Some of the key risk factors for a number of life threatening diseases have increased in prevalence in Australia over the last decade according to a recent report from the Australian Institute of Health and Welfare. The report, Risk factor trends: age patterns in key health risk factors over time
, found that over the period, the proportion of people diagnosed with life threatening conditions including diabetes and chronic kidney disease had increased.
Modifiable risk factors directly associated with these life threatening conditions, including being overweight or obese, physically inactive, and having a poor diet, had increased across all age groups, while excessive alcohol consumption had increased in all but one age group. Only one risk factor, tobacco smoking, saw a decline across all age groups. In 2007–08, some 60 per cent of adults were overweight or obese, up from 45 per cent in 1995, with greater increases in obesity driving this trend. On average, across a fortnight adults spent I hour less on exercise than they did in 1995, while teenagers spent 1.3 hours less. Just 7 per cent of all adults met the recommended intake of 5 serves of vegetables a day, while only 15 per cent of teenagers met their recommended intake.
Meanwhile, the proportion of people diagnosed with type 2 diabetes had more than tripled from 1.5 per cent of the population in 1989–90, to 4.1 per cent in 2007–08, with larger increases for those aged over 55. As well, the proportion of people requiring dialysis or a kidney transplant from end stage kidney disease had almost doubled between 1989 and 2009, the report shows. Mortality from cardiovascular disease has declined, although the rate of decline was slowing for those aged 35–54, and it remains our leading cause of death.
The report also highlights the links between risk factors and disease. It notes that being overweight or obese increases the risk of developing high blood pressure, high cholesterol, heart disease, type 2 diabetes, kidney disease, certain cancers, musculoskeletal problems and mental illness. A diet low in fruit and vegetables can mean missing out on essential vitamins and minerals and dietary fibre, and their protective components. As well low intake of vegetables can indicate substitution with less healthy alternatives. Physical inactivity can contribute to higher blood pressure, cholesterol and weight gain.
While each risk factor on its own can contribute to poorer health outcomes, the co-occurrence of more than one risk factor can further increase the risk of heart disease, diabetes and kidney disease, the report warns.
These trends are worrying, but it is not all gloomy. Rates of smoking continue to fall across all age groups, and teens are drinking less alcohol to excess. As the report notes, although the prevalence of these risk factors may increase, treatments for the diseases linked to them could improve as well.
All governments are now dealing with the spectre of higher health costs associated with the increased prevalence of chronic conditions, like diabetes and kidney disease. Yet the trends in this report suggest that efforts to reduce these risk factors appear to be making little headway, with the exception of tobacco control. While some governments focus on reducing health costs by cutting their health workforce, including cutting the jobs of those working in preventative health, such an approach is not likely to be sustainable.
Simply blaming the individual for their unhealthy habits is not the answer either. Reports including this one from the World Health Organisation
continue to compile evidence that the social determinants of health play a major role in an individual’s health status. Health inequities and social factors, such as lower income levels and less educational attainment, still contribute to poorer health outcomes in Australia, as this recent AIHW report
shows and as has been noted in other reports cited in this previous Flagpost
A new Senate inquiry
will be investigating how the Commonwealth intends to respond to the social determinants of health and the WHO report. But a long term whole of government strategy addressing these social inequities may be needed if the benefits of a healthy lifestyle are to be realised for all, not just some, and to ensure future health costs are contained.