4

Fair/poor

15.0

16.7

19.1

Note: percentages appear to be crude
Source: ABS General Health Survey 2014

http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4159.0Main+Features12014?OpenDocument

Table 16: Self-assessed health status, people 15+,2011-12 (ABS National Health Survey)

 

MC

IR

OR/rem

Excellent/v good

 

 

 

Fair/poor

13.9

16.2

16.4

Source: http://www.adelaide.edu.au/phidu/maps-data/data/

The data in the table above echoes findings from the 2007-08 National Health Survey, which found that people who lived outside major cities were 15% more likely to rate their health as poor or very poor. The comparison figure from 2011-12 above is 17% more likely. http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features30Mar+2011#Endnote14

 

Long term health condition

Percentage with long-term health condition 2014, people 15+: MC 55.2%, IR 61.6%, OR/rem 56.8% (Percentages appear to be crude). Source: ABS General Health Survey 2014 http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4159.0Main+Features12014?OpenDocument

 

Burden of disease

The latest report about which we are aware is the 2003 AIHW burden of disease report http://www.aihw.gov.au/publication-detail/?id=6442467990 (Begg S, Vos T, Barker B, Stevenson C, Stanley L, Lopez AD, 2007. The burden of disease and injury in Australia 2003. PHE 82. Canberra: AIHW.)

Details for two key concepts: Disability adjusted life years (DALY) and healthy life expectancy (HALE):

The DALY extends the concept of potential years of life lost due to premature death (PYLL) by including equivalent years of ‘healthy’ life lost by virtue of being in states of poor health or disability. A DALY for a disease or health condition is calculated as the sum of the years of life lost due to premature mortality (YLL) in the population and the equivalent ‘healthy’ years lost due to disability (YLD) for incident cases of the health condition:

DALY = YLL + YLD

where

  • YLL = number of deaths x standard life expectancy at age of death and
  • YLD = incidence x duration x severity weight.

HALE provides an estimate of the average years of equivalent ‘healthy’ life that a person can expect to live at various ages. HALE is related to life expectancy, which provides an estimate of the average years of life a person can expect to live at various ages given current risks of mortality. HALE extends this concept by reducing the estimated duration by the proportion of time spend at each age in states less than perfect health, adjusted for the relative severity of those health states. The sum of prevalent years lost due to disability (PYLD) across all causes is used to derive this ‘severity-weighted’ proportion for each age.

Tab1e 17: Life expectancy (unadjusted years) at birth by area and sex, Australia 2003

 

Males

Females

Persons

Major cities

78.8

(78.7–78.9)

83.5

(83.4–83.6)

81.2

(81.1–81.2)

Regional

77.5

(77.4–77.7)

82.7

(82.5–82.8)

80.0

(79.9–80.1)

Remote

75.4

(74.8–76.1)

81.5

(80.9–82.2)

78.1

(77.6–78.6)

Australia

78.3

(78.2–78.4)

83.2

(83.1–83.3)

80.7

(80.7–80.8)

Source:http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442459747

Life expectancy decreases with increasing remoteness, being respectively 1 year less in regional (rural) areas and 3 years less in remote areas. Life expectancy is a fraught statistic. Death rates for older non-Indigenous people (from other sources) are lower in remote areas than for their counterparts in major cities, in contrast to the death rate for younger people which tends to be higher. This is likely due to migration of older (less robust and less healthy) people to regional cities or major cities so as to access services, leaving the more robust and more healthy in each age group, who have lower death rates, remaining in remote areas.

A more advanced (but equally poor – from a regional analysis perspective) measure of Life expectancy is the HALE – the Health Adjusted Life Expectancy.

