The risk factors
Recent years have seen daily smoking in Australia decline among people aged 14 and older, from 15.1% in 2010 to 12.85% in 2013.3 Those most likely to smoke are aged 40–49 (16.2%).4 The rates of daily smoking among people aged 18–49 have dropped significantly, from 24.7% in 2001 to 14.9% in 2013. However, daily smoking rates in people aged 60 and older have changed little between 2001 (11.3%) and 2013 (11.6%).3
Smoking kills an estimated 19,000 Australians every year and is the risk factor responsible for the greatest burden of disease in the country (9.7%).5 Smoking is estimated to kill approximately half of all long-term users,6 causing 40% of deaths in men and 20% of deaths in women before the age of 65.7
1.4.2 Overweight and obesity
In 2011–12, 62.8% of Australians aged 18 and older were overweight (35.3%) or obese (27.5%), while 25.7% of Australian children aged 5–17 were either overweight or obese, with the prevalence of both increasing.8 These are comparable with the rates seen in general practice (refer to Section 1.1).
Diet is a key contributor to optimum health throughout every stage of the lifespan. Exclusive breastfeeding for at least the first six months of life offers considerable health benefits to infants and, in the long term, to children and adults.9 Diets low in fruit and vegetables have been causally linked to cancer and CVD, accounting for 2.1% of the total burden of disease and injury in Australia in 2003.10 Most Australians (91%) do not eat enough vegetables and only half eat enough fruit.11
Alcohol consumption accounted for 3.3% of the total burden of disease and injury in Australia in 2003.10 However, this figure may be an underestimate.12 Even though moderate alcohol intake may have beneficial effects at middle and older ages, alcohol is harmful when consumed in excess at all ages.10 Alcohol is responsible for the majority of drug-related deaths and hospital episodes among people aged 15–34, causing more deaths and hospitalisations in this age group than tobacco or all illicit drugs.12
1.4.5 Physical activity
Physical inactivity is responsible for nearly 7% of the total burden of disease and injury and accounted for approximately 13,500 deaths in Australia in 2003.10 Based on data from the 2007–08 National Health Survey, almost 60% of Australians aged 15 and older do not undertake sufficient physical activity to confer a health benefit.13 Physical activity is an important part of a healthy lifestyle. It may reduce the risk of developing conditions such as CVD, diabetes and certain types of cancer.
1.4.6 Health inequalities
There are significant health inequalities in Australia and people’s risk factors can vary according to where they live. People living in more disadvantaged areas have more risk factors (eg. obesity, risky/high-risk alcohol consumption, daily smoking, physical inactivity, high blood pressure, insufficient consumption of fruit, vegetables and whole milk). For example, 27% of people living in areas of least disadvantage report having four or more risk factors compared with 46% who live in the most disadvantaged areas.14
People from low socioeconomic backgrounds, people living in rural and remote areas, and Aboriginal and Torres Strait Islander peoples are at greater risk of CVD than the general population.15 While a study has shown that CVD death rates fell for all socioeconomic groups between 1992–2002, the proportion of CVD deaths due to socioeconomic inequality increased.16 Socioeconomically disadvantaged people make greater use of primary and secondary health services such as doctors, hospitals and outpatient clinics and are at higher risk of chronic disease.17
- Australian Institute of Health and Welfare. Tobacco smoking (NDSHS 2013 key findings). Available at www.aihw.gov.au/alcohol-and-other-drugs/ndshs/2013/tobacco [Accessed 15 September 2014].
- Australian Bureau of Statistics. Australian Health Survey: Updated results 2011–2012. Cat no. 4364.0.55.003. Canberra: ABS; 2013.
- Australian Institute of Health and Welfare. Tobacco smoking. Available at www.aihw.gov.au/risk-factors-tobacco-smoking [Accessed 10 July 2014].
- Peto R, Lopez PR, Boreham J, Thun M, Heath C. Morbidity from smoking in developed countries 1950–2000. Oxford: Oxford University Press; 1994.
- English DR, Holman CD, Milne E, et al. The quantification of drug caused morbidity and mortality in Australia. Canberra: Commonwealth Department of Health and Human Services; 1995.
- Australian Bureau of Statistics. Profiles of Health, Australia 2011–13. Cat no. 4338.0. Canberra: ABS; 2014.
- World Health Organization. The optimal duration of exclusive breastfeeding: A systematic review. Geneva: WHO. Available at www.who.int/nutrition/publications/infantfeeding/WHO_NHD_01.08/en. [Accessed 10 July 2014].
- Begg S, Vos T, Barker B, Stevenson C, Stanley L, Lopez AD. The burden of disease and injury in Australia 2003, PHE 82. Canberra: AIHW; 2007.
- Australian Institute of Health and Welfare. Australia’s food and nutrition 2012: in brief. Available at www.aihw.gov.au/food-and-nutrition/in-brief [Accessed 10 July 2014].
- National Health and Medical Research Council. Australian guidelines to reduce health risks from drinking alchol. Canberra: NHMRC; 2009.
- Australian Institute of Health and Welfare. Risk factors contributing to chronic disease. Cat No. PHE 157. Canberra: AIHW; 2012.
- Australian Institute of Health and Welfare. Australia’s health 2012. Australia’s health series no.13. Cat. no. AUS 156. Canberra: AIHW; 2012.
- Australian Institute of Health and Welfare. Cardiovascular disease: Australian facts 2011. Cardiovascular disease series. Cat. no. CVD 53. Canberra: AIHW; 2011.
- Waters AM, Moon L. Socioeconomic inequalities in cardiovascular disease in Australia. AIHW bulletin no. 37. Cat. no. AUS 74. Canberra: AIHW; 2006.
- Harris M, Furler J. How can primary care increase equity in health? NSW Public Health Bull 2002;13(3):35–8.