The burden and trend of diseases and their risk factors in Australia, 1990–2019 : a systematic analysis for the Global Burden of Disease Study 2019

GBD 2019 Australia Collaborators, Sheikh Mohammed Shariful ISLAM*, Ralph MADDISON, Riaz UDDIN, Kylie BALL, Katherine M. LIVINGSTONE, Asaduzzaman KHAN, Jo SALMON, Ilana N. ACKERMAN, Tim ADAIR, Oyelola A. ADEGBOYE, Zanfina ADEMI, Ripon Kumar ADHIKARY, Bright Opoku AHINKORAH, Khurshid ALAM, Kefyalew Addis ALENE, Sheikh Mohammad ALIF, Azmeraw T. AMARE, Edward Kwabena AMEYAW, Leopold N. AMINDEDeanna ANDERLINI, Blake ANGELL, Adnan ANSAR, Benny ANTONY, Anayochukwu Edward ANYASODOR, Victoria Kiriaki ARNET, Thomas ASTELL-BURT, Prince ATORKEY, Mamaru Ayenew AWOKE, Beatriz Paulina Ayala QUINTANILLA, Getinet AYANO, Nasser BAGHERI, Anthony BARNETT, Bernhard T. BAUNE, Dinesh BHANDARI, Sonu BHASKAR, Raaj Kishore BISWAS, Rohan BORSCHMANN, Soufiane BOUFOUS, Andrew M. BRIGGS, Rachelle BUCHBINDERA, Norma B. BULAMU, Richard A. BURNS, Andre F. CARVALHO, Ester CERIN, Nicolas CHERBUIN, Enayet Karim CHOWDHURY, Liliana G. CIOBANU, Scott Richard CLARK, Marita CROSS, Abel Fekadu DADI

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

10 Citations (Scopus)


Background: A comprehensive understanding of temporal trends in the disease burden in Australia is lacking, and these trends are required to inform health service planning and improve population health. We explored the burden and trends of diseases and their risk factors in Australia from 1990 to 2019 through a comprehensive analysis of the Global Burden of Disease Study (GBD) 2019. Methods: In this systematic analysis for GBD 2019, we estimated all-cause mortality using the standardised GBD methodology. Data sources included primarily vital registration systems with additional data from sample registrations, censuses, surveys, surveillance, registries, and verbal autopsies. A composite measure of health loss caused by fatal and non-fatal disease burden (disability-adjusted life-years [DALYs]) was calculated as the sum of years of life lost (YLLs) and years of life lived with disability (YLDs). Comparisons between Australia and 14 other high-income countries were made. Findings: Life expectancy at birth in Australia improved from 77·0 years (95% uncertainty interval [UI] 76·9–77·1) in 1990 to 82·9 years (82·7–83·1) in 2019. Between 1990 and 2019, the age-standardised death rate decreased from 637·7 deaths (95% UI 634·1–641·3) to 389·2 deaths (381·4–397·6) per 100 000 population. In 2019, non-communicable diseases remained the major cause of mortality in Australia, accounting for 90·9% (95% UI 90·4–91·9) of total deaths, followed by injuries (5·7%, 5·3–6·1) and communicable, maternal, neonatal, and nutritional diseases (3·3%, 2·9–3·7). Ischaemic heart disease, self-harm, tracheal, bronchus, and lung cancer, stroke, and colorectal cancer were the leading causes of YLLs. The leading causes of YLDs were low back pain, depressive disorders, other musculoskeletal diseases, falls, and anxiety disorders. The leading risk factors for DALYs were high BMI, smoking, high blood pressure, high fasting plasma glucose, and drug use. Between 1990 and 2019, all-cause DALYs decreased by 24·6% (95% UI 21·5–28·1). Relative to similar countries, Australia's ranking improved for age-standardised death rates and life expectancy at birth but not for YLDs and YLLs between 1990 and 2019. Interpretation: An important challenge for Australia is to address the health needs of people with non-communicable diseases. The health systems must be prepared to address the increasing demands of non-communicable diseases and ageing. Funding: Bill & Melinda Gates Foundation.

Original languageEnglish
Pages (from-to)e585-e599
JournalThe Lancet Public Health
Issue number8
Early online date27 Jul 2023
Publication statusPublished - Aug 2023

Bibliographical note

Funding Information:
SMSI is funded by the National Heart Foundation of Australia (102112) and a National Health and Medical Research Council (NHMRC) Emerging Leadership Fellowship (APP1195406). RU is supported by an Alfred Deakin Postdoctoral Research Fellowship. KML is supported by an NHMRC Emerging Leadership Fellowship (APP1173803). JS is supported by an NHMRC Leadership Level 2 Fellowship (APP 1176885).

Publisher Copyright:
© 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license


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