Living longer, smoking less but eating ourselves sick

WE ARE living longer, smoking less and fewer of our children are dying, but we are eating ourselves sick, we can't afford the dentist and we are catching diseases that vaccines could prevent.

Meanwhile, indigenous Australians are still being left behind as the overall national health outlook improves.

An extensive final report on health care by the Council of Australian Governments reform council paints a national picture of dramatic improvements over five years but significant challenges.

The chief concern raised by the report, according to COAG reform council chair John Brumby, is that most of us are fat and many of us don't know we have type 2 diabetes (strongly associated with obesity).

"While Australia's current rate of type 2 diabetes is not out of the ordinary … compared with most of the developed world, our rate of obesity is way out of line. We are amongst the three most obese nations," Mr Brumby said yesterday.

He said if diabetes went untreated, there was a great cost to the individual in terms of kidney, heart and eye disease, and limb amputation - "it's bad for the individual, bad for the economy and bad for the health system."

The report also raises alarming figures on preventable hospital stays - including a 16% increase for conditions that could have been prevented by vaccines.

Other concerns include:

  • A sharp increase in the percentage of Australians waiting more than nine months for high residential aged care, while the growth of aged care services has stalled. In bad news for the regions, care places decrease as remoteness increases.
  • The cost of dental care. Nearly one in five of us have delayed or avoided a visit to the dentist because it cost too much.
  • Increased waiting times for most elective surgery. Patients outside major cities do not generally wait longer - unless they are indigenous.

Big wins in the report include:

  • Life expectancy increase for both men and women.
  • 20% drop in child death rates - but the rate for indigenous children is still double that of non-indigenous.
  • Significant falls in heart disease and cancer - though the male heart attack rate is double that of women and there is still a big gap in heart attack rates between indigenous and other Australians.

A cut in the national rate of lung cancer has been led by a 34% drop in men affected since 2006 - but offset by a huge 88% increase in the female rate.

"We can't change what occurred 25-30 years ago," Mr Brumby said. "There was a peak in smoking rates among women then and we're now seeing that translate into a near-peak in women's lung cancer rates.

"Smoking rates are still a lot higher in the regions. We all think we're indestructible when we're young. But the women's statistics show overwhelmingly that there is a consequence 30 or 40 years on."

Despite the continuing gap in life expectancy and child deaths for indigenous Australians, Mr Brumby attributed the overall improvements partly to big reductions in indigenous infant mortality through "getting mums to stop smoking … better post-natal care, tackling things like domestic violence".

Other cancer figures show rates of cervical cancer rates have fallen and bowel and breast cancer rates have stabilised.

Melanoma rates have stabilised nationally but increased markedly in Queensland.

The big wins

  • Life expectancy up (men 79.9 years, women 84.3) - among the highest in the world, but still much lower for indigenous Australians (69.1 and 73.7)
  • Child deaths 20% down to 82.9 per 100,000
  • Heart attacks and deaths from circulatory disease significantly down - except for indigenous Australians
  • Daily smokers down to 16.3% - but a long way to go to meet COAG's target of 10% by 2018.

The big challenges

  • 62.7% of adults are overweight or obese
  • 1 in 25 Aussies have type 2 diabetes - and a quarter of them don't know it
  • A huge, long-term increase in lung cancer among women
  • A jump in the number of hospital stays due to vaccine-preventable conditions
  • Despite improvements, our health system continues to fail Indigenous Australians.

By numbers for Queensland

  • Avoidable deaths for 100,000 people: 155.4 (national figure 146.4)
  • 73% of emergency patients treated within benchmark times (72%)
  • Half of all patients waited at least 27 days for elective surgery (36)
  • 64.4% of patients discharged from psychiatric inpatient services received follow-up (54.6%)
  • 77.7 residential aged care places per 1000 seniors (81.9)
  • 17.9% of adults smoke daily (16.3%)
  • 30% of adults are obese (27.2%)
  • 4.6% of adults have type 2 diabetes (4.3%)

By numbers for New South Wales

  • Avoidable deaths for 100,000 people: 146.6 (national figure 146.4)
  • 76% of emergency patients treated within benchmark times (72%)
  • Half of all patients waited at least 50 days for elective surgery (36)
  • 52.4% of patients discharged from psychiatric inpatient services received follow-up (54.6%)
  • 83.9 residential aged care places per 1000 seniors (81.9)
  • 14.4% of adults smoke daily (16.3%)
  • 26.2% of adults are obese (27.2%)
  • 4.2% of adults have type 2 diabetes (4.3%)

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