Slower increase in life expectancy in Australia than in other high income countries: the contributions of age and cause of death

Abstract

OBJECTIVES: To compare life expectancy at birth in Australia during 1980-2016 with that in other high income countries; to estimate the contributions of age at death and cause of death to differences between Australia and these countries. DESIGN, SETTING, PARTICIPANTS: Data on deaths by age, sex, and cause in Australia and 26 other high income countries obtained from the Global Burden of Disease study. MAIN OUTCOME MEASURES: Contributions of age, cause of death, and birth cohort to differences in life expectancy between Australia and other high income countries and to changes in the differences. RESULTS: From 1981 to 2003, life expectancy at birth increased rapidly in Australia, both in absolute terms and in comparison with other high income countries. The main contributor to greater increases for males in Australia than in western Europe was lower mortality from ischaemic heart disease; compared with the United States, mortality from ischaemic heart disease, cerebrovascular disease, and transport-related injuries was lower. Since 2003, life expectancy has increased more slowly for both sexes than in most other high income countries, mainly because declines in mortality from cardiovascular disease and cancer have slowed. Age-specific mortality for people born since the 1970s is higher in Australia than in most high income countries. CONCLUSIONS: Recent declines in mortality in Australia have been relatively modest. Together with the high prevalence of obesity and the limited scope for further increasing life expectancy by reducing the prevalence of smoking, this suggests that future life expectancy increases will be smaller than in other high income countries. Improved control of health risk factors will be required if further substantial life expectancy increases in Australia are to be achieved.