Healthy Communities: Avoidable deaths and life expectancies in 2009–2011 - Report - Summary

Healthy Communities: Avoidable deaths and life expectancies in 2009–2011

Summary

Deaths are caused by many factors. Some deaths can be avoided through better access to health care or through more effective treatments. Rates of avoidable deaths per head of population can be a useful indicator of how well health systems are performing.

Australia has one of the lowest rates of amenable (potentially treatable) deaths and the seventh-highest life expectancy at birth in the world following Switzerland, Japan, Italy, Spain, Iceland and France.1

Although the overall health and wellbeing of people in Australia is high and improving, national-level figures disguise considerable disparities across local communities, which once revealed can highlight opportunities to improve health and medical care for all Australians.

In order to assist local areas to target improvements in prevention and health services, and improve the health of all Australians, this report for the first time:

  • Presents comparable rates of potentially avoidable deaths and life expectancy at birth across local areas nationally
  • Compares local areas of similar geographic, demographic and socioeconomic circumstance, and
  • Profiles 61 Medicare Local catchments using 18 measures.

Potentially avoidable deaths comprise two sub-categories: preventable deaths, for which the conditions or actions responsible for the deaths might have been prevented (an example being lung cancer), and deaths that might have been avoided by better access to or provision of medical care, even if the medical condition could not itself have been prevented (an example being breast cancer).

For the purposes of this report, this first sub-category is referred to as ‘potentially preventable deaths’, and the second category is referred to as ‘potentially treatable deaths’. These two categories are not mutually exclusive. Some deaths could be avoided by both prevention and treatment.

Potentially avoidable deaths are those that occur prematurely (before the age of 75) that might have been avoided through better prevention or health care. Potentially avoidable deaths include both preventable and treatable deaths.

  • Potentially preventable deaths are those that occur prematurely that might have been avoided through better preventive health activities such as screening, good nutrition and healthy habits such as exercise. Examples include premature deaths related to lung cancer and suicide
  • Potentially treatable deaths are those that occur prematurely that might have been avoided through better medical services and therapeutic interventions, such as surgery or medication. Examples include premature deaths related to bowel, breast and skin cancer, and heart disease.

These two categories are not mutually exclusive. Some deaths could be avoided through both prevention and treatment (Figure 1).

The Council of Australian Governments (COAG) has identified potentially avoidable deaths as a measure of the effectiveness of health care, to be used by the National Health Performance Authority to report on local health systems. Life expectancy data are reported as contextual information about these local areas.

Figure 1: Classification of potentially avoidable deaths as preventable or treatable and most common cause of death by category, in Australia, 2009-11

Image displaying classification of potentially avoidable deaths in Australia during 2009-11.

Classification of potentially avoidable deaths as preventable or treatable and most common cause of death by category, in Australia, 2009-11.

The classification of potentially avoidable deaths are split into Deaths greater or equal to 75 years or less than 75 years (premature). Premature deaths are then split further into unavoidable deaths and avoidable. Avoidable deaths are comprised of two categories: Preventable and Treatable as shown in the following table: Show tabular data Hide tabular data
Preventable cause of death Treatable cause of death
1 Lung cancer Ischaemic heart disease§
2 Ischaemic heart disease§ Colorectal cancer (bowel cancer)
3 Suicide and self-inflicted injuries Breast cancer
4 Chronic obstructive pulmonary disease (lung diseases) Cerebrovascular diseases (stroke)§
5 Road traffic injuries Melanoma of skin (skin cancer)
6 Alcohol-related diseases Selected bacterial and other infections
7 Accidental poisonings Diabetes (type 1 and type 2)§
8 Cerebrovascular diseases (stroke)§ Birth defects
9 Liver cancer Nephritis and nephrosis (kideny disease)
10 Oesophagal cancer (throat cancer) Bladder cancer
*
Avoidable deaths are those before the age of 75 years that are potentially preventable and/or treatable.
Preventable conditions are those which are responsive to preventive activities such as screening, diet and exercise.
Treatable (amenable) conditions are those which are responsive to therapeutic interventions, such as surgery or medication.
§
Ischaemic heart disease, cerebrovascular diseases and diabetes are included in both preventable and treatable categories.
Source:
Australian Bureau of Statistics Causes of Death Customised Report 2009–2011.

For more detailed information refer to Table 1 on Introduction page.