 

Table 18: Health Adjusted Life Expectancy (years)

 

Health adjusted life expectancy (HALE)

Life expectancy at birth lost due to disability (%)

 

 

at birth

at age 60

 

 

 

Males

Females

Persons

Males

Females

Persons

Males

Females

Persons

 

Major cities

71.3

75.6

73.5

17.5

20.8

19.2

9.6

9.4

9.5

 

Regional

69.6

74.5

72

16.5

20.1

18.3

10.3

9.8

10.1

 

Remote

67.3

72.3

69.5

15.4

18.5

16.8

10.8

11.3

11

 

Australia

70.6

75.2

72.9

17.1

20.5

18.9

9.8

9.6

9.7

 

                       

Source: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442459747

 

Table 19: Differentials by burden (DALYs), 2003

 

 

standardised rate ratio

 

Broad cause group

Australian rate (per 1,000)

MC

Regional

Remote

% diff high/low

% of total difference

Cancer

25.1

0.98

1.04

0.98

7.0

4.6

Cardiovascular

23.8

0.96

1.07

1.10

14.6

9.1

Mental

17.6

0.98

1.05

1.06

8.5

4.0

Neurological

15.7

0.99

1.03

1.03

4.2

1.8

Chronic respiratory

9.4

0.97

1.04

1.30

33.6

8.3

Diabetes

7.2

0.94

1.08

1.93

105.6

19.5

Unintentional injuries

6.3

0.87

1.24

1.92

121.3

18.1

Musculoskeletal

5.3

0.95

1.10

0.99

16.0

2.2

Genitourinary

3.3

1.00

0.99

1.11

12.3

1.1

Intentional injuries

3.0

0.90

1.13

2.26

151.5

11.0

All causes

132.4

0.97

1.06

1.22

26.5

100.0

Source: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442459747

% diff high/low column indicates those conditions for which there are large and small proportional inter-regional differences, while % of total difference column indicates those conditions which are most responsible for making overall rural rates higher. So for example, the burden of disease due to Diabetes is more than twice as high in remote areas as in Major cities, with Diabetes being responsible for almost 20% of the higher rate outside major cities.

From the Tables above:

Compared with Major cities, life expectancy is 1 year less in regional areas, and three years less in remote areas. As a health measure, this is likely to be an underestimate as older people with health issues tend to move to less remote areas so as to access services.

Compared with Major cities, HALE at birth is 1.5 years less in regional areas and 4 years less in remote areas.

Compared with Major cities, the burden of disease (expressed as DALYs) is 9% and 26% higher in regional and remote areas.

“Diseases” for which proportionally large differences exist between the major cities and regional/remote area burdens include intentional (152%) and unintentional (121%) injuries, and diabetes (106%).

The “diseases” which contribute most to the additional burden of disease in rural/remote areas include diabetes (20% of the additional burden), unintentional injuries (18%), intentional injuries (11%), cardiovascular diseases (9%) and chronic respiratory diseases (8%).

In 2015, AIHW released an update on Burden of Disease which described years of life lost for Indigenous and non-Indigenous people by Remoteness.

 

Table 20: Age-standardised YLL (Years of life lost) rates (per 1,000 population), by Indigenous status and remoteness, 2010

 

MC

IR

OR

R

VR

 

YLL per 1000 population

Indigenous

195

181

242

339

293

Non-Indigenous

88

103

108

103

108

Source: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129550616

The burden of disease (as expressed by years of life lost) tends to increase with remoteness, both for Indigenous and non-Indigenous people.

From the Table above:

The burden for Indigenous people is two to three times that for non-Indigenous people, being just under 200 years per 1000 population in MCs and inner regional areas, around 250 years per 1000 population in Outer regional areas and around 300 years per 1000 population in remote areas.

The burden for non-Indigenous people is much lower at around 90 years per 1000 population in Major cities, and between 100 and 110 years per 1000 population in regional and remote areas.

Extrapolating the Table above based on the populations given earlier in this little book of rural health numbers, gives the Table below. Table 21 shows a substantial burden in Major cities and regional areas, as a consequence of the relatively large populations in those areas.

 

Table 21: Approximate years of life lost, by Indigenous status and remoteness, 2010

 

MC

IR

OR

R

VR

 

YLL

Indigenous

45,463

26,731

35,363

17,382

26,853

Non-Indigenous

1,359,723

408,225

203,072

27,130

12,064

Total

1,405,186

434,955

238,436

44,513

38,917

Derived by NRHA.

