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Australians who are poor, male, Aboriginal, or live in a rural remote area are much more likely to die than their wealthy, female, non-Aboriginal, urban dwelling counterparts. And it’s not for reasons of biology. The causes of death for these Australians are mainly preventable or treatable - so potentially avoidable.

New research from the Australian Institute of Health and Welfare has found some population groups have a higher death rate than others (see box below). The report, Mortality inequalities in Australia 2009–2011, shows substantial inequalities in terms of overall mortality and for most leading causes of death. In many cases these inequalities are long-standing and there has been no substantial improvement for decades.

Mortality inequalities in Australia
Aboriginal Australians

  • mortality rate nearly twice that of non-Indigenous Australians
  • higher rates of death from diabetes and circulatory conditions
  • death rate has improved by 6% over last ten years and mortality inequality has reduced

People in Remote and Very remote areas

  • mortality rate 1.4 times higher than people living in Major cities
  • higher rates of death from diabetes and land transport accidents
  • 20,000 fewer deaths over two years if people in regional and remote areas had the same death rates as people in major cities.

People in the lowest socioeconomic status (SES) areas

  • mortality rate 1.3 times higher than people in the highest SES areas
  • higher rates of death from diabetes and lung diseases
  • 54,214 (13%) fewer deaths over ten years if all Australians had the same death rates as the highest SES areas

Source: adapted from AIHW 2014. Mortality inequalities in Australia 2009–2011. AIHW bulletin no. 124. Cat. no. AUS 184. Canberra: AIHW.

The greatest inequalities exist for generally preventable causes of death. The leading cause of death in Australia is chronic disease, such as heart disease and diabetes, which can largely be avoided through prevention or treatment interventions. Access to and use of health services is critical. Timely and affordable primary care, emergency care, specialist and community based services can reduce people’s risk of dying early or from avoidable causes. Early mortality risk factors can also be reduced by modifying lifestyle health behaviours, such as better nutrition and exercise. These behaviours are influenced by the social determinants which include factors like the availability of affordable healthy fresh food, safe environments, good urban design, active transport policies, and tobacco-use legislation.

NCOSS has long advocated for a whole of government approach to address the social determinants of health as a way to not only improve population health and well-being, but to make Australia fairer, more inclusive and sustainable. The AIHW report concludes further study of the social determinants of health could help to explain the relationship between these inequalities to inform policy development.