Key findings

Potentially avoidable deaths

In the three calendar years from 2009 to the end of 2011, more than 33,000 Australians died prematurely on average per year from causes that might have been avoided through better prevention or medical treatment. These deaths accounted for two-thirds (66%) of all deaths before the age of 75.

During the three-year period, the age-standardised rate of potentially avoidable deaths on average per year was more than three times higher in the Medicare Local catchment with the highest rate, compared to the Medicare Local with the lowest rate.

The rates ranged from 96 deaths per 100,000 people on average per year in Inner East Melbourne to 316 deaths per 100,000 in Central and North West Queensland (Potentially avoidable deaths section on Key findings page and Fair Comparisons section on Key findings page).

Six causes accounted for just over 50% of all potentially avoidable deaths – ischaemic heart disease, lung cancer, suicide and self-inflicted injuries, bowel cancer, stroke and breast cancer (Table 1).

The age-standardised rate of potentially preventable deaths was almost four times higher in the Medicare Local catchment with the highest rate, compared to the Medicare Local with the lowest rate.

The rates ranged from 53 deaths per 100,000 people on average per year in Northern Sydney to 206 deaths per 100,000 in Central and North West Queensland (Potentially preventable deaths section on Key findings page and Fair Comparisons section on Key findings page).

During the three calendar years from 2009 to the end of 2011, an estimated 20,438 Australians died prematurely on average per year from causes that are considered potentially preventable (Table 1 on Introduction page).

Three causes accounted for almost 50% of all potentially preventable deaths – lung cancer, ischaemic heart disease and suicide and selfinflicted injuries (Figure 1 and Table 1 on Introduction page).

The age-standardised rate of potentially treatable deaths was almost three times higher in the Medicare Local catchment with the highest rate, compared to the Medicare Local with the lowest rate.

The rates ranged from 41 deaths per 100,000 people on average per year in Inner East Melbourne to 110 deaths per 100,000 in Central and North West Queensland (Potentially treatable deaths section on Key findings page and Fair Comparisons section on Key findings page).

During the three calendar years from 2009 to the end of 2011, an estimated 12,858 Australians died prematurely on average per year from causes that are considered treatable (Table 1 on Introduction page).

Three causes accounted for 50% of all potentially treatable deaths – ischaemic heart disease, bowel cancer and breast cancer (Figure 1 and Table 1 on Introduction page).

Rates of potentially avoidable deaths in rural lower-income communities (Rural 2 peer group) were more than twice as high as in wealthier inner-city suburbs (Metro 1 peer group) (Potentially avoidable deaths section on Key findings page and Fair Comparisons section on Key findings page).

Yet there were differences across similar Medicare Local catchments even after accounting for broad geographic and demographic circumstances (Potentially avoidable deaths section on Key findings page).

  • Across metropolitan areas, the age-standardised rate of potentially avoidable deaths was 32% higher in the lower-income urban catchments (Metro 3 peer group, 152 deaths per 100,000 people) compared to the wealthiest inner-city catchments (Metro 1, 115 deaths per 100,000 people)
  • Across regional areas, the age-standardised rate of potentially avoidable deaths was 9% higher in the lower-income catchments (Regional 2 peer group, 171 deaths per 100,000 people) compared to the wealthier catchments (Regional 1, 157 deaths per 100,000 people)
  • Across rural areas, the age-standardised rate of potentially avoidable deaths was 30% higher in the Rural 2 peer group (244 deaths per 100,000 people) compared to Rural 1 (187 deaths per 100,000 people).

There were also large differences in rates of potentially avoidable deaths between males and females, particularly those deaths that are potentially preventable (Potentially avoidable deaths: differences between males and females section on Key findings page and Table 3 on Key findings page).

Potentially treatable deaths

Potentially treatable deaths are a particular focus of this report because they closely reflect how well local medical systems are performing. Potentially treatable deaths are those that occur prematurely that might have been avoided through better medical services and therapeutic interventions, such as surgery or medication.

There were differences across similar Medicare Local catchments even after accounting for broad geographic and demographic circumstances (Potentially treatable deaths section on Key findings page and Fair Comparisons section on Key findings page).