Prevalence of chronic disease

Available prevalence of disease data is of variable quality. Many of the sources are not age standardised, much of the data is self-reported in surveys (ie relies on the respondent knowing, understanding and remembering details of their health, as well as relying in sampling as opposed to census).  Sampling in remote areas is often sparse or avoided, so it can be hard to judge what is happening in these remote areas. Surveys which heavily focus on the health of Indigenous people often oversample in remote areas; such surveys may provide some clues as to prevalence of chronic disease in remote areas.

Some good data is unfortunately dated.

Diabetes (type 2): There is no clear difference between the areas. Age standardised rates show non-significantly and marginally higher rates outside Major cities (14% higher in 2007-08 (Table CD1)), but slightly lower rates in 2011-12 (Table CD2)). Age standardised rates in 2011-12 based on fasting glucose testing show rates in regional and remote areas not significantly different from those in Major cities. Estimates of crude rates (Tables CD3 and CD4) show very slightly higher rates outside major cities, but from the available data, the statistical significance is unclear.

Age standardised prevalence of ischaemic (coronary) heart disease was not clearly higher outside major cities compared with inside major cities in 2007-08 (Table CD1), but crude rates were about 40% higher outside Major cities in 2011-12 (Table CD3).

Crude prevalence of heart, stroke and vascular disease was 15% higher outside MCs compared with inside MCs Table CD4 (but statistical significance was unclear).

Crude prevalence of cardiovascular disease appeared to be 20% higher outside Major cities, compared with inside Major cities (Table CD3).

The age standardised prevalence of hypertensive disease outside Major cities was 15% higher in 2007-08 (Table CD1), and appears similar or slightly higher in 2011-12 (Table CD2). Crude rates appeared about 20% higher outside major cities (Table CD4).

The age standardised prevalence of arthritis in rural and remote areas was 13% higher than in major cities in 2007-08 (Table CD1) and similarly higher in 2011-12 (Table CD2). Crude rates are also slightly higher outside Major cities (Table CD4).

Age standardised prevalence of asthma in rural areas was 20% higher than in Major cities in 2007-08 (Table CD1) while age standardised prevalence in 2011-12 appeared around 30% higher in Inner regional areas (Table CD2).

Age standardised prevalence of back pain was 23% higher in rural areas than in Major cities (Table CD1). Crude rates in 2011-12 were 25% higher in rural areas compared with Major cities (Table CD4).

 

AGE STANDARDISED ESTIMATES

Table CD1: Self-reported, age standardised long term health conditions outside Major cities, 2007-08

Source:http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/0/6715DC9DE00E1C6...$File/41020_HealthOMC_Mar2011.pdf  sighted 19/7/15

 

Table CD2: Prevalence of some chronic diseases, 2011-12, Age standardised rates

 

MC

IR

OR/remote

 

Age standardised rate per 100 population

Diabetes (type 2) (18+)

5.6

4.7

5.1

High blood cholesterol (18+)

31.7

35.8

33.9

Mental or behavioural problems

12.8

15.5

15.1

Disease of circulatory system

16.9

17.7

18.6

Hypertensive disease

10.1

10.1

11.5

Disease of respiratory system

28.1

31.4

28.3

asthma

9.6

12.4

9.4

COPD

2.2

3.0

2.2

Musculoskeletal disease

26.9

29.8

28.9

Arthritis

14.4

15.5

15.7

Source:  ABS National Health Survey via PHIDU http://www.adelaide.edu.au/phidu/maps-data/data/
Note: information on statistical significance was not provided.

