Life expectancy and potentially avoidable deaths in

Life expectancy and potentially avoidable deaths in Published 30th November 2017 This report presents information on life expectancy at birth and potentially avoidable deaths in nationally and across Primary Health Network (PHN) areas. It also includes some results for smaller local areas. Life expectancy information can be used as a broad measure of population health. Potentially avoidable deaths are deaths before the age of 75, which could have been avoided with current health care. This information can indicate how well health systems are performing. has the eighth highest life expectancy at birth in Organisation for Economic Co-operation and Development (OECD) countries (OECD 2017). In, life expectancy at birth was 82.4 years in, up from 82.1 years in 2011 2013. The age-standardised rate of potentially avoidable deaths was 108 per 100,000 people in, down from 117 per 100,000 people in 2009 2011. Similar to the national result, most PHN areas reported increases in life expectancy and decreases in potentially avoidable deaths over the same periods. During, life expectancy in metropolitan PHN areas tended to be longer than in regional PHN areas. Conversely, the rate of potentially avoidable deaths was higher in regional PHN areas than in metropolitan PHN areas. Across PHN areas in, Northern Sydney had the longest life expectancy at birth (85.5 years) and the lowest rate of potentially avoidable deaths (62 per 100,000 people), while the Northern Territory had the shortest life expectancy (77.0 years) and highest rate of potentially avoidable deaths (226 per 100,000 people). In : Life expectancy at birth varied across Primary Health Network areas: Northern Sydney 85.5 National rate 82.4 Northern Territory 77.0 years The rate of potentially avoidable deaths also varied across Primary Health Network areas: Northern Sydney 62 National rate 108 Northern Territory 226 per 100,000 people Visit www.myhealthycommunities.gov.au for more detailed results

Life expectancy at birth Life expectancy at birth is the average number of years that a new born baby could expect to live, assuming that the current age-specific death rates are experienced throughout his/her life. Between 2011 2013 and in, life expectancy at birth for all persons increased from 82.1 years to 82.4 years (Figure 1). Women continue to have a longer life expectancy than men, yet both women and men had an increase in life expectancy between 2011 2013 and an increase from 84.3 to 84.5 years for women and 80.1 to 80.4 years for men. Between 2011 2013 and, most PHN areas recorded an increase in life expectancy at birth. However, life expectancy at birth decreased in some areas (Figure 3, page 4). The largest increase in life expectancy at birth (0.6 years) was seen in four Queensland PHN areas Brisbane North, Brisbane, Darling Downs and West Moreton, and Queensland. Gippsland (Vic) PHN area recorded the largest decrease in life expectancy at birth (0.5 years) over the same period. Variation across During, life expectancy at birth ranged across PHN areas from 77.0 years in the Northern Territory to 85.5 years in Northern Sydney (Figure 2, page 3). Figure 1: Estimated number of years a person is expected the live at birth, by sex, 2011 2013 and Years 88.0 2011 2013 86.0 84.0 82.0 80.0 78.0 76.0 74.0 Males Females Persons 2011 2013 80.1 84.3 82.1 80.4 84.5 82.4 Note: Life expectancy at birth is the average number of years that a new born baby could expect to live, assuming that the current age-specific death rates are experienced throughout his/her life. Source: n Institute of Health and Welfare (AIHW) analysis of life expectancy estimates as provided by the n Bureau of Statistics (ABS). 2

