Burden of disease

Burden of disease is a complex analytical method to measure the gap between the ideal of everyone living to old age in good health and people’s experience of illness and early death.

In Headline measures

At a glance

In 2023:

More than 5.6 million years of healthy life were lost due to illness and injuries nationally. Cancer and other neoplasms was the leading cause, contributing 16.6%
Coronary heart disease, dementia, back pain and problems, anxiety disorders and COPD were the next leading specific causes.
COVID-19 contributed 0.9%, mainly through fatal burden.
Disability burden increased from 46.9% in 2003 to 53.9% in 2023 reflecting the growing burden of chronic diseases.

In 2018:

The total burden rate was 1.4 times higher in remote and very remote areas than in major cities. It was 1.6 times higher in the most disadvantaged areas than in the least disadvantaged areas.
In Australia, 37.5% of the total disease burden could be attributed to the joint effect of modifiable risk factors. Tobacco use, overweight (including obesity), and all dietary risks accounted for 8.6%, 8.4% and 5.4% of total health burden, respectively.

Introduction

This section summarises the health burden of disease groups based on over 200 specific conditions. Burden of disease is a complex analytical method measuring the gap between the ideal of everyone living to old age in good health and people’s experience of illness and early death. Burden of disease analysis uses multiple data sources to estimate health impacts based on:

the causes and progression of diseases
life expectancy
population size.

Each burden of disease analysis is updated with the latest health evidence. To understand changes in burden over time, results from prior years are updated based on latest health evidence.

The analysis generates three measures of health burden:

the total estimate of health loss, measured as disability adjusted life years (DALYs)
loss due to early death, measured as years of life lost (YLL)
loss due to living with illness or disability, measured as years lived with a disability (YLD).

DALYs are the sum of YLLs and YLDs. All three measures can be reported as a count, an age-standardised rate (ASR, or standardised rate), or a crude rate.

The Australian Institute of Health and Welfare (AIHW) conducts the Australian Burden of Disease Study (ABDS) applying the best current health evidence for the Australian context.¹ National results are updated regularly with periodic updates for regions within Australia and modifiable risk factors.

The most recent national ABDS study was in 2023. The most recent jurisdictional, remoteness, socioeconomic areas and risk factor results are for 2018.²

The 2023 ABDS results cannot be compared to other burden of disease studies such as:

the Global Burden of Disease because it was developed for the global health context
earlier ABDS studies due to changes in health evidence and the addition of new diseases based on social and disease priorities, and emerging conditions.

Recent additions to ABDS include:

2018
- specific conditions added: scabies, asbestosis, silicosis and other pneumoconiosis
- risk factors: bullying victimisation, low birthweight and short gestation. Perpetrator type and sex were added to homicide and violence reporting.

2022

National ABDS results were recalculated for 2003, 2011, 2015 and 2018 using the 2023 methods. For jurisdictions and other small area analyses, the 2018 ABDS recalculated results from 2011.

This section focuses on the most recent 2023 ABDS with a subset of 2018 ABDS jurisdictional results.

2023 Australian Burden of Disease Study

From 2003 to 2023, the health burden (DALYs):

overall increased from 4.2 to 5.6 million years of healthy life lost
the standardised rate decreased from 209.3 to 186.0 per 1,000 persons.

This inverse relationship between total burden and the standardised rate is due, in part, from increasing population size and changing age distributions. There was little change in standardised burden rates from 2018 (186.2 per 1,000 persons) to 2023 (186.0 per 1,000 persons), in contrast to an 11.1% decline from 2003 to 2018.¹

The proportion of life lost due to illness/disability in Australia is increasing—from 46.9% in 2003 to 53.9% in 2023. This change reflects greater gains in preventing early deaths than in preventing illness and disability.¹ This is driven by gains for females in the proportion of total burden attributable to disability. While an increasing proportion of disability burden is also evident in males, fatal burden still outweighs disability burden.

Increasing disability burden shows the impact of an aging population. In future, greater effort will be required for hearing and vision disorders, arthritis and gout which impact mobility, and managing neurological disorders including dementia. Results also show the higher burden of chronic and disabling conditions that affect many young adults and middle-aged people including mental health disorders and musculoskeletal conditions such as back pain.

Health loss by disease group

In 2023, the leading disease group for health loss in Australia was cancer and other neoplasms, where almost all the burden was due to early death (Table 1). Mental and substance use disorders, musculoskeletal disorders, cardiovascular diseases followed closely. Together these four disease groups explained more than half the total burden.

Musculoskeletal conditions, mental health and substance use disorders have relatively high disability burden while cancers, injury and cardiovascular diseases have high fatal burden. Changes in the leading disease groups from 2003 to 2023 were:¹

cancer and other neoplasms: 20.8% increase in number of DALYs but a 26.2% decline in standardised rate
mental and substance use disorders: 66.2% increase in number of DALYs and a 27.3% increase in standardised rate
musculoskeletal disorders: 42.9% increase in number of DALYs and a 4.8% decline in standardised rate
cardiovascular diseases: 9.7% decrease in number of DALYs and a 47.0% decrease in standardised rate
neurological conditions: 91.9% increase in number of DALYs and a 14.6% increase in standardised rates.