 

CRUDE ESTIMATES

Table CD3: Crude self-reported prevalence of chronic disease (aged 18+), 2011-12

 

MC

IR

OR/remote

 

Percent

Cardiovascular disease

20

25

27

Coronary heart disease

3.1

4.3

4.4

Stroke

1.4

1.6

1.5

Diabetes (type 2)1

5.3

5.5

6.1

Diabetes (type 2)2

4.8

5.5

5.3

CKD3

10.1

10.7

8.7

One of these chronic diseases

21.0

24.2

23.3

Two of  these chronic diseases

5.8

7.1

6.1

Three of these chronic diseases

1.0

0.9

2.0

Source: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549614
Notes: it appears unlikely that these estimates have been age standardised. Consequently, valid comparison between the populations would likely show slightly lower estimates in IR areas and slightly higher estimates in OR/remote areas, than are shown in this table. Numbers in bold are known to be statistically significantly higher than in Major cities; numbers not bold are either not statistically significantly different from Major cities, or the significance has not been reported.
Note 1: based on HbA1c and self-report
Note2: based on self-report alone
Note3: Chronic Kidney Disease

 

Table CD4: Self reported long term health conditions, 2011-12, crude proportions

 

MC

IR

OR

 

Percent

Arthritis

13.8

17.2

16.4

Asthma

9.7

12.4

9.4

Backpain/problem

11.8

14.9

14.7

COPD

2.2

3.2

2.3

Deafness

9.7

12.5

11.6

Diabetes II

3.9

4.2

4.0

Hayfever and allergic rhinitis

16.9

16.4

16.5

Heart, stroke and vascular disease

4.4

5.1

5.8

Hypertensive disease

9.7

11.3

12.1

Long sightedness

26.5

31.7

30.3

Cancer

1.4

1.8

1.7

Mental and behavioural problems

12.8

15.5

15.1

Osteoporosis

3.4

3.3

2.6

Short sightedness

24.7

20.9

21.4

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012011-12?OpenDocument sighted 22/7/15
Note: Information on relative standard errors was provided, these need to be processed  - next edition.
It may be possible to indirectly age standardise rates for these conditions based on age specific national rates provided by ABS – next edition.

 

OTHER ESTIMATES

Table CD5: Prevalence of Type 2 diabetes, age standardised, based on fasting glucose test and self report, 2011-12

 

MC

IR

OR

R

18 years and older

4.3

4.0

5.2

4.3

25 years and older

4.9

4.6

5.7

5.0

Source: http://pandora.nla.gov.au/pan/146265/20140703-0935/www.coagreformcouncil.gov.au/reports/healthcare/healthcare-australia-2012-13-five-years-performance.html
Note, none of the estimates appeared statistically significantly different from major cities

Crude incidence of new cases of Type 1 diabetes 2011: MC (10.2 per 100,000 pop), IR (12.1), OR (11.3), remote (7.7) (based on data from the National (Insulin treated) diabetes register). Source: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549614

From 2001–2013, the (age standardised) rate of Type 1 diabetes was lower in remote and very remote areas compared with other areas of Australia—7 cases per 100,000 population compared with 11–13 per 100,000, respectively.  Source: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129550898

 

Table CD6: Age standardised rates of End Stage Kidney Disease (ESKD)

 

MC

IR

OR

R

VR

 

Rate per 100,000 population

Prevalence of treated ESKD 2012

85

77

89

163

181

Incidence of treated ESKD 2012

9.7

9.2

12.0

24.9

40.5

Total incidence 2005-07

20

19

23

36

81

Source http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549614
Note: Based on A&NZ Dialysis and Transplant Registry data. ESKD=End Stage Kidney Disease. The difference between “Incidence of treated ESKD” and “Total incidence”, relates to those people newly diagnosed with End Stage Kidney Disease who either do not receive dialysis or do not receive a kidney transplant.

