New data shows that life expectancy in Australia and New Zealand - the number of years a person can expect to live in good health - has increased steadily over the past three decades to 70.0 years in Australia (a 4.1 year increase from 1990) and 69.4 in New Zealand (a 4.7 year increase) in 2019.
However, it has not risen as much as overall life expectancy (82.9 and 81.8, respectively; 5.9 and 6.2 year increases from 1990), indicating that people are living more years in poor health.
Ischaemic heart disease was the leading cause of poor health measured by disability-adjusted life-years (DALYs) in the region in 2019, followed by low back pain, falls, chronic obstructive pulmonary disease (COPD), and depressive disorders.
The top-five risk factors for death in both Australia and New Zealand in 2019 were high systolic blood pressure (contributing to an estimated 25,500 deaths and 5,970 deaths respectively), dietary risks (21,600 deaths; 5,050 deaths), tobacco use (20,100; 5,030), high BMI (18,700; 3,630), and high blood sugar (17,700; 3,410).
Over the past 30 years, overall rates of death among 15-49 year olds declined by 31% in Australia and 36% in New Zealand.
However, rates of death due to endocrine, metabolic, blood, and immune disorders among this age group rose sharply, by 75.2% in Australia and 61.8% in New Zealand.
The data was published as part of The Lancet’s latest Global Burden of Disease Study, which analysed 286 causes of death, 369 diseases and injuries, and 87 risk factors in 204 countries and territories.
Tipping point
The study reveals that the rise in exposure to key risk factors, including high blood pressure, high blood sugar, high BMI and elevated cholesterol, combined with rising deaths from cardiovascular disease in some countries, suggests that the world might be approaching a turning point in life expectancy gains.
The authors stress that the promise of disease prevention through government actions or incentives that enable healthier behaviours and access to health-care resources is not being realised around the world – particularly in relation to diet and nutrition.
“Most of these risk factors are preventable and treatable, and tackling them will bring huge social and economic benefits. We are failing to change unhealthy behaviours, particularly those related to diet quality, caloric intake, and physical activity, in part due to inadequate policy attention and funding for public health and behavioural research,” says Professor Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, USA, who led the research.
Several of the risk factors and non-communicable diseases (NCDs) highlighted by the study, including obesity, diabetes, and cardiovascular disease, are associated with increased risk of serious illness and death from COVID-19, the study added.
It also highlighted that disability, rather than early death, has become an increasingly large share of the global disease burden - rising from around a fifth (21%) of total burden in 1990 to more than a third (34%) in 2019.
In 11 countries, more than half of all health loss measured by DALYs is now due to disability caused by NCDs and injuries - including in Singapore, Iceland, Norway, Ireland, Australia, New Zealand, and Qatar.
The study noted that the global health efforts to tackle infectious diseases and address prenatal care have been successful in improving the health of children aged under 10 years in the past few decades ,with the overall disease burden declining by approximately 55%, but this has not been matched by a similar response in older age groups.
Age impact
Indeed, the top ten contributors to increasing health loss worldwide over the past 30 years, measured as the largest absolute increases in number of DALYs, include six causes that largely affect older adults. These are ischaemic heart disease (with numbers of related DALYs increasing by 50% between 1990 and 2019), diabetes (up 148%), stroke (32%), chronic kidney disease (93%), lung cancer (69%), and age-related hearing loss (83%).
For example, from 1990 to 2019, the number of DALYs due to ischaemic heart disease rose by more than 400% in the Philippines, while the number of DALYs due to diabetes rose by more than 1000% in the United Arab Emirates.
Such increases in ill health threaten to strain health-care systems ill-equipped to handle the chronic conditions associated with growing, ageing populations, the authors noted.
The greatest cumulative impact on health comes from the striking rise in metabolic risks, which have risen 1.5% a year since 2010. Collectively, metabolic risks (namely high BMI, high blood sugar, high blood pressure, and high cholesterol) accounted for nearly 20% of total health loss worldwide in 2019— 50% higher than in 1990 (10.4%).
They are also responsible for a huge number of deaths globally—with high blood pressure contributing to 1 in 5 deaths (almost 11 million) in 2019, high blood sugar (6.5 million deaths), high BMI (5 million), and high cholesterol (4.4 million).
“Simply providing information on the harms of these risks is not enough”, said co-author Professor Emmanuela Gakidou from IHME. “Given that individual choices are influenced by financial considerations, education, and the availability of alternatives, governments should collaborate globally on initiatives to make healthier behaviour possible for everyone. And, drawing lessons from decades of tobacco control, when there is a major risk to population health, such as obesity, concerted government action through regulation, taxation, and subsidies may be required
Healthy Ageing was the topic of our first Growth Asia 2020 interactive broadcast series. You can watch on demand, free of charge, here.
Source: The Lancet