Over this period the burden for infectious diseases increased (52.5% increase in number of DALYs), largely driven by the 2018 to 2023 increase from the COVID-19 pandemic.

Table 1: Health burden by broad cause in Australia, 2023

	DALY in 2023	% Change in total DALY between 2003 and 2023
Cancer and other neoplasms	934,551	91.4	8.6	16.6	20.8	-26.2
Mental and substance use disorders	818,255	1.7	98.3	14.5	66.2	27.3
Musculoskeletal disorders	722,733	2.8	97.2	12.8	42.9	-4.8
Cardiovascular diseases	665,766	74.0	26.0	11.8	-9.7	-47.0
Neurological conditions	464,997	48.9	51.1	8.3	91.9	14.6
Injury (external cause)	449,920	82.5	17.5	8.0	26.3	-7.4
Injury (nature)	449,920	82.5	17.5	8.0	26.3	-7.4
Respiratory diseases	407,715	36.6	63.4	7.2	48.1	-5.9
Gastrointestinal disorders	185,934	62.3	37.7	3.3	45.5	-4.0
Endocrine disorders	154,743	37.9	62.1	2.7	55.2	-4.3
Infectious diseases	140,799	70.6	29.4	2.5	52.5	-5.7
Oral disorders	129,253	0.3	99.7	2.3	51.0	3.6
Hearing and vision disorders	127,179	0.0	100.0	2.3	91.5	12.6
Infant and congenital conditions	115,794	81.8	18.2	2.1	-5.4	-25.0
Skin disorders	93,946	8.4	91.6	1.7	37.3	0.8
Kidney and urinary diseases	81,807	61.2	38.8	1.5	75.0	1.6
Blood and metabolic disorders	70,882	54.7	45.3	1.3	60.7	6.8
Reproductive and maternal conditions	69,651	1.9	98.1	1.2	50.6	8.1
Total	5,633,926	46.1	53.9	100.0	34.7	-11.1

	DALY in 2023	% Change in total DALY between 2003 and 2023
Cancer and other neoplasms	521,960	91.4	8.6	17.8	20.9	-28.4
Mental and substance use disorders	406,907	2.2	97.8	13.9	60.1	22.4
Cardiovascular diseases	399,883	75.0	25.0	13.6	-6.2	-46.8
Musculoskeletal disorders	315,458	2.7	97.3	10.7	33.7	-10.6
Injury (external cause)	310,251	85.5	14.5	10.6	21.8	-9.2
Injury (nature)	310,251	85.5	14.5	10.6	21.8	-9.2
Neurological conditions	197,208	56.6	43.4	6.7	103.8	18.1
Respiratory diseases	192,002	41.5	58.5	6.5	46.4	-10.3
Gastrointestinal disorders	101,922	67.5	32.5	3.5	43.3	-6.1
Endocrine disorders	90,489	40.6	59.4	3.1	58.6	-4.6
Infectious diseases	73,240	72.2	27.8	2.5	50.8	-9.4
Oral disorders	67,389	0.3	99.7	2.3	54.1	5.5
Infant and congenital conditions	67,130	80.7	19.3	2.3	-5.0	-24.6
Hearing and vision disorders	63,709	0.0	100.0	2.2	116.5	21.2
Kidney and urinary diseases	50,176	54.8	45.2	1.7	70.3	-6.7
Skin disorders	46,295	8.8	91.2	1.6	41.0	2.1
Blood and metabolic disorders	29,242	74.0	26.0	1.0	45.4	-7.4
Reproductive and maternal conditions	3,227	11.5	88.5	0.1	85.8	31.1
Total	2,936,487	51.7	48.3	100.0	31.4	-15.3

	DALY in 2023	% Change in total DALY between 2003 and 2023
Cancer and other neoplasms	412,591	91.5	8.5	15.3	20.7	-24.6
Mental and substance use disorders	411,348	1.2	98.8	15.2	72.7	32.9
Musculoskeletal disorders	407,275	2.8	97.2	15.1	51.0	0.0
Neurological conditions	267,789	43.3	56.7	9.9	84.0	12.9
Cardiovascular diseases	265,883	72.5	27.5	9.9	-14.5	-48.3
Respiratory diseases	215,713	32.2	67.8	8.0	49.7	-3.1
Injury (external cause)	139,669	75.7	24.3	5.2	37.8	-2.4
Injury (nature)	139,669	75.7	24.3	5.2	37.8	-2.4
Gastrointestinal disorders	84,012	56.0	44.0	3.1	48.2	-1.2
Infectious diseases	67,559	68.7	31.3	2.5	54.4	-1.7
Reproductive and maternal conditions	66,424	1.4	98.6	2.5	49.2	7.8
Endocrine disorders	64,253	34.0	66.0	2.4	50.7	-4.8
Hearing and vision disorders	63,469	0.0	100.0	2.4	71.5	3.5
Oral disorders	61,864	0.3	99.7	2.3	47.8	1.7
Infant and congenital conditions	48,664	83.5	16.5	1.8	-6.0	-25.4
Skin disorders	47,651	8.0	92.0	1.8	34.0	-0.2
Blood and metabolic disorders	41,641	41.1	58.9	1.5	73.5	19.4
Kidney and urinary diseases	31,630	71.3	28.7	1.2	82.9	11.6
Total	2,697,438	40.0	60.0	100.0	38.5	-6.8

Health loss by select specific causes

In 2023, the leading specific causes of health loss were:

coronary heart disease
dementia
back pain and problems
anxiety disorders
COPD (Table 2).¹

These and others in the top 20 specific causes accounted for 54.9% of the total disease burden. About half of these leading conditions had a high disability burden, indicating that management will require ongoing, long-term care. This is the nature of the changing health burden—the dominance of chronic conditions, impacting the wellbeing of the individual and driving demand for ongoing health support services.