Incidence of cancers

Table CD7: Incidence of new cases of cancer, 2010, age standardised rate per 100,000 population

 

Bowel

Lung

Melanoma

Female Breast

Cervical

MC

58.5

40.8

45.2

118.7

6.7

IR

65.9

43.2

54.3

117.9

7.6

OR

70.0

45.7

53.6

111.5

8.1

R

68.4

46.5

46.5

99.4

11.4

VR

49.1

62.1

31.7

104.0

13.1

Source: http://pandora.nla.gov.au/pan/146265/20140703-0935/www.coagreformcouncil.gov.au/reports/healthcare/healthcare-australia-2012-13-five-years-performance.html
Note: Rates whose confidence intervals fail to overlap those in Major cities (so are therefore likely to be significantly different from those in Major cities) are displayed as bold in this table

From the Table above, the incidence of new cases of Bowel and Lung cancer, and of Melanoma tend to be higher in regional and remote Australia (except for lower rates of Melanoma in Very remote areas, likely a reflection of low rates amongst Indigenous people who constitute a large proportion of the population in these areas.

The data shows lower incidence of Breast cancer in outer regional and remote areas and slightly higher incidence of Cervical cancer in rural and remote areas, but the differences may not be statistically significant when comparing individual remoteness areas with major cities.

Five year cancer survival tends to be lower outside major cities –see page 42. 

Prevalence of mental health issues:

  • 2007 ABS survey of mental health and wellbeing
  • 2011-12 ABS National Health Survey
  • PHIDU

Table 22: Prevalence of mental health issues, 2007 and 2011-13

 

 

MC

IR

OR/Remote 

People 18+, with high or very high psychological distress based on the Kessler 10 Scale (K10) 2011-13

 

10.6%

11.5%

10.7% 

Age standardised percentage of people 15+, with mental or behavioural problems, 2011-13

 

12.8%

15.5%

15.1% 

People (16-85 years) with any 12-month mental disorder, 2007  

 

Capital city

Balance of state 

 

20.5%

19.1% 

 

Major urban

Other urban

Bal. of state 

 

20.4%

19.2%

19.2% 

Sources:

Note that the percentage with mental or behavioural problems in IR areas (15.5%) is statistically significantly higher than in major cities (12.8%), while the percentage in OR areas is not statistically significantly higher than in MCs (or indeed IR areas)

  • The percentage of adults with high or very high psychological distress is similar (11%) in Major cities, IR and OR/remote areas (2011-12).
  • The percentage of adults with any mental disorder in the past 12 months (20%) appears similar in major urban areas, other urban areas and balance of state areas (2007).
  • About 13% of people 15 years or older in Major cities have a mental or behavioural problem, compared with about 16% in IR areas, with rates in OR/remote areas unclear but potentially similar to those in IR areas (2011-12) .

Access to mental health services is poorer or much poorer outside major cities (see page 49), and rates of suicide are higher or much higher (see page 43).

 

Injury and poisoning

Transport accidents

Comparison of indigenous and non-indigenous land transport injury by remoteness.
http://www.aihw.gov.au/publication-detail/?id=60129543939

Table 23:

Source:http://www.aihw.gov.au/publication-detail/?id=60129543939
Other sources of information by remoteness include:

Australian Government Department of Infrastructure and Regional Development, Road Trauma Australia-Annual Summaries, Available at: http://bitre.gov.au/publications/ongoing/road_deaths_australia_annual_summaries.aspx

Australian Institute of Health and Welfare, 2012, Trends in serious injury due to landtransport accidents, Australia 2000–01 to 2008–09, Available at: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737421990

Australian Bureau of Statistics, Health Outside Major Cities, Available at: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features30Mar+2011

AIHW: Henley G & Harrison JE 2013. Injury of Aboriginal and Torres Strait Islander people due to transport, 2005–06 to 2009–10.Injury research and statistics series no. 85. Cat. no. INJCAT 161.Canberra: AIHW. Available at:
http://www.aihw.gov.au/publication-detail/?id=60129543939

And also AIHW mortalityinequity publication
http://www.aihw.gov.au/publication-detail/?id=60129548021HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"&HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"tab=3

 

Disability

Percentage of people (15+) with a core activity restriction: MC 15.7%, IR 20.7%, OR/rem 22.6% (percentages appear to be crude). Source: ABS General Health Survey 2014 http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4159.0Main+Features12014?OpenDocument

 

Mothers and babies

The AIHW perinatal portal reports antenatal smoking rates, duration of pregnancy at first antenatal visit, previous ceasarian section, maternal BMI,
http://www.aihw.gov.au/perinatal-data/

 

Oral Health

As of 2015, the most recent National Survey of Oral health was in 2004-06.
http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442455420

Untreated decay was more prevalent among residents of non–capital-city areas than capital-city dwellers (32.8% compared with 21.5%).

