Year 12 – Health and Movement Science

1.4 Examine cardiovascular disease, cancer and ONE other condition in Australia using Australia’s Health and other health reports

About the dot point

Chronic conditions, diseases and injuries are major causes of morbidity and mortality in Australia, and they create long-term demand on health services through ongoing treatment, rehabilitation, and management of risk factors. National health reporting, including Australia’s Health, uses measures such as prevalence and incidence alongside patterns in hospitalisations and deaths to show how these health problems affect different groups, change over time, and contribute to overall disease burden.

For this dot point, you must explore CVD, cancer and ONE other condition.
On this page, the other condition explored is diabetes because it links well with obesity & CVD.

However, you can choose any other condition, such as mental health conditions, respiratory diseases, injuries, kidney disease
musculoskeletal conditions (e.g. arthritis), etc. Just make sure that whatever condition you choose, it has: 1) clear Australian data on mortality, morbidity, prevalence and incidence, 2) identifiable risk and protective factors and 3) clear trends showing where and for whom rates are changing.

Across all three conditions (cardiovascular disease, cancer and diabetes), Australian health data show that chronic disease burden increases with age, is shaped by shared risk factors such as smoking, poor diet, physical inactivity and overweight/obesity, and is not distributed equally across the population. Aboriginal and Torres Strait Islander peoples, disadvantaged populations, and people in regional and remote areas often experience a higher burden and worse outcomes. However, the conditions differ in the way burden appears in the data:

  • Cancer has the highest mortality overall
  • Cardiovascular disease remains a major cause of death despite long-term improvement
  • Diabetes creates a particularly large burden through long-term complications, comorbidity and ongoing management.

How to approach it

In this dot point, the directive verb is examine. This means you must look closely and carefully into chronic conditions, diseases and injury by using relevant evidence from Australia’s Health and other health reports, not just recalling facts. As you work through this page, use the data and examples provided to identify key patterns, differences and issues within conditions such as cardiovascular disease, cancer, and one other condition, disease or injury, and explain what the evidence reveals about their burden and distribution in Australia.

Cardiovascular disease

Cardiovascular disease (CVD) is a broad term for conditions that affect the heart and blood vessels. In Australian health reporting, this broad category commonly includes coronary heart disease, stroke and peripheral vascular disease. Many cardiovascular conditions develop gradually over time as the blood vessels become damaged or narrowed, often through processes linked to atherosclerosis, high blood pressure and other long-term risk factors. This means CVD can appear as both a chronic, long-developing condition and a sudden serious event such as a heart attack or stroke.

In the previous PDHPE syllabus, students were required to learn the nature of the issue, which often meant memorising specific conditions and terms such as angina and atherosclerosis, etc. These were commonly assessed through multiple-choice questions that focused on definitions and recall.

In the current syllabus, the wording suggests the focus has shifted to interpreting health data. Students are expected to examine:
• mortality and morbidity, and prevalence and incidence
• risk and protective factors
• where and for whom conditions are changing
This reflects a stronger emphasis on data analysis and trends.

Do you still need to know specific terms?
We have not yet seen a Health and Movement Science HSC exam, so it is still useful to recognise key terms. These may appear in questions and are commonly used in Australia’s Health and other reports. For instance, cardiovascular disease (CVD) is a broad category, but reports often refer to specific conditions such as coronary heart disease, stroke, and peripheral vascular disease. Understanding these terms may help you interpret data and identify where trends are occurring.

Coronary heart disease

Coronary heart disease occurs when the blood supply to the heart muscle is reduced because the coronary arteries become narrowed or blocked. It is one of the most common forms of CVD and is often a major contributor to cardiovascular deaths in Australia.

Cerebrovascular disease i.e. Stroke

A stroke occurs when blood supply to part of the brain is interrupted, either because a vessel is blocked or because a vessel ruptures and bleeds. Because brain cells are highly dependent on oxygen, this interruption can quickly cause disability or death. Stroke is usually included in broad CVD reporting because it involves disease of the blood vessels.

Peripheral vascular disease

Peripheral vascular disease refers to reduced blood flow in vessels outside the heart and brain, especially in the legs. It usually develops when arteries become narrowed or blocked. This condition is relevant because it shows that CVD is not only about the heart. It also affects blood vessels throughout the body.

Angina

Angina is chest pain or tightness caused by reduced blood flow to the heart. It is usually temporary and does not mean the heart muscle has died, but it shows that the heart is not getting enough oxygen-rich blood. Angina is often treated as a warning sign of underlying coronary heart disease.

Heart attack

A heart attack happens when blood flow through a coronary artery is blocked so severely that part of the heart muscle is damaged. This is a sudden and serious cardiovascular event. In report data, heart attacks are often grouped under broader terms such as acute coronary events or coronary heart disease.

Heart failure

Heart failure does not mean the heart has stopped. It means the heart is no longer pumping blood as effectively as it should. It can develop after a heart attack, long-term high blood pressure, or other cardiovascular problems. This is one reason many people live with long-term morbidity from CVD, even when they survive an acute event.