Figure 2: Estimated number of years a person is expected to live at birth, by Primary Health Network area, DARWIN Northern Queensland Northern Territory Central Qld, Wide Bay & Sunshine Coast Queensland Country Darling Downs & West Moreton BRISBANE Country North Coast New Wales PERTH Hunter New England & Central Coast Years Murrumbidgee 83.3 85.5 82.8 83.2 81.7 82.7 81.0 81.6 77.0 80.9 ADELAIDE CANBERRA Eastern NSW Murray Victoria SYDNEY Gippsland MELBOURNE Tasmania 76 All metro PHN areas Northern Sydney (NSW) Eastern Melbourne (Vic) Central & Eastern Sydney (NSW) Perth North (WA) Eastern Melbourne (Vic) n Capital Territory North Melbourne (Vic) Sydney (NSW) Brisbane North (Qld) Brisbane (Qld) Perth (WA) Gold Coast (Qld) Sydney (NSW) Adelaide (SA) Nepean Blue Mountains (NSW) 83.3 85.5 84.3 83.8 83.8 83.3 83.2 83.2 83.2 83.1 82.9 82.8 82.8 82.6 82.6 82.1 All regional PHN areas Central Qld, Wide Bay & Sunshine Coast Country SA Eastern NSW Victoria Country WA Darling Downs & West Moreton (Qld) Northern Queensland Hunter New England & Central Coast (NSW) Murray (Vic & part NSW) North Coast (NSW) Gippsland (Vic) Tasmania Murrumbidgee (NSW) NSW Queensland Northern Territory 81.2 82.1 81.9 81.7 81.6 81.6 81.3 81.2 81.1 81.1 81.0 80.9 80.8 80.7 80.2 78.7 77.0 Source: 78 80 82 84 HOBART 86 CANBERRA North BRISBANE ACT Gold Coast North Nepean Blue Mountains PERTH North ADELAIDE Northern SYDNEY Central & Eastern Eastern MELBOURNE Eastern n Institute of Health and Welfare (AIHW) analysis of life expectancy estimates as provided by the n Bureau of Statistics (ABS). 3

Figure 3: Estimated number of years a person is expected to live at birth, by metropolitan and regional Primary Health Network area, 2011 2013 and Primary Health Network area Northern Sydney Eastern Melbourne Perth North Central & Eastern Sydney Eastern Melbourne n Capital Territory North Melbourne Sydney Brisbane North Brisbane Perth Gold Coast (Qld) Adelaide Sydney Cent. Qld, Wide Bay & Sunshine Coast Nepean Blue Mountains (NSW) Country SA Eastern NSW Country WA Victoria Darling Downs & West Moreton (Qld) Northern Queensland Murray (Vic & part NSW) Hunter New Engl. & Cent. Coast (NSW) North Coast (NSW) Gippsland (Vic) Tasmania Murrumbidgee (NSW) NSW Queensland Northern Territory 72.0 74.0 76.0 78.0 80.0 82.0 84.0 86.0 Years Metropolitan Regional 2011 2013 2011 2013 2011 2013 Note: Life expectancy at birth is the average number of years that a new born baby could expect to live, assuming that the current age-specific death rates are experienced throughout his/her life. Source: n Institute of Health and Welfare (AIHW) analysis of life expectancy estimates as provided by the n Bureau of Statistics (ABS). 4

Potentially avoidable deaths Potentially avoidable deaths are those that occur prematurely before the age of 75 from causes that might have been avoided through the provision of care and/or treatment through existing primary or hospital care. The causes are based on nationally agreed definitions (AIHW 2017). Information on potentially avoidable deaths is used as an indicator of the effectiveness of the health system, including hospital, primary and community care (n Commission on Safety and Quality in Health Care, 2017). During, there were almost 80,000 potentially avoidable deaths in, accounting for 17% of all deaths over this period. However, between 2009 2011 and, the age-standardised rate of potentially avoidable deaths decreased from 117 to 108 deaths per 100,000 people (Figure 4). The rate of potentially avoidable deaths in women is nearly half that of men. However, rates of potentially avoidable deaths for both women and men decreased between 2009 2011 and from 84 to 77 per 100,000 for women, and from 151 to 139 per 100,000 for men. Variation across During, the age-standardised rate of potentially avoidable deaths varied by 164 deaths per 100,000 people across PHN areas. The rate ranged from 226 deaths per 100,000 people in the Northern Territory to 62 per 100,000 in Northern Sydney (Figure 5, page 6). Between 2009 2011 and, the rate of potentially avoidable deaths decreased in most PHN areas. The greatest decrease was seen in Queensland, from 213 to 194 deaths per 100,000 people. However, the rate of potentially avoidable deaths increased in some PHN areas. The greatest increase over this time was in the Northern Territory, from 219 to 226 deaths per 100,000 people (Figure 6, page 7). Variation across metropolitan and regional areas On average, during from, metropolitan PHN areas had a lower rate of potentially avoidable deaths (96 deaths per 100,000 people) than regional PHN areas (129 per 100,000) (Figure 5, page 6). Between 2009 2011 and, the average rate of potentially avoidable deaths for all metropolitan areas decreased, from 106 to 96 deaths per 100,000 people. Similarly, the average rate across all regional areas also decreased, from 138 to 129 per 100,000 over this time (Figure 6, page 7). Figure 4: Number of potentially avoidable deaths (age-standardised), per 100,000 people by sex, 2009 2011 to Potentially avoidable deaths per 100,000 people Figure 4: Potentially avoidable deaths, age standardised, per 100,000 people, by gender, 2009-2011 to 2013-2015 Potentially avoidable deaths (per 100,000 people) 160 140 120 120 100 100 80 80 60 60 40 40 20 2009 2011 2010 2012 2011 2013 2012 2014 20 0 Males Females Persons Notes: 0 1. Potentially avoidable deaths Menare deaths below the age of 75 from conditions Women that are potentially preventable through individualised Persons care and/or treatable through existing primary or hospital care. 2. Rates have been age-standardised to facilitate 2009-2011 comparisons 2010-2012between 2011-2013 populations 2012-2014 with different 2013-2015 age structures. Source: n Institute of Health and Welfare (AIHW) National Mortality Database (NMD) and n Bureau of Statistics ERP. 5