  • In 2004–2006, people living in Inner regional areas had the highest average DMFT at 14.75.
  • Fillings contributed the most to DMFT scores in all remoteness areas.
  • People in Inner regional areas had the highest average number of teeth missing due to decay.
  • The proportion of people with untreated decay varied from 23.5% in Major cities to 37.6% in Remote/Very remote areas.

Source:  http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129548452 based on the (latest) National Survey of Adult Oral Health, 2004–2006.

In 2012–13, Indigenous Australians living in remote areas were more likely than those in non-remote areas to have never consulted a dental professional (21% and 12%).  Source: http://aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129551281

Regular updates from the National Dental Telephone Interview Survey (eghttp://www.aihw.gov.au/publication-detail/?id=60129544634) provides self-reported data relating to use of dental services and self-reported oral health. The use of telephone surveys potentially biases responses to those wealthy enough to own and operate a telephone, potentially under-assessing oral poor health in rural and remote areas.

RFDS report on Oral Health http://www.flyingdoctor.org.au/ignitionsuite/uploads/docs/Filling%20the%20gap%20-%20final%20for%20online%20-%20commas.pdf?130866584312077896

 

Mortality

AIHW has good data on mortality by age group, gender, cause and remoteness for deaths, excess deaths, avoidable and preventable deaths
http://www.aihw.gov.au/publication-detail/?id=60129548021HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"&HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"tab=3

ABS has good data on deaths at http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3302.02013?OpenDocument

Table M1:Age standardised death rate time series, Australian population, 2003 to 2013

 

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

 

Age standardised rate (per 1,000 population)

MC

6.6

6.5

6.2

6.1

5.9

5.9

5.8

5.7

5.6

5.5

5.4

IR

7.1

7.0

6.8

6.6

6.5

6.5

6.4

6.3

6.2

6.1

6.0

OR

7.4

7.3

7.1

6.9

6.8

6.8

6.8

6.7

6.5

6.4

6.2

R

7.5

7.4

7.4

7.5

7.3

7.1

7.0

7.0

6.9

6.7

6.3

VR

9.1

9.4

9.5

9.4

9.0

8.9

8.5

8.7

8.2

8.4

7.8

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3302.02013?OpenDocument

In 2006, Mortality was higher in rural than in urban women (hazard ratio, HR 1.14; 95% CI, 1.03,-1.26), however, the classification of rural and urban appears to be unclear. Australian Longitudinal Study on Women’s Health http://www.alswh.org.au/substudies-and-analyses/analyses?projpubid=386HYPERLINK "http://www.alswh.org.au/substudies-and-analyses/analyses?projpubid=386&projid=A208"&HYPERLINK "http://www.alswh.org.au/substudies-and-analyses/analyses?projpubid=386&projid=A208"projid=A208

 

Table M2: Age standardised all-cause mortality, per 100,000 population 2011

 

Rate

Variability band

MC

543.1

3.5

IR

613.8

6.7

OR

640.4

10.3

R

670.5

31.7

VR

770.3

53.3

Source: http://pandora.nla.gov.au/pan/146265/20140703-0935/www.coagreformcouncil.gov.au/reports/healthcare/healthcare-australia-2012-13-five-years-performance.html

 

Mortality by cause

 

Figure M1: Age standardised mortality, per 100,000 population, by major cause 2009-2011

Source: derived from http://www.aihw.gov.au/publication-detail/?id=60129548021HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"&HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"tab=3

 

Table M2: Age standardised mortality, per 100,000 population, by major cause 2009-2011 (as for the Figure above)

 

MC

IR

OR

R

VR

 

