Australia’s new leading contributor to burden of disease

Australians lost an estimated 5.8 million years of healthy life in 2024 due to disease and dying prematurely – and overweight and obesity is the leading risk factor.
 
At 8.3%, overweight and obesity overtook tobacco smoking (7.6%), followed by dietary risks (4.8%) and high blood pressure (4.4%).
 
The findings are from the latest Australian Burden of Disease Study, released on Thursday, by the Australian Institute of Health and Welfare (AIHW).
 
AIHW spokesperson Michelle Gourley said more than a third of the total burden of disease and injury in Australia in 2024 ‘could have been avoided or reduced’ due to modifiable risk factors.
 
She attributed overweight and obesity overtaking tobacco to a ‘substantial fall’ (41%) in the age-standardised rate of total burden due to tobacco use since 2003.
 
‘This fall is likely due to declines in smoking prevalence and burden rates from some of the major linked diseases, such as lung cancer and chronic obstructive pulmonary disease (COPD),’ Ms Gourley said.
 
Dr Terri-Lynne South, who is a GP, dietitian and Chair of RACGP Specific Interests Obesity Management, told newsGP she is not surprised by the findings.
 
‘If we think about the prevalence of overweight and obesity increasing in Australia, I would expect that the health consequences of that would be increasing as well,’ she said.
 
‘On the one hand you’ve got overweight and obesity increasing, on the other hand, the population of tobacco use is decreasing, that’s not including vapes.’
 
According to data from 2022−23, 65.8% of Australians aged 18 years and over were living with overweight or obesity, comprised of 34% overweight and 31.7% obesity.
 
For Dr South, the findings are a ‘call to action’.
 
She says this is the information policymakers need to better prioritise health initiatives in the management of overweight and obesity for Australians.
 
‘We need better funding and health equity towards evidence-based primary, secondary and tertiary prevention and management of overweight and obesity,’ Dr South said.
 
‘We’ve got some good interventions there, but they are out of reach for our patient population who needs it the most.’
 
When it came to specific diseases causing burden in 2024, cancer remained in the top spot at 16.4%, with 91.3% of the burden fatal and 8.7% non-fatal. This was followed by coronary heart disease (5.5%), dementia (4.5%), back pain and problems (4.3%), anxiety disorders (3.9%) and COPD (3.7%).
 
The study, which also breaks down the burden of disease based on age and gender, found males experienced more total disease burden than females across all age groups, with the leading cause of burden among males coronary heart disease, and dementia for females.
 
Meanwhile, for young males aged 15–24, the most burden was caused by suicide and self-inflicted injuries (12%), followed by anxiety disorders (10%) and depression (7%), with alcohol and illicit drug use the leading risk factors.
 
For females in the same age bracket, anxiety disorders (17%) were the leading cause of burden, followed by depression (12%) and eating disorders (7%), with child abuse and neglect the main contributing risks.
 
However, after adjusting for population ageing, the report did find a 10% decrease in total disease burden between 2003 and 2024, driven by a 26% drop in the rate of fatal burden, while the non-fatal burden rate increased by 7%.
 
The study, which is conducted annually, sets out to estimate the years of healthy life Australians lose due to injury, illness and premature death. It measures more than 200 diseases and injuries, as well as assessing and estimating disease burden attributed to 20 individual risk factors.
 
Ms Gourley said it was concerning to see that while Australians are living longer on average, the years they are living in ill health are also growing.
 
‘[This is] resulting in little change in the proportion of life spent in full health,’ she said.
 
‘This contributes to the growing demand and pressures on the health system and services.’
 
Meanwhile, Dr South noted that while overweight and obesity is the leading cause of disease burden in Australia, there were other overlapping concerns, including dietary risks and high blood pressure.
 
This is where she says GPs have a pivotal role to play.
 
‘GPs have a role in what we would call primary prevention of overweight and obesity; secondary prevention, which is if someone does have a diagnosis of clinical obesity, helping them avoid the complications of that clinical condition called obesity; and then tertiary prevention, which is when someone has clinical obesity, they have some of the complications, and trying to help manage the burden of those complications,’ Dr South said.
 
‘We have not been treating obesity as its own clinical condition deserving of quality care in all three domains, as we may have with other non-communicable health conditions.
 
‘[We need] to try and put more initiatives into trying to stop the rising rates of overweight and obesity.’
 
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AIHW burden of disease obesity overweight preventive health tobacco