  • Across metropolitan areas, the age-standardised rate of potentially treatable deaths was 30% higher in the lower-income urban catchments (Metro 3 peer group, 60 deaths per 100,000 people) compared to the wealthiest inner-city catchments (Metro 1, 46 deaths per 100,000 people)
  • Across regional areas, the age-standardised rate of potentially treatable deaths was 3% higher in the lower-income catchments (Regional 2 peer group, 62 deaths per 100,000 people) compared to the wealthier catchments (Regional 1, 60 deaths per 100,000 people)
  • Across rural areas, the age-standardised rate of potentially treatable deaths was 23% higher in the Rural 2 peer group (87 deaths per 100,000 people) compared to Rural 1 (71 deaths per 100,000 people).

More detailed information on differences across local areas even after accounting for geographic and socioeconomic circumstances is on Potentially preventable deaths section on Key findings page and Fair Comparisons section on Key findings page with regard to potentially preventable deaths, and on Potentially treatable deaths section on Key findings page and Fair Comparisons section on Key findings page with regard to potentially treatable deaths.

Life expectancy at birth

Life expectancy at birth is an estimate of the average number of years a newborn baby is expected to live, assuming the average death rates at the time of the reporting period continue throughout their lifetime.

During the three calendar years from 2009 to the end of 2011, life expectancy at birth varied across Medicare Local catchments from 84.6 years in Northern Sydney to 76.1 years in Central and North West Queensland, a difference of 8.5 years in life expectancy.

Yet there were differences across similar Medicare Local catchments even after accounting for broad geographic and demographic circumstances.

  • Across metropolitan areas, life expectancy was 81.7 years for males and 85.5 for females in the wealthiest inner-city catchments (Metro 1 peer group), which is 1.9 years higher for males and 1.3 years higher for females compared to life expectancy in lower-income catchments (Metro 3)
  • Across regional areas, life expectancy was 79.3 years for males and 83.8 for females in the wealthier catchments (Regional 1 peer group), which is 0.9 years higher for males and 0.4 years higher for females compared to life expectancy in lower-income catchments (Regional 2)
  • Across rural areas, life expectancy was 78.1 years for males and 83.0 for females in the Rural 1 peer group, which is 2.2 years higher for males and 2.3 years higher for females compared to life expectancy in Rural 2.

More detailed information on differences across local areas in life expectancy even after accounting for geographic and demographic circumstances is on Life expectancy at birth section on Key findings page and Fair Comparisons section on Key findings page.

Health profiles of Medicare Locals

At a national level, Australia is already an international leader in the prevention of avoidable deaths (Figure 2 on Introduction page).

This report is intended to reveal local level variations that enable health care professionals to see which areas could benefit from further targeting of health care services.

In this context, the report includes profiles for each Medicare Local catchment using 18 measures of health, prevention, use of health services and experiences, comprising:

  1. Potentially avoidable deaths
  2. Life expectancy at birth
  3. Adults who are overweight or obese
  4. Adults who are obese
  5. Adults who smoke daily
  6. Immunisation rates for 1 year old children
  7. Immunisation rates for 5 year old children
  8. GP attendances
  9. Specialist attendances
  10. People who saw an allied health professional or nurse
  11. Adults who visit hospital EDs
  12. Adults admitted to hospital
  13. Potentially avoidable hospitalisations
  14. Waiting times for GP appointments
  15. Waiting times for medical specialists
  16. Cost barriers to GP care
  17. Cost barriers to prescribed medication
  18. Cost barriers to seeing a medical specialist

Four of these 18 indicators have not previously been reported at the local level nationally, including COAG indicators in relation to potentially avoidable deaths, life expectancy at birth, specialist attendances and use of allied health professionals and nurses.

Next steps

In the coming months, the National Health Performance Authority will further develop and report on other measures of health and access to health services across Medicare Local catchments.

New information about health services in your area

The National Health Performance Authority has released new information on http://www.myhealthycommunities.gov.au for each Medicare Local catchment, and where possible, for more than 300 local areas regarding:

  • Potentially avoidable deaths
  • Life expectancy at birth
  • Seeing an allied health professional or nurse
  • Specialist attendances.

The Authority has also released updated information for 2012–13 for many more measures of health services on http://www.myhealthycommunities.gov.au

Find out how your local area compares at http://www.myhealthycommunities.gov.au

1. Organisation for Economic Co-operation Development [Internet] OECD Health Data; 2011 [cited 2013 Nov 21]. Available from: http://www.compareyourcountry.org/health/index.php