We’re not just living for longer – we’re staying healthier for longer, too



Improvements in heart health accounted for more than half of the improvements in our overall health.
From shutterstock.com

John Goss, University of Canberra

In the 12 years to 2015, life expectancy in Australia increased by 2.3 years for men (to 80.4) and 1.6 years for women (to 84.6). Our health-adjusted life expectancy increased along with it – by two years for men (to 71.5) and 1.3 years for women (to 74.4).

Health-adjusted life expectancy estimates the number of full health years people can expect to experience over the course of their lives. By comparing this measure to life expectancy, we can see whether longer life expectancy is accompanied by more years lived in full health.

Pleasingly, these trends show we’re not just living for longer – but we’re staying healthy for longer, too.




Read more:
Health Check: why do women live longer than men?


In the Australian Burden of Disease study, released today, the Australian Institute of Health and Welfare has mapped the impact and causes of illness and death in Australia between 2003 and 2015.

The improvement in health-adjusted life expectancy alongside life expectancy in the last 12 years builds on continual improvements in life expectancy seen in Australia over several decades.

These improvements in our health can be accorded to advancements in science and medicine, and certain changes we’ve made in our lifestyles. But there’s still plenty of room to do better.

How have we achieved this?

Some 89% of the health improvement between 2003 and 2015 was due to improvements in heart health, reductions in cancer, and improved infant health.

Health improvement refers to reductions in the burden of disease, measured in disability adjusted life years (DALYs). DALYs take into account premature death as well as the burden of illness and disability caused by disease and injury.

Heart disease and stroke

In the period from 2003 to 2015, there was a 36% reduction in the age-standardised burden of disease due to heart disease and stroke. Improvements in heart health accounted for 56% of the overall improvement in health.

The vast majority of the reduction in the cardiovascular disease burden has been due to reductions in smoking, high blood pressure and high cholesterol. Some of the improvement is due to better treatment (for example, surgical interventions like stent insertions).

We’ve been seeing strong progress in this area over many years. The chance of dying from heart disease or stroke is now one sixth of what it was in 1970.




Read more:
How Australians Die: cause #1 – heart diseases and stroke


Cancer and infant health

The reduction in the burden of disease from cancer, which accounted for 25% of the improvement in health, has been partly due to the reduction in risk factors such as smoking. Prevention through screening has also played an important role.

But improved treatment, in the form of drugs, radiation and surgery, has been the most important factor. Five year survival rates for cancer increased from 50% in 1986-1990 to 69% in 2011-2015.

Reductions in the burden of disease due to infant and congenital conditions accounted for 8% of the improvement in health between 2003 and 2015. This was due to improved treatment of infants with congenital conditions and better prevention of problems such as sudden infant death syndrome (SIDS).

Advances in medicine – both prevention and treatment of disease – contribute to Australians living longer than they used to.
From shutterstock.com

Managing our risk factors is key

Overall, reductions in risk factors has been responsible for 51% of the health improvement we’ve seen between 2003 and 2015.

Although some risk factors like overweight and obesity have worsened, the decline in smoking, high blood pressure, high cholesterol and alcohol use has more than compensated for those risk factors which have worsened or those risk factors, like physical inactivity, which have not improved.

We’re by no means reaching the end of the line in terms of opportunities to improve our health.

Some 38% of the burden of disease in 2015 was due to risk factors like smoking (still accounting for 9.3% of the burden), overweight and obesity (8.4% of the burden), poor diet (7.3%), high blood pressure (5.8%), excessive alcohol intake (4.5%), high cholesterol (3%), insufficient physical activity (2.5%) and child abuse and neglect (2.2%).

Health isn’t equal

The report reveals significant inequalities in health, with those living in the poorest areas having a health-adjusted life expectancy at least five years lower than those living in the richest areas.

The burden of disease in the poorest areas is 50% higher than in the richest areas. For some diseases like heart disease, the burden of disease is 70% higher in the lowest socioeconomic areas, whereas for cancer the burden of disease is 40% higher.




Read more:
Low-income earners are more likely to die early from preventable diseases


So the news isn’t all good. While there’s opportunity for us to manage our risk factors on an individual level, these health disparities warrant urgent attention on a broader health policy level.The Conversation

John Goss, Adjunct Associate Professor, Health Research Institute, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Migrants are healthier than the average Australian, so they can’t be a burden on the health system



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Increasing numbers of migrants will inevitably have an impact on Australia’s health system.
from shutterstock.com

Santosh Jatrana, Swinburne University of Technology

Population growth has profound impacts on Australian life, and sorting myths from facts can be difficult. This article is part of our series, Is Australia Full?, which aims to help inform a wide-ranging and often emotive debate.


