11 October 2021

Heart disease one of several wins for Indigenous health

Chronic Disease Clinical Indigenous health Public Health

The Indigenous Australian burden of disease may have improved in several meaningful ways over the past 20 years, but the health gap remains virtually the same.

Despite being among the most significant health burdens, coronary heart disease improved the most of any health condition between 2003 and 2018, going from 55 disability-adjusted life years to 29.

During that time, the contributions from COPD, hearing loss, rheumatoid arthritis and type 2 diabetes also dropped significantly.

In the 15 years to 2008, the absolute gap in burden of disease between Indigenous and non-Indigenous Australians narrowed from 263 disability-adjusted life years to 223; the relative gap, however, remained stable at a rate ratio of 2.3 in each year.

According to the Australian Institute of Health and Wellbeing, this outcome was driven by the balance of fatal burden of disease for Indigenous Australians decreasing, but the non-fatal burden increasing.

Mental and substance use disorders was the disease group with the largest burden in Aboriginal and Torres Strait Islander adults, accounting for 23% of the total burden for that population.

This was followed by injuries (including suicides), which accounted for 12% of the total burden; unlike mental health and substance use, however, injuries mainly contributed to the fatal burden.

These disease groups were followed by cardiovascular diseases (mostly fatal), cancer (mostly fatal) and musculoskeletal conditions (mostly non-fatal); combined, the five groups accounted for almost two-thirds of the total burden.

Meanwhile, mental health and substance use made up just 12% of the non-Indigenous Australian burden of disease.

Overall, the non-Indigenous burden of disease was more evenly spread across the various disease groups, but the order in which they contributed differed significantly.

In descending order, the top five contributors to the non-Indigenous burden of disease were cancer, musculoskeletal conditions, cardiovascular diseases, mental health conditions and injuries.

Breaking the Indigenous Australian burden from groups into specific diseases, coronary heart disease contributed the most, followed by anxiety disorders, self-inflicted injuries, alcohol use and depressive disorders.

Meanwhile, the burden from anxiety, alcohol use and depressive disorders all increased.

Breaking the data down by age group and sex, Indigenous men consistently carried a higher rate of the total burden, with the burden trending upwards for both genders depending on age.

The data was compiled by the Australian Institute of Health and Welfare as part of the Australian burden of disease study 2018, a more extensive report on the health of the nation scheduled for release in early 2022.

AIHW 2021, online October 7

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