There was a substantial increase in health burden due to dementia, osteoarthritis, hearing loss, falls, asthma, COPD, back pain, suicide and rheumatoid arthritis since 2003—again reflecting an ageing population and the emergence of disabling/non-fatal problems.¹

The greatest improvements in reducing burden were achieved for coronary heart disease and stroke. This can be attributed to success in primary prevention through better monitoring of blood pressure and cholesterol, reduced smoking rates, and advances in treatment and early clinical intervention.

Table 2: Top 50 conditions causing health loss in Australia, 2023

		DALY in 2023				% Change in total DALY between 2003 and 2023
Disease group	Disease	Healthy years lost - DALY (Number)	% fatal (YLL)	% disability (YLD)	% of total DALY	Number	ASR
Cardiovascular diseases	Coronary heart disease	304,800	77.7	22.3	5.4	-28.3	-58.2
Neurological conditions	Dementia	247,714	58.5	41.5	4.4	165.4	39.8
Musculoskeletal disorders	Back pain and problems	242,124	0.5	99.5	4.3	53.1	8.3
Mental and substance use disorders	Anxiety disorders	219,635	0.1	99.9	3.9	74.1	33.2
Musculoskeletal disorders	Other musculoskeletal	218,329	6.9	93.1	3.9	39.2	-8.2
Respiratory diseases	COPD	204,867	52.1	47.9	3.6	54.6	-12.9
Mental and substance use disorders	Depressive disorders	167,171	0.3	99.7	3.0	46.0	11.2
Cancer and other neoplasms	Lung cancer	159,238	97.5	2.5	2.8	14.8	-31.4
Injury (external cause)	Suicide and self-inflicted injuries (external cause)	155,739	99.2	0.8	2.8	51.5	16.6
Musculoskeletal disorders	Osteoarthritis	143,410	0.4	99.6	2.5	102.5	26.7
Respiratory diseases	Asthma	141,621	5.7	94.3	2.5	47.1	8.4
Endocrine disorders	Type 2 diabetes mellitus	124,465	37.7	62.3	2.2	60.7	-3.6
Cardiovascular diseases	Stroke	123,669	84.9	15.1	2.2	-17.9	-52.8
Musculoskeletal disorders	Rheumatoid arthritis	113,670	2.7	97.3	2.0	0.7	-35.4
Mental and substance use disorders	Autism spectrum disorders	100,967	0.3	99.7	1.8	379.2	257.9
Cancer and other neoplasms	Bowel cancer	98,091	92.8	7.2	1.7	-0.3	-39.0
Hearing and vision disorders	Hearing loss	91,623	0.0	100.0	1.6	92.7	14.1
Injury (external cause)	Falls (external cause)	90,810	54.8	45.2	1.6	105.4	24.1
Injury (external cause)	Poisoning (external cause)	74,312	99.2	0.8	1.3	99.2	53.8
Cancer and other neoplasms	Breast cancer	73,287	84.8	15.2	1.3	3.5	-32.7
Cardiovascular diseases	Atrial fibrillation and flutter	71,477	27.8	72.2	1.3	140.2	34.8
Gastrointestinal disorders	Chronic liver disease	69,869	94.6	5.4	1.2	68.5	14.6
Kidney and urinary diseases	Chronic kidney disease	63,448	72.4	27.6	1.1	89.9	10.6
Cancer and other neoplasms	Pancreatic cancer	62,516	98.3	1.7	1.1	75.6	5.9
Mental and substance use disorders	Alcohol use disorders	61,230	13.7	86.3	1.1	1.4	-21.7
Mental and substance use disorders	Bipolar affective disorder	58,705	0.3	99.7	1.0	70.6	32.6
Cancer and other neoplasms	Prostate cancer	57,089	72.0	28.0	1.0	25.8	-30.3
Mental and substance use disorders	Eating disorders	54,684	1.1	98.9	1.0	52.7	21.1
Oral disorders	Dental caries	53,416	0.1	99.9	0.9	57.3	16.4
Mental and substance use disorders	Drug use disorders (excluding alcohol)	51,353	2.4	97.6	0.9	49.9	16.2
Cardiovascular diseases	Other cardiovascular diseases	50,389	73.7	26.3	0.9	25.9	-19.0
Neurological conditions	Other neurological conditions	48,440	58.3	41.7	0.9	83.1	21.8
Infectious diseases	COVID-19	48,383	82.8	17.2	0.9	NA	NA
Neurological conditions	Migraine	48,305	0.0	100.0	0.9	23.0	-7.1
Oral disorders	Periodontal disease	46,336	0.0	100.0	0.8	107.2	40.0
Neurological conditions	Epilepsy	45,346	21.6	78.4	0.8	8.1	-18.5
Cancer and other neoplasms	Liver cancer	44,477	98.2	1.8	0.8	131.5	40.1
Cancer and other neoplasms	Brain and central nervous system cancer	42,704	95.6	4.4	0.8	25.6	-14.7
Neurological conditions	Parkinson disease	42,565	59.6	40.4	0.8	121.6	24.0
Cancer and other neoplasms	Other malignant neoplasms (cancers)	42,544	93.9	6.1	0.8	79.3	15.0
Mental and substance use disorders	Schizophrenia	39,090	3.0	97.0	0.7	33.9	0.5
Skin disorders	Dermatitis and eczema	37,929	0.0	100.0	0.7	35.2	0.1
Blood and metabolic disorders	Other blood and metabolic disorders	36,231	95.5	4.5	0.6	45.9	-4.2
Reproductive and maternal conditions	Genital prolapse	35,956	0.5	99.5	0.6	55.2	1.8
Infectious diseases	Lower respiratory infections incl influenza and pneumonia	35,114	85.5	14.5	0.6	-20.8	-53.0
Injury (external cause)	Road traffic injuries - motor vehicle occupants (external cause)	34,739	87.5	12.5	0.6	-44.1	-57.2
Cardiovascular diseases	Non-rheumatic valvular disease	32,958	59.5	40.5	0.6	36.4	-24.4
Oral disorders	Severe tooth loss	28,666	0.0	100.0	0.5	-0.1	-40.7
Cancer and other neoplasms	Non-hodgkin lymphoma	28,636	92.6	7.4	0.5	-4.7	-43.5
Injury (external cause)	Other unintentional injuries (external cause)	27,768	52.6	47.4	0.5	-13.4	-35.6
Total		5,633,926	46.1	53.9	100.0	34.7	-11.1