Figure 5: Potentially avoidable deaths (age-standardised), per 100,000 people by Primary Health Network area, DARWIN Northern Queensland Northern Territory Country Potentially avoidable deaths (agestandardised), per 100,000 people North Coast New Wales PERTH Hunter New England & Central Coast Murrumbidgee ADELAIDE SYDNEY CANBERRA Eastern NSW Murray Victoria Gippsland MELBOURNE Tas. 50 6 Darling Downs & West Moreton BRISBANE Country 132 226 121 131 105 120 96 104 62 95 All regional PHN areas Northern Territory Queensland NSW Country WA Northern Queensland Darling Downs & West Moreton (Qld) Murrumbidgee (NSW) Tasmania Hunter New England & Central Coast (NSW) North Coast (NSW) Gippsland (Vic) Murray (Vic & part NSW) Country SA Victoria Central Qld, Wide Bay & Sunshine Coast Eastern NSW 129 226 194 156 137 134 132 130 130 129 128 125 121 120 117 116 114 All metro PHN areas Nepean Blue Mountains (NSW) Brisbane (Qld) Sydney (NSW) Perth (WA) Adelaide (SA) Brisbane North (Qld) Sydney (NSW) Gold Coast (Qld) North Melbourne (Vic) Perth North (WA) Eastern Melbourne (Vic) n Capital Territory Central & Eastern Sydney (NSW) Eastern Melbourne (Vic) Northern Sydney (NSW) 96 117 107 105 104 104 100 98 97 96 93 90 89 87 78 62 Source: Central Qld, Wide Bay & Sunshine Coast Queensland 100 150 200 HOBART 250 North CANBERRA BRISBANE n Capital Territory Gold Coast North PERTH Nepean Blue Mountains SYDNEY North ADELAIDE Northern Central & Eastern Eastern MELBOURNE Eastern n Institute of Health and Welfare (AIHW) National Mortality Database (NMD) and n Bureau of Statistics ERP at 30 June.