Developed economies, including Australia, have increasingly been using international migration to compensate for demographic trend and skill shortages. Australia has one of the highest proportion of overseas-born people in the world: an estimated 26% of the total resident population was born overseas. This is expected to increase over the next decade.

So the health of immigrants and their use of health services are having increasing impacts on demands on the health system, its responsiveness, and the national health profile.

The proportion of older people relative to young and working-age populations is increasing in Australia.
Australian Institute of Health and Welfare

One of the most significant demographic trends in Australia today is the ageing of the population. This is an increase in the share of older people – defined as people aged 65 and older – relative to the youth (0 to 14 years) and working-age population (15 to 64 years). One in six Australians is now over 65, compared to one in seven in 2011 and only one in 25 in 1911.

The reasons for this trend are complex. These include the impact of the “baby boomer” generation and declines in fertility and mortality, combined with an increase in life expectancy.

Older people are living longer, which is an achievement of our health system. But an increase in life expectancy and decline in the death rate have created a paradoxical situation in which these older people have increased the country’s rates of illness and disability. This has led to a rise in health-care costs and an increase in use of health services, as well as hospitalisation.

While an ageing population adds to the burden on the health system, an intake of migrants who are generally young and healthier than the average Australian, due to their selectivity, might help balance this out. So, in fact, increasing migration would be of benefit to Australia’s health.

Australian immigrants are healthy

Australia uses something called the “points system” to determine the eligibility of most of those who apply to immigrate here. Points are given for productivity-related factors such as language, education, age (more points are given to younger applicants) and skills.

But it is reasonable to assume the points system would not apply to English migrants who arrived before the abandonment of the White Australian policy in 1973 and to New Zealand migrants. Together, these two groups make up a large proportion of the migrants from English-speaking countries. The points system also does not apply to those who migrate under the family, special eligibility, and humanitarian and refugee programs.

Having said that, skilled migrants selected under a points-based system make up most (around 68%) of all migrants in Australia. The rest (32%) taken in under the migration program come in through having a family member here.

Migrant doctors make up a large part of the Australian workforce.
from shutterstock.com

Skilled migrants (and in many cases, their dependants) go through medical screening to meet minimum health requirements. The Department of Immigration and Border Protection specifies that, to meet the health requirement, an applicant must be free of a health condition that is:

  • considered to be a threat to public health or a danger to the Australian community
  • likely to result in significant health care and community service costs to the Australian community
  • likely to require health care and community services that would limit the access of Australian citizens and permanent residents to those services as these are already in short supply.

Humanitarian migrants have a health waiver provision, but they make up a very small proportion of the total migration program.

Research has shown that immigrants tend to have better health status that the Australia-born populations. This health advantage narrows significantly over time, leading to their health becoming similar to that of Australians.

Migrants’ contribution to the workforce

Immigrants make up a substantial part of the health workforce in Australia. The international movement of health professionals is a major component of migration. Australia has been dependent on international medical graduates for a long time.

For example, according to an estimate by the Department of Health and Ageing, international medical graduates comprise about 39% of the medical workforce in Australia and 46% of general practitioners in rural and remote locations. Another estimate suggests 53% of medical practitioners in Australia are foreign-trained.

The dependence on international doctors will likely be maintained in future for a variety of reasons, such as to redress medical workforce maldistribution. Given Australia’s ageing patient and practitioner base and some key areas of the health workforce already in very short supply, this contribution of migrants is significant for Australia’s health profile.

Monitoring the health and well-being of immigrants is important for the overall health and public health systems in Australia. The issue of migrant health has become additionally important because the goal of Australia’s migration program has moved towards meeting the labour market needs of the economy. Good health is essential to fully realise the social and economic potential of immigrants.

We must also continue to collect and examine data on the health care needs and health service utilisation of Australian-born and foreign-born patients. Finally, we must educate ourselves about important contributions migrants make to ensure informed decisions are made to protect the public health system.


The ConversationYou can read other articles in the Is Australia Full? series here.

Santosh Jatrana, Associate Professor and Principal Research Fellow, Centre for Social Impact Swinburne, Swinburne University of Technology

This article was originally published on The Conversation. Read the original article.