		DALY in 2023				% Change in total DALY between 2003 and 2023
Disease group	Disease	Healthy years lost - DALY (Number)	% fatal (YLL)	% disability (YLD)	% of total DALY	Number	ASR
Cardiovascular diseases	Coronary heart disease	206,070	79.5	20.5	3.7	-22.7	-56.0
Musculoskeletal disorders	Back pain and problems	119,873	0.6	99.4	2.1	45.3	2.9
Injury (external cause)	Suicide and self-inflicted injuries (external cause)	116,771	99.5	0.5	2.1	46.1	12.3
Neurological conditions	Dementia	97,376	63.7	36.3	1.7	209.0	47.1
Musculoskeletal disorders	Other musculoskeletal	97,001	6.7	93.3	1.7	32.8	-12.5
Respiratory diseases	COPD	95,275	58.9	41.1	1.7	46.0	-22.3
Cancer and other neoplasms	Lung cancer	89,834	97.6	2.4	1.6	1.0	-40.7
Mental and substance use disorders	Anxiety disorders	88,487	0.1	99.9	1.6	75.7	33.9
Mental and substance use disorders	Autism spectrum disorders	76,355	0.0	100.0	1.4	348.1	234.4
Endocrine disorders	Type 2 diabetes mellitus	73,813	40.2	59.8	1.3	64.5	-3.6
Mental and substance use disorders	Depressive disorders	71,990	0.2	99.8	1.3	46.8	11.2
Respiratory diseases	Asthma	63,929	6.0	94.0	1.1	52.3	13.7
Cardiovascular diseases	Stroke	63,046	83.3	16.7	1.1	-12.1	-52.6
Cancer and other neoplasms	Prostate cancer	57,089	72.0	28.0	1.0	25.8	-34.8
Cancer and other neoplasms	Bowel cancer	55,466	93.1	6.9	1.0	-0.9	-40.5
Injury (external cause)	Poisoning (external cause)	51,433	99.4	0.6	0.9	96.1	53.1
Musculoskeletal disorders	Osteoarthritis	50,845	0.4	99.6	0.9	88.8	17.3
Hearing and vision disorders	Hearing loss	48,432	0.0	100.0	0.9	124.7	27.5
Injury (external cause)	Falls (external cause)	46,261	59.3	40.7	0.8	98.1	20.2
Gastrointestinal disorders	Chronic liver disease	45,979	95.4	4.6	0.8	54.9	5.9
Musculoskeletal disorders	Rheumatoid arthritis	43,124	2.2	97.8	0.8	-9.8	-42.1
Cardiovascular diseases	Atrial fibrillation and flutter	38,429	23.4	76.6	0.7	148.4	35.0
Mental and substance use disorders	Alcohol use disorders	37,560	17.5	82.5	0.7	-17.7	-36.0
Cancer and other neoplasms	Pancreatic cancer	34,396	98.4	1.6	0.6	77.3	6.7
Mental and substance use disorders	Drug use disorders (excluding alcohol)	33,812	2.0	98.0	0.6	44.8	12.6
Kidney and urinary diseases	Chronic kidney disease	33,757	74.1	25.9	0.6	94.1	6.7
Cancer and other neoplasms	Liver cancer	30,248	98.1	1.9	0.5	121.0	33.2
Oral disorders	Dental caries	28,291	0.1	99.9	0.5	53.0	13.4
Infectious diseases	COVID-19	26,935	85.6	14.4	0.5	NA	NA
Cancer and other neoplasms	Brain and central nervous system cancer	26,471	95.9	4.1	0.5	32.8	-9.3
Oral disorders	Periodontal disease	25,817	0.0	100.0	0.5	95.6	34.9
Mental and substance use disorders	Schizophrenia	25,507	1.8	98.2	0.5	30.9	-0.1
Injury (external cause)	Road traffic injuries - motor vehicle occupants (external cause)	24,891	90.3	9.7	0.4	-43.1	-56.1
Neurological conditions	Parkinson disease	24,684	69.7	30.3	0.4	160.5	34.4
Cardiovascular diseases	Other cardiovascular diseases	24,539	75.0	25.0	0.4	23.2	-21.9
Neurological conditions	Epilepsy	24,356	24.1	75.9	0.4	12.8	-15.4
Cancer and other neoplasms	Other malignant neoplasms (cancers)	23,031	94.5	5.5	0.4	84.0	18.1
Neurological conditions	Other neurological conditions	22,921	70.7	29.3	0.4	72.1	14.5
Blood and metabolic disorders	Other blood and metabolic disorders	20,281	96.0	4.0	0.4	41.3	-7.5
Injury (external cause)	Other unintentional injuries (external cause)	20,030	53.7	46.3	0.4	-17.4	-38.3
Cancer and other neoplasms	Oesophageal cancer	19,695	97.8	2.2	0.3	22.0	-26.4
Mental and substance use disorders	Bipolar affective disorder	19,278	0.3	99.7	0.3	23.4	-3.0
Skin disorders	Dermatitis and eczema	18,815	0.0	100.0	0.3	35.0	0.1
Mental and substance use disorders	Eating disorders	18,456	0.3	99.7	0.3	57.5	23.7
Cardiovascular diseases	Cardiomyopathy	18,455	86.9	13.1	0.3	20.4	-23.2
Cancer and other neoplasms	Non-hodgkin lymphoma	17,487	93.1	6.9	0.3	-1.0	-41.5
Infectious diseases	Lower respiratory infections incl influenza and pneumonia	17,396	86.0	14.0	0.3	-24.1	-57.4
Cardiovascular diseases	Non-rheumatic valvular disease	17,317	59.2	40.8	0.3	44.3	-24.2
Cancer and other neoplasms	Melanoma of the skin	16,375	85.1	14.9	0.3	-11.8	-45.2
Infant and congenital conditions	Pre-term birth and low birth weight complications	15,397	73.4	26.6	0.3	19.3	-4.9
Total		2,936,487	51.7	48.3	100.0	31.4	-15.3