Figure 6: Potentially avoidable deaths (age-standardised), per 100,000 people by metropolitan and regional Primary Health Network area, 2009 2011 and Primary Health Network (PHN) area n Capital Territory Perth Northern Territory Queensland Perth North NSW Adelaide Country WA Gold Coast Northern Queensland Brisbane Tasmania Brisbane North Murrumbidgee (NSW) Eastern Melbourne Eastern Melbourne North Coast (NSW) North Melbourne Gippsland (Vic) Murray (Vic & part NSW) Sydney Country Nepean SABlue Mountains Victoria Sydney Nepean Blue Mountains (NSW) Northern Sydney Eastern Central NSW and Eastern Sydney Brisbane Northern Territory Sydney Tasmania Perth Country WA Adelaide Brisbane North Country SA Sydney Northern Queensland Central Queensland, Gold Wide Coast Bay (Qld) and Sunshine Coast North Melbourne Queensland Perth North Darling Downs and West Moreton Eastern Melbourne n Capital Territory Victoria Central & Eastern Sydney Murray Eastern Melbourne Gippsland Northern Sydney Murrumbidgee All regional PHN areas All metropolitan PHN areas North Coast Hunter New England and Central Coast NSW Eastern NSW All regional PHN areas All metropolitan PHN areas Primary Health Network area Darling Downs & West Moreton (Qld) Hunter New Engl. & Cent. Coast (NSW) Cent. Qld, Wide Bay & Sunshine Coast 0 50 100 150 200 250 Potentially avoidable deaths per 100,000 people Metropolitan Regional 2009 2011 2009 2011 2009 2011 Note: 1. Potentially avoidable deaths are deaths below the age of 75 from conditions that are potentially preventable through individualised care and/ or treatable through existing primary or hospital care. 2. Rates have been age-standardised to facilitate comparisons between populations with different age structures. Source: n Institute of Health and Welfare (AIHW) National Mortality Database (NMD) and n Bureau of Statistics ERP at 30 June. 7

Variation across local areas Rates of potentially avoidable deaths are also available for more than 300 local areas called Statistical Areas Level 3 (SA3s) (Figure 7). Across these local areas during, the rate varied by 395 potentially avoidable deaths per 100,000 people, from 48 per 100,000 in Pennant Hills-Epping (NSW) to 443 per 100,000 in Daly-Tiwi-West Arnhem (NT). There was also variation in the rate of potentially avoidable deaths per 100,000 people across capital cities (Figure 7 continued, page 9). Figure 7: Potentially avoidable deaths (age-standardised), per 100,000 people, across local areas (SA3), DARWIN BRISBANE PERTH SYDNEY CANBERRA ADELAIDE Potentially avoidable deaths (agestandardised), per 100,000 people 154 443 137 153 127 136 119 126 112 118 103 111 95 102 86 94 73 85 48 72 Not available for publication Source: 8 MELBOURNE HOBART PHN boundary SA3 boundary n Institute of Health and Welfare (AIHW) National Mortality Database (NMD) and n Bureau of Statistics ERP at 30 June.

Figure 7 (cont.): Potentially avoidable deaths (age-standardised), per 100,000 people, across local areas (SA3), NEWCASTLE DARWIN SUNSHINE COAST PERTH BRISBANE SYDNEY ROCKINGHAM MANDURAH GOLD COAST WOLLONGONG CANBERRA ADELAIDE MELBOURNE GEELONG HOBART Source: n Institute of Health and Welfare (AIHW) National Mortality Database (NMD) and n Bureau of Statistics ERP at 30 June. 9

Potentially avoidable deaths and health risk factors Potentially avoidable deaths include both preventable and treatable deaths. Potentially preventable deaths are those that are responsive to preventive health activities such as screening, good nutrition and healthy habits such as exercise. Potentially avoidable deaths that are preventable may be influenced by a person s individual health risk factors attributes, characteristics or exposures that increase the likelihood of a person developing a disease or health disorder. For example, tobacco use, high body mass, alcohol consumption, physical inactivity and high blood pressure have all been shown to have strong links with the development of chronic diseases (AIHW 2016). Many of these chronic diseases are listed as causes of potentially avoidable deaths, for example, cancer or cardiovascular disease. Similar to potentially avoidable deaths, regional PHN areas had a higher proportion of people reporting health risk factors than people in metropolitan PHN areas, and the national average. For more information on health risk factors across PHN areas, refer to the following Healthy Communities reports: Health risk factors in 2014 15 All results in this report can be explored further at www.myhealthycommunities.gov.au The interactive website allows you to compare results for more than 130 health measures including: Adults who smoke tobacco daily Adults who are overweight and obese Hospital admissions for mental health conditions and intentional self-harm GP attendances After-hours GP attendances Child immunisation rates Use of emergency departments. Overweight and obesity rates across, 2014 15 Tobacco smoking rates across, 2014 15 Detailed data is available for download at www.myhealthycommunities.gov.au 10

