Burden of Disease

This section was prepared by the First Nations Health Office with technical support by the area that prepares The Health of Queenslanders: Report of the Chief Health Officer Queensland. Data sources may differ from those used in the wider report and results may not be comparable. Please see technical documentation for additional information.

Introduction

Burden of disease summarises estimated health loss in populations by cause using a measure called the disability adjusted life year (DALY) which is a sum of fatal and non-fatal health loss. The Queensland Burden of Disease Study 2018 provides the most recent detailed Burden of Disease estimates for Queensland by First Nations status.¹ Below is a summary of results from this study.

Note that these results are not comparable to national results summarised in the Burden of Disease section in the whole of population report (which reports data from the Australian Burden of Disease Study produced by the Australian Institute of Health and Welfare).

Health-adjusted life expectancy

Accounting for health loss from all causes, the health-adjusted life expectancy (HALE), defined as the average cumulative years of life lived in full health, for First Nations peoples was 59.4 years. This was 1.4 years longer than in 2011, but 15.8 years less than other Queenslanders. Two-thirds of the HALE gap (10.1 years) between First Nations and Other Queenslanders was due to non-fatal health loss.

Leading causes of health loss

Disease groups

The burden of disease can be attributed to 17 disease groups (also known as ‘cause groups’). The leading five disease groups together contributed 63% of the disease burden experienced by First Nations peoples in Queensland in 2018. These disease groups were:

• mental and substance use disorders (24%)
• injury (12%)
• cancers and other neoplasms (10%)
• cardiovascular diseases (9%)
• musculoskeletal conditions (8%).

Mental and substance use disorders were the leading disease group for both males and females. For females, cancer and musculoskeletal disease groups were the 2nd and 3rd respectively, while injury and cardiovascular disease groups were 2nd and 3rd for males.

Specific causes

Each disease group can be disaggregated further into specific conditions. In the Queensland Burden of Disease Study 2018 there were 201 specific conditions. Anxiety disorders followed by suicide and self-inflicted injury, and coronary heart disease were the leading causes of disease burden among First Nations peoples in 2018.

Trends

The Queensland Burden of Disease Study estimates the population health loss at two time points—2011 and 2018. Over this time there was considerable decrease in the burden of disease due to cardiovascular diseases with an age-standardised rate (ASR or standardised rate) reduction of 16.9 DALYs per 1,000 persons or 27%. This was driven by decreases in both coronary heart disease and stroke burden. At the same time, the standardised rate of mental and substance use disorder burden increased by 13.6 DALYs per 1,000 persons or 24%. Health loss from all specific mental and substance use disorders were estimated to have increased except for eating disorders.

Regional differences

The burden of disease and injury rates in First Nations peoples in Queensland increased with increasing remoteness. The standardised rate in remote and very remotes areas was 23% higher than in major cities. This was driven by the high rate of fatal health loss in remote areas, which was 40% higher.

Figure 1: Standardised burden rate for First Nations peoples by remoteness categories

Compared to other Queenslanders

The standardised rate of disease burden in First Nations peoples in Queensland in 2018 was 2.1 times that of other Queenslanders (388.0 and 181.5 DALY per 1,000 persons, respectively). Rates for both populations had come down slightly from 2011 levels with a 4% reduction in the rate for First Nations peoples in Queensland and a 3% reduction in the rate for other Queenslanders. As a result, the standardised rate ratios between the two populations have remained stable over the period (2.1 in 2011).

There is a significant difference in the age distribution of burden (Figure 2), and while the leading disease groups among First Nations peoples in Queensland tend to be those associated with younger age (mental and substance use disorders and injury), those in other Queenslanders are associated with older age (cancers and cardiovascular diseases).

Figure 2: Age distribution of burden rate for First Nations peoples and other Queenslanders

Risk factors

Together, the 13 modifiable risk factors included in the Queensland Burden of Disease Study 2018 accounted for 45% of the burden for First Nations peoples in Queensland in 2018. The rate of burden due to these risk factors combined was 3.3 times higher among First Nations peoples compared to other Queenslanders.

The individual risk factors that caused the greatest burden were:

• tobacco use (13.3%)
• alcohol use (10.4%)
• overweight and obesity (10.2%).

Additional information

Information and strategies

A more fulsome analysis of the results from the Queensland Burden of Disease Study 2018 for First Nations peoples is available on the Queensland Health Burden of Disease website.¹

Section technical notes

Results presented in this section are not directly comparable to:

• the burden of disease results presented for the whole of population Burden of disease – Report of the Chief Health Officer Queensland.
• the Australian Burden of Disease Study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2018 produced by the Australian Institute of Health and Welfare.

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