		DALY in 2023				% Change in total DALY between 2003 and 2023
Disease group	Disease	Healthy years lost - DALY (Number)	% fatal (YLL)	% disability (YLD)	% of total DALY	Number	ASR
Neurological conditions	Dementia	150,338	55.2	44.8	2.7	143.2	38.7
Mental and substance use disorders	Anxiety disorders	131,147	0.1	99.9	2.3	72.9	32.9
Musculoskeletal disorders	Back pain and problems	122,252	0.4	99.6	2.2	61.7	14.1
Musculoskeletal disorders	Other musculoskeletal	121,327	7.0	93.0	2.2	44.8	-4.6
Respiratory diseases	COPD	109,592	46.2	53.8	1.9	62.9	-4.3
Cardiovascular diseases	Coronary heart disease	98,730	73.8	26.2	1.8	-37.8	-63.4
Mental and substance use disorders	Depressive disorders	95,180	0.3	99.7	1.7	45.4	11.4
Musculoskeletal disorders	Osteoarthritis	92,565	0.4	99.6	1.6	110.8	32.6
Respiratory diseases	Asthma	77,692	5.5	94.5	1.4	43.1	4.1
Cancer and other neoplasms	Breast cancer	72,648	84.9	15.1	1.3	3.0	-33.1
Musculoskeletal disorders	Rheumatoid arthritis	70,546	3.1	96.9	1.3	8.5	-30.7
Cancer and other neoplasms	Lung cancer	69,404	97.3	2.7	1.2	39.4	-15.8
Cardiovascular diseases	Stroke	60,623	86.5	13.5	1.1	-23.1	-53.2
Endocrine disorders	Type 2 diabetes mellitus	50,652	34.0	66.0	0.9	55.4	-4.6
Injury (external cause)	Falls (external cause)	44,549	50.2	49.8	0.8	113.5	31.6
Hearing and vision disorders	Hearing loss	43,191	0.0	100.0	0.8	66.2	-0.1
Cancer and other neoplasms	Bowel cancer	42,624	92.5	7.5	0.8	0.4	-37.4
Mental and substance use disorders	Bipolar affective disorder	39,427	0.3	99.7	0.7	110.0	62.7
Injury (external cause)	Suicide and self-inflicted injuries (external cause)	38,968	98.3	1.7	0.7	70.3	31.7
Mental and substance use disorders	Eating disorders	36,228	1.6	98.4	0.6	50.4	20.3
Neurological conditions	Migraine	34,706	0.0	100.0	0.6	24.9	-6.0
Reproductive and maternal conditions	Genital prolapse	34,380	0.4	99.6	0.6	51.7	-0.4
Cardiovascular diseases	Atrial fibrillation and flutter	33,048	33.0	67.0	0.6	131.4	34.4
Kidney and urinary diseases	Chronic kidney disease	29,691	70.4	29.6	0.5	85.5	12.8
Cancer and other neoplasms	Pancreatic cancer	28,120	98.2	1.8	0.5	73.5	5.2
Cardiovascular diseases	Other cardiovascular diseases	25,850	72.5	27.5	0.5	28.6	-16.2
Neurological conditions	Other neurological conditions	25,520	47.1	52.9	0.5	94.2	29.3
Oral disorders	Dental caries	25,126	0.1	99.9	0.4	62.3	19.9
Mental and substance use disorders	Autism spectrum disorders	24,612	1.3	98.7	0.4	510.4	353.1
Gastrointestinal disorders	Chronic liver disease	23,890	93.2	6.8	0.4	102.6	37.6
Mental and substance use disorders	Alcohol use disorders	23,670	7.7	92.3	0.4	60.4	23.8
Injury (external cause)	Poisoning (external cause)	22,879	98.9	1.1	0.4	106.7	56.5
Infectious diseases	COVID-19	21,448	79.3	20.7	0.4	NA	NA
Neurological conditions	Epilepsy	20,990	18.6	81.4	0.4	3.0	-21.6
Cancer and other neoplasms	Ovarian cancer	20,837	94.1	5.9	0.4	16.5	-27.3
Oral disorders	Periodontal disease	20,518	0.0	100.0	0.4	124.0	47.5
Cancer and other neoplasms	Other malignant neoplasms (cancers)	19,513	93.2	6.8	0.3	74.1	11.4
Skin disorders	Dermatitis and eczema	19,114	0.0	100.0	0.3	35.4	0.1
Neurological conditions	Parkinson disease	17,882	45.8	54.2	0.3	83.6	9.4
Infectious diseases	Lower respiratory infections incl influenza and pneumonia	17,718	85.0	15.0	0.3	-17.4	-49.0
Mental and substance use disorders	Drug use disorders (excluding alcohol)	17,540	3.2	96.8	0.3	60.7	24.2
Reproductive and maternal conditions	Polycystic ovarian syndrome	17,285	0.0	100.0	0.3	35.8	7.5
Blood and metabolic disorders	Iron-deficiency anaemia	16,764	0.8	99.2	0.3	93.4	44.7
Mental and substance use disorders	Other mental and substance use disorders	16,541	2.6	97.4	0.3	261.2	179.9
Cancer and other neoplasms	Brain and central nervous system cancer	16,233	95.0	5.0	0.3	15.5	-22.4
Blood and metabolic disorders	Other blood and metabolic disorders	15,949	94.9	5.1	0.3	52.1	1.0
Oral disorders	Severe tooth loss	15,766	0.0	100.0	0.3	-6.6	-43.2
Cardiovascular diseases	Non-rheumatic valvular disease	15,641	59.9	40.1	0.3	28.7	-25.8
Cancer and other neoplasms	Liver cancer	14,229	98.4	1.6	0.3	157.5	56.5
Gastrointestinal disorders	Inflammatory bowel disease IBD	13,728	3.3	96.7	0.2	58.2	12.6
Total		2,697,438	40.0	60.0	100.0	38.5	-6.8

