What is chronic disease?Chronic diseases are complex and varied in terms of their nature, how they are caused and the extent of their impact on the community. While some chronic diseases make large contributions to premature death, others contribute more to disability.
Many different illness and health conditions can be classified under the broad heading of chronic disease. Typically, chronic diseases are long-lasting, and have persistent effects. Chronic diseases can range from mild conditions, such as short-sightedness, dental decay and minor hearing loss, to debilitating arthritis and low back pain, and to life-threatening heart disease and cancers. These conditions may never be cured completely, so there is generally a need for long term management. Once present, chronic diseases often persist throughout life, although they are not always the cause of death.
How common is chronic disease?Chronic diseases are the leading cause of illness, disability and death in Australia, accounting for 90% of deaths in 2011. Many people have more than 1 chronic illness or condition at the same time.
- Australia’s ageing population means that there will be an increase in chronic disease. People aged 65 and over have much higher levels of arthritis, high blood pressure, heart disease, stroke, vascular diseases, diabetes and cancer than younger people.i
- In 2007-08, around 15% of people in the 0-24 age group reported having either asthma, type 2 diabetes, coronary heart disease, cerebrovascular disease, arthritis, osteoporosis, chronic obstructive pulmonary disease, depression or high blood pressure. Similarly, around half of people aged 65-74 had to cope with 5 or more chronic diseases, increasing to 70% of those aged 85 and over.i
- Increasing prevalence of chronic disease has also been attributed to early detection and improved treatments for diseases that previously caused premature death, as well as lifestyle factors, such as smoking or poor diet, that increase the risk of developing chronic disease.
- Population ageing and improved treatments have also contributed to people living longer with chronic disease.
MortalityChronic diseases accounted for 90% of all deaths in 2011.i Often more than 1 disease is associated with a death and 3 diseases is the average. About 20% of deaths have 5 or more associated diseases.i
Cardiovascular diseases (coronary heart disease and stroke), dementia and Alzheimer disease, lung cancer and chronic respiratory disease including COPD are the most common underlying causes, together being responsible for 40% of all deaths.i
For further detail about mortality rates for individual chronic diseases, visit the web page specific to each disease.
What are the risk factors for chronic disease?A broad range of risk factors for chronic disease has been identified. These can be demographic, behavioural, biomedical, genetic, environmental, social or other factors, which can act independently or in combination, and some of which can be modified to reduce the risk of developing a chronic condition.
Common modifiable chronic disease risk factors include tobacco smoking, harmful use of alcohol, overweight and obesity, physical inactivity and poor nutrition. Such modifiable risk factors can lead to overweight and obesity, high blood pressure and high cholesterol levels, which in turn can lead to chronic disease and conditions such as cardiovascular disease, diabetes, cancer and mental health issues.
It is widely acknowledged that many chronic diseases not only share common risk factors, but can also be risk factors for each other.
While the presence of a single risk factor can lead to illness, there is an increasing risk of developing chronic disease when more than one risk factor is present. The effects of multiple risk factors can manifest in the earlier development of a condition, in an increased burden and need for management of a condition, in greater health care costs and ultimately in reduced life expectancy.
Across all ages, changes in health behaviours can reduce the incidence and impact of chronic diseases – the World Health Organization estimates that up to 80% of heart disease, stroke and type 2 diabetes, and more than one-third of cancers worldwide, could be prevented by eliminating smoking, unhealthy diet, physical inactivity and the harmful use of alcohol.i
Treatment or management of chronic diseaseTreatment and management of chronic conditions usually requires the use of a variety of health services.
GPs are usually the initial point of contact for people with chronic conditions and, along with other primary and allied health professionals, will commonly manage chronic conditions in collaborative care arrangements. For a number of people, a key step in managing chronic disease involves addressing the modifiable risk factors above.
Additionally, there is a range of medicines and surgical treatments available for treating certain chronic diseases.
For further detail about treatment or management for individual chronic diseases, visit the web page specific to each disease.
Chronic disease programmes and initiativesChronic disease is addressed at a national level through a wide range of programmes and initiatives to support treatment and management. Significant funding is also provided to ensure that quality clinical research is conducted into chronic conditions, and to maintain national monitoring and surveillance measures.
Programmes that support chronic disease management and care include:
- The Medicare Benefits Schedule, which provides subsidies for patient care and includes Medicare items for the planning and management of chronic and terminal conditions. Eligible patients can also be referred by a GP for up to five Medicare subsidised allied health services that are directly related to the treatment of their chronic condition. In order to encourage early detection, diagnosis and intervention for treatable conditions, health assessment items are also available for people aged 45-49 years who are at risk of developing chronic disease, people aged 75 years and older and Aboriginal and Torres Strait Islander people.
- The Pharmaceutical Benefits Scheme, which continues to provide subsidies for a range of medicines used in the treatment of, or symptoms associated with chronic diseases.
- Significant investments in research into chronic diseases through the National Health and Medical Research Council (NHMRC), with a focus on investigating the causes, effects, impacts and complications of chronic disease. Improving the care of patients with multiple and complex chronic diseases has also been identified by the NHMRC as a major focus in its 2013-15 Strategic Plan.
- Funding is provided to chronic disease peak bodies to support a number of chronic disease related programmes and initiatives.
- Work is also underway to develop a National Strategic Framework for Chronic Conditions, along with national strategies for diabetes and asthma, to inform how existing resources can be better coordinated and targeted for these conditions.
National Strategic Framework for Chronic ConditionsWork has commenced to develop a National Strategic Framework for Chronic Conditions (the Framework). This will replace the National Chronic Disease Strategy 2005, and aims to inform how existing resources can be better coordinated and targeted for chronic conditions.
Further information on the development of the Framework, including consultation opportunities, can be found on the page National Strategic Framework for Chronic Conditions.
- Information relating to monitoring and surveillance of chronic disease, including chronic disease publications, can be found at the Australian Institute of Health and Welfare website.
i Australian Institute of Health and Welfare 2014. Australia's Health 2014. Australia's health series no. 14. cat. no. AUS 178. Canberra: AIHW
ii Australian Institute of Health and Welfare 2014. Australia's Health 2014. Australia's health series no. 14. cat. no. AUS 178. Canberra: AIHW