Driving assessment

Burden of COVID and dementia set to increase: AIHW report

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The life expectancy of boys is rising faster than that of girls, as the true impact of the pandemic shows in the national agency’s latest health assessment.

Dementia is already one of the leading causes of death and it is expected to increase.


The good news in the latest health report from the Australian Institute of Health and Wellbeing (AIHW) is that we are likely to live longer. The most disturbing finding is that the burden of chronic disease continues to grow, a trend now fueled by COVID-19 and rising rates of dementia.


This is the snapshot of the the health of the nation in the AIHW’s 18th gender report.


Released this week, it reports the life expectancy of a girl born between 2018 and 2020 at 85.3, with 81.3 the equivalent figure for boys.


This represents an increase from 80.1 and 73.9 years respectively in 1990, with the increase of 7.4 years for boys (nearly 10%) narrowing the gap significantly.


The report, however, highlights significant and predictable inequalities, with the life expectancy of Aboriginal and Torres Strait Islander people nearly 10 years lower than that of non-Aboriginal residents, at 75.6 years for women and 71 .6 years for men.


It also says the rate of serious illness – defined as admission and/or death in intensive care – was about seven times higher among Indigenous Australians than the general population.



Impact of COVID
A key focus of the report is the growing impact of COVID-19 in Australia, with data from earlier this year showing the prevalence of the disease leading to higher death rates. There were 3,105 more deaths than expected in the first two months of 2022 alone, reports the AIHW.


Despite the huge daily disruptions, Australians had been mostly shielded from the mortality impacts of COVID-19 in 2020 and 2021, although the AIHW reports an increase in the use of mental health services – a familiar trend to many working in general medicine.


Falling death rates continued in 2020 and 2021, years that saw 205 and 94 fewer deaths, respectively, than expected once statistical variations are taken into account, according to the AIHW.


Earlier figures showed Australia’s death rate hit its lowest on record in 2020 – an age-standardized death rate of 487.7 deaths per 100,000 – with restrictions introduced for stopping the spread of the virus which was probably key.


Again, the AIHW highlights heightened risks by socioeconomic status, with COVID-19-related death rates in the poorest areas three times higher than those in the most affluent neighborhoods. The report also points to the disproportionate burden of migrants, a trend that shows no signs of abating according to the latest data from the Australian Bureau of Statistics (ABS).



Burden of chronic disease
Coronary heart disease continues to be the leading cause of disease burden and death, despite the dramatic fall in the death rate per 100,000 in recent decades – from 428 deaths per 100,000 in 1968 to 49 per 100,000 in 2020 .


For men, the top five causes of death in 2020 in descending order were: coronary heart disease, dementia including Alzheimer’s disease, lung cancer, cerebrovascular disease and prostate cancer.


For women, it was dementia, including Alzheimer’s disease, coronary heart disease, cerebrovascular disease, lung cancer and breast cancer.


In people aged over 85, dementia was by far the biggest cause of death, with the report warning that “the number of Australians with dementia – and the resulting mortality – is set to continue to rise, with more Australians living to older ages”. .


It also indicates that almost half of the population – or 47% or 11.6 million people – suffered from at least one chronic condition in 2020-2021, including arthritis, asthma, back problems, diabetes and mental and behavioral disorders.


“More than a third of the disease burden was potentially preventable – that is, it could have been avoided if Australians had reduced or avoided exposure to certain risk factors,” the report said. the AIHW.


It identifies smoking, overweight and obesity, dietary risks, high blood pressure and alcohol consumption as the five most important risk factors.



General practice
A slightly decreasing proportion of people had at least one Medicare GP service in 2020-21, the report says – a total of 85% compared to 87% in 2019-2020.


The AIHW says there were 171 million GP visits in 2020-21, of which around 108 million were a Level B consultation lasting less than 20 minutes, and women are more likely to see their general practitioner than men.


It also indicates that a lower proportion of people delayed or did not see their GP due to cost compared to the previous year (2.4% compared to 3.7%, although this number has fallen to 3.1% for people with a long-term health problem).


Of the 16.6 million patients who used prescription drugs in 2020-21, about a third of the drugs were for cardiovascular disease, and there was a total of $12.9 billion spent on subsidized pharmaceuticals, including $11.9 billion used for other drugs.


In 2020-21, the AIHW reports that $17 billion was spent on health insurance for primary care services, with the majority of that spending ($8.8 billion, or 51%) going to health care visits. general practitioners, followed by $4.2 billion in diagnostic imaging.



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