Australian males lost more years of healthy life than females—accounting for 52.1% of the total burden. More than half the years lost to premature death were for males (58.5% of fatal total) but less than half of the years lost to illness/disability (46.7% disability burden).¹

Although rates of burden increased with age, substantial health burden were experienced in younger age groups, especially as disability burden (Figure 1). Delaying the onset of chronic diseases would have long-term benefits to individuals and the healthcare sector as younger people aged.

Figure 1. Australian premature death (YLL) and disability (YLD) health burden by age and sex, 2023

Burden of disease due to COVID-19

Nationally in 2023, the total burden of disease from COVID-19 was 48,383 years of healthy life lost (26,935 for men and 21,448 for women). While this accounted for 0.9% of the total burden, the COVID-19 pandemic may have affected other causes so this figure may not capture the full burden of COVID-19. COVID-19 ranked 33rd out of all burden of disease conditions. Most of the burden was from premature mortality (82.8%) with males contributing more to the years of healthy life lost (55.7%).¹

2018 Australian Burden of Disease Study

National comparisons

In 2018 (most recent Queensland estimate), Queenslanders lost more than 1.0 million years of healthy life.² In 2018, the total burden standardised rate in Queensland (189.6 per 1,000 population) was similar to most other jurisdictions except the Northern Territory (Figure 2) which was higher.

Figure 2: Jurisdictional burden of disease rates, 2018

In Queensland, the standardised rate of burden decreased from 2011 to 2018—from 196.6 to 189.6 DALYs per 1,000 persons.² The proportion of life lost due to illness/disability in Queensland increased and in 2018, was 52.0% disability burden.²

Remoteness and socioeconomic differences

In Australia, the standardised rate of total burden in remote and very remote areas in 2018 was 1.4 times higher than in major cities.² If all areas had the same rates of burden as major cities, the total burden in Australia would have been 4.4% lower. Kidney and urinary diseases were the most prominent disease groups contributing to this difference. Injury, infectious diseases, endocrine disorders and cardiovascular diseases also played a part. The fatal burden was 75.2% higher in remote areas than major cities, while the disability burden was 12.8% higher.

