Mortality

Introduction

Mortality is used internationally as an indicator of overall population health and socioeconomic development. Differences in mortality patterns are commonly used in public health to identify new pathogens, exposure to harmful substances or conditions, and underlying inequities that may negatively impact health.

Key statistics

In 2022, 38,160 Queensland residents died with an age-standardised mortality rate (ASR or standardised rate) of 5.6 per 1,000 persons. Females had a lower standardised mortality rate (4.7 per 1,000) than males (6.7 per 1,000).¹

• The Queensland standardised mortality rate was similar to the Australian rate (5.5 per 1,000 persons) and Queensland ranked 6th among the eight Australian jurisdictions.¹
• Median age at death in Queensland in 2022 was 81.1 years (78.9 for males and 83.8 years for females) compared to 82.2 years for Australia overall.¹
• More than a third (36.9%) of deaths were of people 85 years and older.²

Infant mortality

In 2022, there were 283 infants deaths (defined as deaths before 12 months of age), resulting in an infant mortality rate of 4.6 per 1,000 live births.¹ The Australian infant mortality rate was 3.2 per 1,000 live births and Queensland ranked 7th among the eight Australian jurisdictions, with only the Northern Territory reporting a worse infant mortality rate.¹

Perinatal mortality

In 2021, there were 712 perinatal deaths in Queensland (including stillborn infants and deaths in the first 28 days).³ Of these, 71.6% were stillbirths. The perinatal death rate was 11.2 per 1,000 births.³

Queensland ranked 7th in 2021 among the jurisdictions based on the national definition of perinatal deaths.⁴

Mortality trends

Queensland mortality rates have declined steadily over the past several decades, a trend similarly reflected for the Australian population as whole (Figure 1). This trend, however, was disrupted due to COVID-19 and all Australian states and territories recorded an increase in deaths between 2020 and 2022.

• In 1971, the age standardised mortality rate for Queensland was 12.7 per 1,000 persons declining to 5.2 per 1,000 persons in 2021.  In 2022, this increased to 5.6 per 1,000 persons.¹
• The median age of death increased from 70.4 years in 1971 to 81.1 years in 2022.¹
• Queensland’s infant mortality rate decreased from 19.0 per 1,000 live births in 1971 to 4.6 per 1,000 live births in 2022.  This was an increase from the 2020 rate of 3.8. Nationally, the infant mortality rate in 2022 was 3.2 per 1,000 live births.¹

Figure 1: Trends in selected mortality measures for Queensland and Australia

Age at death

Older people have a higher risk of death than younger age groups. Age distributions are changing in most developed countries with older age groups making up a larger proportion of the total population. This phenomenon along with an increasing population size means that the total number of deaths will continue to increase. For this reason, age-specific rates and age-standardised rates, both of which adjust for changing age distributions, better monitor changes in mortality trends over time.

In 2022, 36.9% of Queensland deaths were among adults 85 years and older (Figure 2), while this age group makes up only 1.9% of the population.²

Remoteness and socioeconomic differences

Queensland is a diverse state with areas classified from major cities to remote or very remote based on travel distances to the nearest service centre.⁵ Socioeconomic differences in mortality metrics are assessed using the area-based index of socioeconomic advantage and disadvantage.⁶

In 2022:

• The age-standardised mortality rate was 31.4% higher in very remote areas than in major cities (6.7 and 5.1 per 1,000 persons, respectively), while the median age at death was 6.7 years younger (74.8 years in very remote areas and 81.5 years in major cities).
• Standardised death rates were 5.1 per 1,000 persons for major cities and 6.7 per 1,000 persons for very remote areas.⁷
• The median age at death for people living in major cities was 81.5 years, while it was 74.8 years for those living in very remote areas.⁷
• Infant mortality rates were 36.8% greater in outer regional areas compared to major cities.
• Queensland’s infant mortality rates were higher than the national rates in all categories of remoteness except in very remote regions.⁷
• The standardised death rate in the most socioeconomically disadvantaged areas was 39.5% higher than that of the most advantaged areas (6.7 per 1,000 persons compared with 4.8 per 1,000 persons).⁶

Premature and potentially avoidable deaths

Measures of avoidable mortality, such as premature and potentially avoidable deaths, provide a broad indication of the effectiveness of health care systems and public health strategies. Premature deaths are defined as death before 75 years of age. A subset of premature deaths from certain conditions are considered potentially avoidable meaning that they could have been prevented with individualised care or through existing health care services. In this report, potentially avoidable deaths (PADs) are classified using the National Healthcare Agreement definition.⁸

In Queensland in 2021:

• The percentage of premature deaths was 35.9% and of those, 49.1% were classified as potentially avoidable.⁹
• Males had a higher standardised premature death rate (2.6 per 1,000) than females (1.5 per 1,000). Males also had a higher standardised rate of potentially avoidable deaths (1.3 and 0.8 per 1,000 for males and females, respectively).⁹
• The standardised premature death rate in Queensland was similar to the national rate (2.1 per 1,000 compared to 2.0 per 1,000, respectively) and Queensland ranked 5th among the Australian states and territories.⁹

Figure 4: Queensland premature and potentially avoidable deaths

Leading causes of death

Globally, COVID-19 ranked 2nd in age-standardised deaths (94.0 deaths per 100,000) in 2021, ahead of stroke which had ranked 2nd since 1990.¹⁰

In 2022:

• COVID-19 was the 6th ranked cause of death in Queensland (1,581 deaths), behind the chronic conditions, coronary heart disease (4,057 deaths), dementia including Alzheimer’s disease (3,537 deaths), cerebrovascular disease (2,091 deaths), lung cancer (2,044 deaths) and COPD (1,793 deaths; Figure 5).¹¹

