Mental ill-health and substance use second only to cancer in nation’s disease burden

Mental health and substance use now sit behind only cancer as the leading cause of chronic ill-health and premature death in Australia, a new study finds.

Mental health is now one of the leading causes of disease burden in Australia, a new AIHW report finds. Picture: iStock

Mental health and substance use disorders now sit only behind cancer in the nation’s leading causes of ill-health and premature death, new data shows.

Anxiety disorders increased by 33 per cent since 2003 and are now the fourth leading cause of disease burden, behind only coronary heart disease, dementia and back pain, an Australian Institute of Health and Welfare study finds.

For women, they rank second, behind dementia, the Australian Burden of Disease 2023 study finds.

Offsetting the rise in mental health disorders are improvements in other areas such as coronary heart disease, stroke, arthritis and lung, bowel and breast cancers, leaving Australians living longer and in better health.

“Adjusted for population ageing, there was an 11 per cent decline in the rate of total disease burden between 2003 and 2023,” AIHW spokeswoman Michelle Gourley said.

“This was driven by a 27 per cent decrease in the rate of fatal burden, as the non-fatal burden rate increased by 6.3 per cent.”

“Australians are, on average, living longer and spending more years in full health.”

Overall disease burden is a combination of years of life lost because of dying prematurely, known as fatal burden, and years of healthy life lost from living with ill health (non-fatal burden).

In 2023, cancer topped the list of disease burden, followed by mental health conditions and substance use disorders, musculo­skeletal conditions, cardio­vascular diseases and neurological conditions.

While most of the cancer burden was fatal (92 per cent), for mental health and musculo­skeletal it was almost entirely non-fatal.

For men, the leading cause of disease burden was coronary heart disease, followed by back pain and then suicide and self-harm; for women, it was dementia, followed by anxiety disorders and then back pain.

Ms Gourley said new Australian Bureau of Statistics data on mental health in the past year had enabled the AIHW to better calculate its impact on the nation’s total disease burden.

“Anxiety disorders, depressive disorders and bipolar disorder accounted for over half (54 per cent) of the burden in this disease group,” she said. Alcohol and substance use disorders accounted for a further 14 per cent.

The study shows Australians are living longer on average, with more years in full health, but the additional life expectancy is also seeing people experiencing more years of ill-health. “Males and females born in 2023 could expect to live an average of 88 per cent and 87 per cent of their lives in full health respectively (71.6 years of the 81.3 years of average life expectancy for males, 73.6 years of the 85.1 years of average life expectancy for females),” it says.

Suicide and self-inflicted injuries was the leading cause of disease burden in males aged 15 to 34 years, while anxiety disorders was the leading cause of burden in females of the same age, it finds.

Lung cancer featured in the top five causes of disease burden for males aged 45 and over and breast cancer was the third leading cause of burden among women aged 45 to 64 years.

Dementia was the leading cause of disease burden for males and females 85 and over.

The study also shows little progress has been made from the 2018 base year on goals set in the National Preventative Health Strategy 2021-31.