Socioeconomic disadvantage was also a significant contributor to total burden. If all areas in Australia had the same rates of burden as the least disadvantaged areas the total burden in 2018 would have been 21.4% lower.² The burden rate in the most disadvantaged areas was 1.6 times higher than in the least disadvantaged areas.

Endocrine disorders contributed greatly to this socioeconomic difference (2.3 times higher in most disadvantaged areas), along with injury (2.0 times higher) and kidney and urinary diseases (1.9 times higher). Fatal burden rates in the most disadvantaged areas were 85.7% higher than in the least disadvantaged areas, while the disability burden rate was 35.5% higher.

This would indicate there is much to be gained in reducing fatal outcomes for remote and/or disadvantaged populations, many of which also have a higher prevalence of modifiable risk factors such as tobacco use, higher alcohol consumption, unhealthy weight and poor diets.

Risk factor burden

In Australia (jurisdictional results not available), 37.5% of the total disease burden in 2018 could be attributed to the joint effect of a range of largely preventable risk factors (Table 3).³

Tobacco use was the leading risk factor in 2018 and accounted for 12.9% of deaths in Australia (Table 3). Despite the success of anti-smoking campaigns, tobacco use continues to dominate because of its very substantial contribution to fatal outcomes, particularly lung cancer and COPD, and the long lag between smoking exposure and developing tobacco-related health conditions. Preventing the uptake of smoking in young people has been a critical factor in reducing smoking rates and associated disease in Australia. Smoking cessation, especially reducing the age that people quit, also plays an important role.

Overweight (including obesity) was the second largest risk, evidence of the growing prevalence of unhealthy weight in children and adults, with increases particularly evident during the late 1990s and 2000s. It now accounts for 10.3% of deaths in Australia with its impact evident in a range of diseases including cardiovascular disease and cancer and is a leading cause of health loss.

Dietary risks combined are a significant contributor to health loss. The full range of dietary risks and their relative impact are described in more detail by AIHW.

	Percent of total			Deaths
Risk Factor	DALY	YLL	YLD	no.	%
All risk factors (joint effects)	37.5	47.9	28.0	77,794.0	48.8
Tobacco use	8.6	13.3	4.4	20,482.4	12.9
Overweight (including obesity)	8.4	9.6	7.4	16,417.7	10.3
All dietary risks	5.4	8.8	2.4	15,802.4	9.9
High blood pressure	5.1	8.1	2.3	17,326.6	10.9
Alcohol use	4.5	5.6	3.4	6,512.3	4.1
High blood plasma glucose	4.3	5.0	3.7	9,475.1	5.9
Illicit drug use	3.0	4.2	1.9	2,855.1	1.8
High cholesterol	2.7	4.6	1.0	8,044.2	5.0
Physical inactivity	2.5	3.6	1.5	8,253.0	5.2
Child abuse & neglect	2.2	1.5	2.7	812.5	0.5
Impaired kidney function	1.9	2.8	1.1	7,149.9	4.5
Occupational exposures & hazards	1.8	1.5	2.1	1,743.6	1.1
Air pollution	1.3	2.0	0.7	3,235.8	2.0
Diet low in legumes	1.2	2.0	0.5	3,603.3	2.3
Opioid use	0.9	1.4	0.5	798.2	0.5
Diet low in whole grains & high fibre cereals	0.9	1.6	0.4	2,584.0	1.6
Diet high in sodium	0.9	1.5	0.4	2,655.6	1.7
Diet high in red meat	0.9	1.4	0.4	2,345.7	1.5
Diet low in fruit	0.8	1.3	0.3	2,131.4	1.3
Amphetamine use	0.7	0.9	0.6	452.5	0.3
High sun exposure	0.7	1.3	0.2	1,932.9	1.2
Diet low in nuts & seeds	0.7	1.1	0.3	2,091.1	1.3
Low birth weight & short gestation	0.7	1.2	0.2	320.2	0.2
Intimate partner violence	0.7	0.4	0.9	227.9	0.1
Diet low in vegetables	0.6	1.0	0.2	1,934.3	1.2
Unsafe injecting practices	0.5	1.1	0.0	1,194.9	0.8
Low bone mineral density	0.4	0.4	0.4	1,373.0	0.9
Iron deficiency	0.3	0.0	0.6	23.6	0.0
Cocaine use	0.3	0.5	0.2	227.5	0.1
Diet high in processed meat	0.3	0.4	0.2	749.5	0.5
Cannabis use	0.3	0.3	0.3	177.4	0.1
Unsafe sex	0.2	0.3	0.1	308.2	0.2
Other illicit drug use	0.2	0.0	0.3	4.6	0.0
Diet low in polyunsaturated fats	0.1	0.2	0.0	336.0	0.2
Diet low in fish & seafood	0.1	0.2	0.0	313.1	0.2
Bullying victimisation	0.1	0.0	0.2	0.0	0.0
Diet high in sugar-sweetened beverages	0.1	0.1	0.1	191.9	0.1
Diet low in milk	0.1	0.2	0.0	259.3	0.2