Deaths per 100,000 population, per annum

IHD

80.4

93.5

97.5

101.3

118.4

COPD

19.9

25.2

29.2

31.2

36.0

Land transport accidents

4.4

10.1

12.6

18.8

24.1

Diabetes

14.7

17.5

21.4

37.0

58.9

Cancer, unknown, ill-defined

13.6

17.5

21.3

23.9

25.7

Heart failure & ill-defined heart disease

11.6

14.9

17.1

19.6

19.8

Lung cancer

31.7

34.6

36.8

40.9

46.9

Stroke

42.1

45.8

44.8

44.8

45.3

Prostate cancer (C61)

11.8

14.9

15.9

16.1

19.6

Hypertensive diseases

6.0

7.9

9.7

11.2

9.6

Suicide

9.6

11.8

12.9

16.9

21.2

Ill defined causes

3.6

4.2

7.0

12.6

19.4

Conditions originating in perinatal period

5.2

5.5

5.8

6.1

9.7

Kidney failure

9.8

9.6

10.3

10.3

20.6

Pancreatic cancer

9.7

9.5

9.8

9.7

9.3

Source: derived from http://www.aihw.gov.au/publication-detail/?id=60129548021HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"&HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"tab=3

 

Figure M3: Rates of death, for 11 leading causes of death, expressed as multiples of the Major cities rate for that cause, age standardised, 2009-2011

Source: http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3

 

Figure M4: Number of deaths, by cause, in each area, in excess of the Major cities rate, for the 3 year period 2009-2011

Source: http://www.aihw.gov.au/publication-detail/?id=60129548021HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"&HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"tab=3

 

Figure M5: Percentage of excess deaths, due to each cause, in each area, for the 3 year period 2009-2011

Source: http://www.aihw.gov.au/publication-detail/?id=60129548021HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"&HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129548021&tab=3"tab=3

 

Suicide

Table 24: Rates of suicide and suicide hospitalisation, per 100,000 population, 2010-11

 

MC

IR

OR

R

VR

Suicide death rate

9.4

10.7

12.9

16.8

18.1

Suicide hospitalisation rate

111.6

132

124.6

153.2

166.2

 

 

 

 

 

 

Rate ratios

MC

IR

OR

R

VR

Suicide death rate

1.00

1.14

1.37

1.79

1.93

Suicide hospitalisation rate

1.00

1.18

1.12

1.37

1.49

Source: http://www.aihw.gov.au/publication-detail/?id=60129549729HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129549729&tab=3"&HYPERLINK "http://www.aihw.gov.au/publication-detail/?id=60129549729&tab=3"tab=3
Note: Rates are age standardised

According to AIHW, suicide death rates were 14% and 37% higher in IR and OR areas, and 79% and 93% higher in Remote and Very remote areas.

 

Table 25: Suicide death rate, per 100,000 population, 2011

Population

Suicide rate (deaths per 100,000 population)

Persons inside Major cities

8.2

Persons outside Major cities

13.6

15-29 males inside Major cities

15

15-29 males outside Major cities

32

Non Indigenous persons

9.6

Aboriginal and Torres Strait Islander persons

25.7

15-24 non Indigenous persons

8.1

15-24 Aboriginal and Torres Strait Islander persons

41.2

Persons employed, Qld

10.6

Persons in agriculture, Qld

24.1

Source:http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features30Mar+2011
and re Qld: http://www.matesinconstruction.org.au/flux-content/mic/pdf/suicideinselectedoccupations.pdf

Suicide death rate in Aboriginal and Torres Strait Islander people is about double that for non-Indigenous people. Young people, particularly in rural areas, and particularly Indigenous people, as well as people employed in agriculture have higher rates again.

In 2008, suicide death rates were 66% higher outside Major Cities http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features30Mar+2011

Suicide death rates, by state and remoteness, 2001-05 and 2006-10

http://www.abs.gov.au/ausstats/abs@.nsf/Products/3309.0~2010~Chapter~Geography?OpenDocument

Small area suicide data at  http://www.adelaide.edu.au/phidu/maps-data/data/