• Nationally, COVID-19 was the 3rd ranked cause of disease (9,859 deaths), and was listed as a contributing factor in a further 2,782 deaths across Australia.¹¹

From 2017–2021:

• The leading cause of death for Queensland residents was coronary heart disease, with dementia including Alzheimer’s disease the leading cause for females and coronary heart disease the leading cause of death for males (Figure 5).⁹

• The top five leading causes of death in this 5-year period in Queensland were:

1. Coronary heart disease: 11.6% of all deaths (12.6% for males and 10.4% for females)
2. Dementia including Alzheimer’s disease: 8.7% of all deaths (6.0% for males and 11.7% for females)
3. Cerebrovascular disease: 6.1% of all deaths (4.9% for males and 7.5% for females)
4. Lung cancer: 5.8% of all deaths (6.3% for males and 5.1% for females)
5. Chronic obstructive pulmonary disease: 4.6% of all deaths (4.7% for males and 4.4% for females).

Additional information

Data and statistics

The visualisations below provides more detailed information for mortality.

Supplemental Figure S1: Mortality measures

Section technical notes

Age-standardised rates of data from the the ABS Data Explorer and the AIHW Mortality Over Regions and Time (MORT) books were calculated by standardising to the 2001 Australian standard population.

Mortality data presented in this section were sourced from the Australian Coordinating Registry held by the Statistical Services Branch, Queensland Health. Data are presented by year of death, rather than year of registration and are subject to change.

Death data for recent periods are preliminary and subject to change. Refer to Causes of Death, Australia on the Australian Bureau of Statistics website for further information.

References

1. Australian Bureau of Statistics. 2024. Deaths, Year of registration, Summary data, Sex, States, Territories and Australia, https://explore.data.abs.gov.au/vis?fs[0]=ABS%20Topics%2C0%7CPEOPLE%23PEOPLE%23&fs[1]=ABS%20Topics%2C2%7CPEOPLE%23PEOPLE%23%7CPopulation%23POPULATION%23%7CDeaths%23DEATHS%23&pg=0&fc=ABS%20Topics&df[ds]=ABS_ABS_TOPICS&df[id]=DEATHS_SUMMARY&df[ag]=ABS&df[vs]=1.0.0&pd=2009%2C&dq=1%2B2%2B3%2B4%2B5%2B6%2B7%2B8%2B9%2B10%2B11.3.AUS.A&ly[cl]=TIME_PERIOD&ly[rw]=MEASURE, accessed 17 January 2024.
2. Australian Bureau of Statistics. 2024. Deaths, Year of registration, Age at death, Age-specific death rates, Sex, States, Territories and Australia, https://explore.data.abs.gov.au/vis?fs[0]=ABS%20Topics%2C0%7CPEOPLE%23PEOPLE%23&fs[1]=ABS%20Topics%2C2%7CPEOPLE%23PEOPLE%23%7CPopulation%23POPULATION%23%7CDeaths%23DEATHS%23&pg=0&fc=ABS%20Topics&df[ds]=ABS_ABS_TOPICS&df[id]=DEATHS_AGESPECIFIC_REGISTRATIONYEAR&df[ag]=ABS&df[vs]=1.0.0&pd=2009%2C&dq=12.3.TOT%2BA04%2BA59%2BA10%2BA15%2BA20%2BA25%2BA30%2BA35%2BA40%2BA45%2BA50%2BA55%2BA60%2BA65%2BA70%2BA75%2BA80%2BA85%2BA90%2BA95%2BA99%2B999..A&ly[cl]=TIME_PERIOD&ly[rw]=AGE&ly[rs]=REGION, accessed 17 January 2024.
3. Queensland Health. 2023. Queensland perinatal statistics 2021, Queensland Government, Brisbane, https://www.health.qld.gov.au/hsu/peri/peri2021/queensland-perinatal-statistics-2021, accessed 17 January 2024.
4. Australian Institute of Health and Welfare. 2023. Australia’s mothers and babies, AIHW, Canberra, https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies/contents/about, accessed 17 January 2024.
5. Hugo Centre for Population and Migration Studies. 2018. Accessibility/Remoteness Index of Australia (ARIA), https://able.adelaide.edu.au/hugo-centre/services/aria, accessed 1 October 2022.
6. Australian Coordinating Registry. 2022. Cause of death unit record file, https://www.qld.gov.au/law/births-deaths-marriages-and-divorces/data/national-data, accessed 26 September 2022.
7. Australian Bureau of Statistics. 2023. Deaths, Australia 2022, Australian Bureau of Statistics, https://www.abs.gov.au/statistics/people/population/deaths-australia/2022, accessed 1 January 2024.
8. Australian Institute of Health and Welfare. 2021. National healthcare agreement: PI 16–potentially avoidable deaths, 2022, https://meteor.aihw.gov.au/content/740864, accessed 10 October 2022.
9. Australian Institute of Health and Welfare. 2023. Mortality Over Regions and Time (MORT) books: State and territory, 2017 - 2021., https://www.aihw.gov.au/reports/life-expectancy-deaths/mort-books/contents/mort-books, accessed 17 January 2024.
10. Naghavi M, Ong KL, Aali A, et al. 2024. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021, The LancetS0140673624003672, doi:10.1016/S0140-6736(24)00367-2.
11. Australian Bureau of Statistics. 2023. Causes of death, Australia, 2022, ABS, Canberra, https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/2022, accessed 18 March 2022.