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

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 center dot 0 years (95% uncertainty interval [UI] 76 center dot 9-77 center dot 1) in 1990 to 82 center dot 9 years (82 center dot 7-83 center dot 1) in 2019. Between 1990 and 2019, the age-standardised death rate decreased from 637 center dot 7 deaths (95% UI 634 center dot 1-641 center dot 3) to 389 center dot 2 deaths (381 center dot 4-397 center dot 6) per 100 000 population. In 2019, non-communicable diseases remained the major cause of mortality in Australia, accounting for 90 center dot 9% (95% UI 90 center dot 4-91 center dot 9) of total deaths, followed by injuries (5 center dot 7%, 5 center dot 3-6 center dot 1) and communicable, maternal, neonatal, and nutritional diseases (3 center dot 3%, 2 center dot 9-3 center dot 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 center dot 6% (95% UI 21 center dot 5-28 center dot 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 f