Australia – the healthy country?

A decade ago, the Australian Government released a roadmap for prevention Australia: the healthiest country by 2020. As we near the end of 2020, it is worth asking, “how healthy are we?”

While Australia can’t yet claim to be the healthiest country, we’re not too far from the top. Australians are living longer compared to most OECD nations and we are largely happy with our health. In fact, 85 per cent of us rate our health as good to excellent.

But delve a little deeper and the number of Australians with chronic disease risk factors provides a reality check.

Globally, Australia has one of the highest rates of overweight and obesity – a leading risk factor for heart disease, stroke, cancers, kidney disease and type 2 diabetes. In regional Australia, overweight and obesity is more prevalent, affecting up to 78 per cent of men. Also concerning is generational change, with one in four children now overweight or obese.

Our alcohol consumption is higher than the OECD average and, together with smoking, more prevalent in regional areas compared to cities. Unhealthy diets, physical inactivity and high blood pressure are other common risk factors that will impact longevity and quality of life for the next generation if we don’t intervene now.

Why does risk matter?

One in two Australians have a chronic disease and one in five have multiple conditions. Yet much disease could be prevented through timely risk assessment and early detection to improve treatment options.

Cardiovascular disease is a leading cause of death in Australia, yet it is largely preventable. At the same time 1.5 million people are living with undiagnosed kidney disease and around 500,000 people have undiagnosed type 2 diabetes. The longer these conditions remain undetected and untreated, the more likely they are to progress to serious conditions with long-term complications.

For many people in regional Australia, the effects of chronic disease are amplified due to geographic challenges in accessing diagnosis, treatment, and care. For example, regional Australians are more likely to experience a stroke but less likely to receive the care they need.

A focus on risk assessment and early detection

The Australian Chronic Disease Prevention Alliance (ACDPA) is calling for a national focus on chronic disease risk assessment and early detection in the National Preventive Health Strategy.

There is strong evidence supporting risk assessment and early detection as cost-effective and feasible solutions to prevent and control chronic disease. The World Health Organization recommends absolute cardiovascular disease risk assessment as a ‘Best Buy’ and Australian modelling recommends screening for type 2 diabetes and chronic kidney disease.

ACDPA members are currently updating the Absolute Cardiovascular Disease Risk guidelines to reflect the latest available evidence. Led by the Heart Foundation, members are bringing together experts around Australia to update the existing guidelines and risk assessment calculator, which assists GPs to calculate patients’ risk of vascular disease.

The Heart Health Check MBS item supports GPs to assess and manage cardiovascular disease risk, and recent data highlight the urgent need to also consider undetected diabetes and kidney disease. One in four eligible Australians are at clinically high risk of heart disease or stroke due to age or other conditions like pre-existing diabetes and/or kidney disease.

Australia is not yet the healthiest country, but we can aspire to reach this goal by 2030. We must be bold, determined, and relentless in our pursuit to do better for ourselves and future generations. Any long journey starts with the first step, so let us start by prioritising risk assessment and early detection to prevent chronic disease and reduce health disparities across Australia.