In Regional areas had a higher rate of potentially avoidable deaths than metropolitan areas Regional PHN areas 129 National rate 108 Metropolitan PHN areas 96 age-standardised per 100,000 people 11

About the data The data were sourced from the n Institute of Health and Welfare (AIHW) analysis of n Bureau of Statistics (ABS) Life Tables, 2011 2015, and the AIHW National Mortality Database, 2009 2015. Life expectancy at birth is the number of years of life that a person is expected to live at the time they are born. Potentially avoidable deaths are deaths below the age of 75 from conditions that are potentially preventable through individualised care and/or treatable through existing primary or hospital care. For more information refer to the Technical Note at www.myhealthycommunities.gov.au/publications References 1. n Bureau of Statistics (ABS). 2013. n Statistical Geography Standard: Volume 5 Remoteness Structure, July 2011; ABS Cat. no. 1270.0.55.005. Viewed 15 September 2017 http://www.abs.gov.au/ausstats/abs@.nsf/ mf/1270.0.55.005?opendocument 2. ABS. 2015. National Health Survey: First Results, 2014 15; ABS Cat. No. 4364.0.55.001. Viewed 15 September 2017 http://www.abs.gov.au/ausstats/abs@.nsf/ PrimaryMainFeatures/4364.0.55.001?OpenDocument 3. n Institute of Health and Welfare. 2016. Evidence for chronic disease risk factors, 2016. Viewed 20 September 2017 https://www.aihw.gov.au/reports/ chronic-disease/evidence-for-chronic-disease-risk-factors behavioural-and-biomedical-risk-factors 4. n Government Department of Health. 2016. Primary Health Networks (PHNs). Viewed 18 September 2017 http://www.health.gov.au/phn 5. n Government Department of Health. 2014. The Department of Health: s Physical Activity and Sedentary Behaviour Guidelines. Viewed 18 September 2017 http://www.health.gov.au/internet/main/ publishing.nsf/content/health-pubhlth-strateg-phys-actguidelines 6. n Government National Health and Medical Research Council (NHMRC). 2017. n Guidelines to Reduce Health Risks from Drinking Alcohol. Viewed 19 September 2017 https://www.nhmrc.gov.au/_ files_nhmrc/publications/attachments/ds10-alcohol.pdf 7. Whitworth JA 2003. 2003 World Health Organization/ International Society of Hypertension statement on management of hypertension. Journal of Hypertension 21:1983-92. Viewed 18 September 2017 http://www.who.int/cardiovascular_diseases/guidelines/ hypertension_guidelines.pdf What is a Primary Health Network? Primary Health Networks (PHNs) are local organisations that connect health services across a specific geographic area, with the boundaries defined by the n Government Department of Health. Thirty-one PHNs commenced operations on 1 July 2015, replacing Medicare Locals. They have the key objectives of increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time. In this report, a PHN area refers to the population that lives in the geographic area covered by a particular PHN. The results in this report relate to the period before PHNs were established; therefore, the findings do not reflect the performance of PHNs. n Institute of Health and Welfare 2017 The n Institute of Health and Welfare licenses use of this report under Creative Commons Attribution-Non Commercial-No Derivatives Licence 3.0, and the terms of this notice. You are permitted to make fair use of the report consistent with the terms of the licence. You must not make use of the report in a misleading or deceptive manner or in a manner that is inconsistent with the context of the report. Permissions beyond the scope of the licence may be available by contacting info@aihw.gov.au Disclaimer This report is produced for health research, health care and health advocacy purposes. This report is not intended to provide guidance on particular health care choices. You should contact your medical advisors on particular health care choices. ISSN: 2202-9184 ISBN: 978-1-76054-254-2 Suggested citation: n Institute of Health and Welfare 2017. Healthy Communities: Life expectancy and potentially avoidable deaths in. Cat. no. HPF 5. Canberra: AIHW. Please note that there is the potential for minor revisions of this document.