Chronic disease is Australia’s biggest killer, contributing to nearly 90% of deaths, a new Grattan Institute report has warned.
Yet prevention of chronic disease remains underfunded and unless the government does more, millions more Australians will suffer avoidable illnesses, the report says.
The report, Australian Centre for Disease Control (ACDC): Highway to health, sets out a path for Australia to change course.
It urges prevention of chronic disease be at the heart of the soon-to-be-established ACDC, a body that the Labor government is setting up to improve Australia’s response to public health emergencies.
“The Centre for Disease Control must be independent, to keep governments on track. And a new body alone won’t be enough, governments must also commit to more prevention funding,” said report author and the Grattan Institute’s health and aged care program director, Peter Breadon.
“If we don’t stop chronic disease before it starts then these trends will just continue [to] increase unchecked and we’ll end up with so much avoidable suffering.”
Over the past three decades, chronic disease in Australia has increased by 38%, the report says. Almost half of Australians now live with one chronic disease and almost half of Australians over the age of 65 live with two or more.
But the report says the burden is more severe for disadvantaged Australians, who are twice as likely to live with two or more chronic conditions. This includes Australians living in rural areas, people on low incomes and First Nations people.
Australia only spends about $130 a person every year on public health, the report said. This is less than a third of what Canada spends and half what the UK spends.
The report said meaningful investment in prevention has been stymied by vested interests in tobacco, food and beverage industries, a lack of collaboration between state and federal governments and short-term political thinking.
Obesity is raised as a particular concern in the report. It has more than tripled in Australia since 1980 and continues to rise, the report said, yet the food industry remains self-regulated in advertising of unhealthy food.
The report said past efforts made to curb smoking and improve sun smart behaviour proved why building a focus on health rather than sickness into the ACDC was crucial. The risk of being diagnosed with melanoma by the age of 30 is half what it was in the 1990s after government supported education campaigns.
The vice-president of the Royal Australian College of General Practitioners, Dr Bruce Willett, said more chronic illness prevention was needed, particularly on the issue of childhood obesity.
“We do have a growing burden of public disease and people are getting sicker,” he said. “Prevention of that is a lot of what GPs do, yet we’ve seen the progressive underfunding of general practice.”
The federal government has said prevention of chronic diseases would be a part of the ACDC’s role but the consultation paper suggests it won’t be an early priority and the report’s authors fear this will mean it is sidelined.
The health minister, Mark Butler, said the ACDC would focus on pandemic preparedness, preventing infectious diseases and chronic diseases.
“All Australians will benefit from improved pandemic preparedness response and a renewed focus on preventing chronic disease,” he said.
But Prof Clara Chow, a health expert at the University of Sydney, said not making chronic conditions the ACDC’s top priority would be a missed opportunity.
“I think if we want to think about what is the leading causes of death and morbidity, it’s chronic diseases,” she said. “It isn’t infectious diseases.”