There is limited capacity to assess the broad scope of environmental and climate effects on health burden due to data limitations and the expanding evidence base. Currently air pollution is included and in 2018 accounted for 2.0% of deaths nationally (3,236 deaths) and 1.3% of total burden. High sun exposure accounted for 1.2% of deaths and 0.7% of total burden. Occupational exposures and hazards accounted for 1.1% of deaths and 1.8% of total burden.²

The joint effect of the included risk factors accounted for 95.9% of the burden of endocrine disorders in Australia in 2018—74.2% of burden due to kidney and urinary diseases, 67.7% of the cardiovascular disease burden, 51.5% of the respiratory disease burden, 44.6% of the injury burden and 42.2%% of cancer burden.² There is, therefore, great potential to improve health outcomes through a continuing focus on prevention.

Some risk factors had impacts across quite a number of disease groups and specific conditions. Tobacco use contributed to the burden for nine disease groups, including:

39.3% of respiratory diseases
21.5% of cancer
10.7% of cardiovascular diseases
6.2% of infectious diseases
3.2% of endocrine disorders.²

Overweight and obesity contributed to a range of disease groups, including:

44.1% of the burden for endocrine disorders
31.1% for kidney and urinary diseases
21.8% for cardiovascular diseases
8.9% for musculoskeletal conditions
7.0% for cancer.²

International comparisons

The Global Burden of Disease Study (GBD) 2019⁴ is used to compare Australia with other countries and regions. Australian GBD results will differ from those in the ABDS. Considering developed countries, Australia had the 10th lowest rate of disease burden of all OECD countries and was lower than the OECD average.²

Australia ranked 6th lowest for fatal burden of all OECD countries. Conversely, Australia was ranked 26th of all OECD countries for rate of disability burden and was similar to the OECD average. The leading causes of health loss in Australia were similar to other high-income countries in the OECD and globally—cancers, cardiovascular disease, musculoskeletal disorders and mental disorders.⁴

Additional information

Data and statistics

Where presented, ratios were calculated using higher precision estimates than those that are displayed within the report.

Visit the AIHW website for more information about the Australian Burden of Disease studies:

Visit the Institute of Health Evaluation and Metrics website for more information about Global Burden of Disease (GBD).

Section technical notes

Technical information for ABDS is available on the AIHW website:

Australian Burden of Disease Study: Methods and supplementary material 2018
Australian Burden of Disease Study 2023 Technical notes

References

Australian Institute of Health and Welfare. 2023. Australian Burden of Disease Study 2023, https://www.aihw.gov.au/reports/burden-of-disease/australian-burden-of-disease-study-2023/contents/about.
Australian Institute of Health and Welfare. 2021. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018, doi:10.25816/5PS1-J259.
Australian Institute of Health and Welfare. 2021. Australian Burden of Disease Study 2018: Interactive data on risk factor burden, Australian Burden of Disease Study 2018: Interactive data on risk factor burden, https://www.aihw.gov.au/reports/burden-of-disease/abds-2018-interactive-data-risk-factors/contents/about.
GBD Collaborative Network 2020. 2022. Global Burden of Disease Study 2019: results, http://ghdx.healthdata.org/gbd-results-tool, accessed 26 October 2022.

Last updated: June 2024

	DALY in 2023				% Change in total DALY between 2003 and 2023
Disease group	Healthy years lost - DALYs	% fatal (YLL)	% disability (YLD)	% of total DALYs	Number	ASR
Cancer and other neoplasms	934,551	91.4	8.6	16.6	20.8	-26.2
Mental and substance use disorders	818,255	1.7	98.3	14.5	66.2	27.3
Musculoskeletal disorders	722,733	2.8	97.2	12.8	42.9	-4.8
Cardiovascular diseases	665,766	74.0	26.0	11.8	-9.7	-47.0
Neurological conditions	464,997	48.9	51.1	8.3	91.9	14.6
Injury (external cause)	449,920	82.5	17.5	8.0	26.3	-7.4
Injury (nature)	449,920	82.5	17.5	8.0	26.3	-7.4
Respiratory diseases	407,715	36.6	63.4	7.2	48.1	-5.9
Gastrointestinal disorders	185,934	62.3	37.7	3.3	45.5	-4.0
Endocrine disorders	154,743	37.9	62.1	2.7	55.2	-4.3
Infectious diseases	140,799	70.6	29.4	2.5	52.5	-5.7
Oral disorders	129,253	0.3	99.7	2.3	51.0	3.6
Hearing and vision disorders	127,179	0.0	100.0	2.3	91.5	12.6
Infant and congenital conditions	115,794	81.8	18.2	2.1	-5.4	-25.0
Skin disorders	93,946	8.4	91.6	1.7	37.3	0.8
Kidney and urinary diseases	81,807	61.2	38.8	1.5	75.0	1.6
Blood and metabolic disorders	70,882	54.7	45.3	1.3	60.7	6.8
Reproductive and maternal conditions	69,651	1.9	98.1	1.2	50.6	8.1
Total	5,633,926	46.1	53.9	100.0	34.7	-11.1