Congratulations, Australia, you’re healthier than you think

Australians are healthier than ever, according to data from the Australian Institute of Health and Welfare, refuting claims of a public health crisis pushed by sectoral interests.

The AIHW’s Australian Burden of Disease Study released in May looks in detail at the impact of disease, conditions and injuries on Australians — both fatal and non-fatal. The most recent report examines data up to 2011 and uses the standard Disability-Adjusted Life Year (DALY) measure.

One unit of DALY represents a year of healthy life lost, either through premature death or from living with an illness or injury — in the latter case, the calculation weighted according to the disability caused by a disease, its progression and co-morbidities, to determine health loss. The study represents the first major study of the burden of disease in Australia since 2003.

In the intervening eight years, there was, surprisingly, a noticeable improvement in Australians’ health. The study found

“… after accounting for population increase and ageing, the burden of disease for the Australian population decreased by 10%, from 210.5 to 189.9 DALY per 1,000 people.”

That is, overall we were losing 10% fewer DALYs to death, illness and injury than in 2003.

The bulk of that improvement has come from Australians living longer — non-indigenous Australians are among the longest-lived people in the world. However, it’s difficult to identify what exactly has improved in this regard, because of the nature of the calculation involved. If you think about what a DALY represents, it’s a complex thing. Relatively few infants die each year, but they produce a very high loss of DALYs because of the lifespan lost, whereas most deaths are of elderly people, who lose relatively little lifespan; the greatest contributors to loss of DALYs are people in their 50s through to their 80s.

But it’s not merely that Australians are living longer — they may be living longer in poorer health, which is not a particularly optimal outcome. The study finds that there was also a:

“3.8% reduction in non-fatal burden, after accounting for population increases and ageing, [which] indicates that the substantial successes in preventing or delaying deaths between 2003 and 2011 has not increased the impact of ill health in the population; rather, it has decreased it slightly.”

That means we’re not merely living longer, but we’re in better health as well. The results place Australia well ahead of other OECD countries on virtually every major illness except asthma and depression, according to results from comparable methodology. And that’s despite Australia spending 9.4% of GDP on health during the period studied — well below the expenditure of many Western Europeans countries or Canada and of course nearly half the level of the United States.

Health outcomes for indigenous Australians continue to badly lag those of non-indigenous Australians, but the full extent of that gap won’t be clear until the AIHW releases a similar study on the burden of disease in indigenous communities in coming months.

The report contradicts claims that Australia is facing a health emergency of ever greater obesity and chronic disease. One of the country’s premier nanny statists, Professor Rob Moodie of University of Melbourne, recently wrote of how Australia was “losing the health fight”, that we faced “a looming health crisis” and “that we are losing the war against alcohol and weight-related illnesses” (this, hilariously, despite a huge drop in alcohol consumption in recent years that even anti-alcohol campaigns have had to acknowledge).

There are routine claims of an “obesity epidemic” destroying the lives of Australians (along with the need for bans and taxes on sugary foods and drink) — despite a regular flow of evidence that there is no such thing. Another public health lobbyist recently claimed diabetes threatened “the survival of the species” and that in western Sydney “we will have to build factories to cut off people’s toes, feet and limbs and help them when they go blind”. According to the AIHW study, Australia is well below the OECD average for DALYs lost to diabetes.

Oddly, the strong improvement in Australian health during the noughties attracted little media attention when the report was released in early May.