Atherosclerosis and arteriosclerosis

Atherosclerosis is the build-up of fatty deposits, cholesterol and other material inside the artery wall. Over time, this narrows the artery and reduces blood flow. Arteriosclerosis refers more broadly to hardening and loss of elasticity in the artery wall. These processes help explain why CVD often develops gradually over many years before appearing as a major event such as a heart attack or stroke.

Linking this background back to the dot point

CVD can show high mortality, high morbidity, and a large ongoing burden even while long-term death rates improve. Reports may discuss the broad category, or they may zoom in on conditions such as coronary heart disease and stroke to show where change is occurring.

1. What does the data tell us about the mortality and morbidity, prevalence and incidence rates of cardiovascular disease?

Australian health data show that CVD remains a major cause of death, illness and health system use, even though long-term trends have improved. The clearest way to examine CVD is to consider mortality, morbidity, prevalence and incidence together, because each measure shows a different part of the overall burden.

1.1 Mortality and morbidity

Mortality

Cardiovascular disease remains one of the leading causes of mortality in Australia. In 2022, around 45,000 Australians died from CVD, accounting for about 24% of all deaths. Within this broader category, coronary heart disease remains a major contributor to deaths, and stroke also contributes substantially.

Morbidity

CVD also causes a large morbidity burden. Morbidity means illness, reduced functioning and the need for ongoing care. Many people survive acute events and continue living with long-term impacts such as:

  • reduced physical function
  • ongoing treatment needs
  • disability
  • repeated hospital care.

This is especially important after stroke, but it also applies across other chronic cardiovascular conditions. Hospital data show that heart, stroke and vascular conditions continue to create high demand on the healthcare system.

Long-term declines in CVD mortality are strongly linked to improvements in prevention and treatment. Key contributors include:

  • lower smoking rates
  • better detection and management of high blood pressure
  • better detection and management of cholesterol
  • improved emergency care
  • more effective medical and surgical treatment.

However, lower mortality does not mean the burden has disappeared. It often means more people survive and continue living with CVD over many years.

Example: If more older Australians survive a heart attack and then live for many years with medication, rehabilitation and follow-up care, mortality can fall while long-term morbidity remains high.

1.2 Prevalence and incidence

Prevalence

Prevalence data show that large numbers of Australians are living with CVD, and that prevalence rises sharply with age. Around 1.2 million Australian adults, or about 6.2%, are estimated to have one or more heart, stroke or vascular conditions. This helps explain why the overall burden remains high even when outcomes improve, because more people are living longer with chronic cardiovascular conditions.

Several prevalence patterns are especially important:

  • CVD is much less common in younger adults
  • prevalence increases strongly across older age groups
  • prevalence rises to more than one in four Australians over 75
  • prevalence is higher in males than in females.

These patterns help explain why Australia’s ageing population continues to maintain a high total burden of cardiovascular disease.

Incidence

Incidence means how many new cases or events occur in a period of time. Incidence data for acute cardiovascular events show long-term improvement. The rate of acute coronary events fell substantially between 2001 and 2020, although many thousands of Australians still experience first events each year. Stroke patterns also show long-term improvement, with age-adjusted death rates falling markedly over time. Together, these patterns suggest that prevention and treatment have reduced fatal events and lowered age-standardised rates. Age-standardised means the data has been adjusted so fair comparisons can be made across populations with different age structures.

At the same time, total hospital use can remain high or even increase. This is because:

  • Australia has an ageing population
  • more people survive acute events and live longer with CVD
  • better detection identifies more people with diagnosed cardiovascular conditions
  • more people require long-term treatment and follow-up care.

This is an important point when interpreting the data: age-standardised rates can fall while the absolute burden stays high.

2. What are the risk and protective factors for cardiovascular disease?

Risk of CVD is shaped by a combination of modifiable and non-modifiable factors. Much cardiovascular disease is preventable or can be delayed, which is why the risk factor profile is so important.

2.1 Risk factors

Modifiable risk factors

Non-modifiable risk factors

The main modifiable risk factors include:

  • smoking
  • poor diet
  • high blood pressure
  • high blood cholesterol
  • physical inactivity
  • overweight or obesity.

These factors often interact rather than acting in isolation. For example, excess body fat is strongly linked to:

  • high blood pressure
  • abnormal blood lipids
  • type 2 diabetes.

All of these increase cardiovascular risk. In Australia, high blood pressure and diet-related risks make a particularly large contribution to overall cardiovascular burden.

The main non-modifiable risk factors include:

  • age
  • sex
  • family history or genetics.

Risk increases substantially with age. Males tend to experience CVD earlier than females, although CVD remains a major cause of death for women as well, particularly in later life.

2.3 Protective factors

Protective factors reduce risk and can delay disease onset. These include:

  • not smoking
  • being physically active
  • maintaining a healthy weight
  • eating in ways that support healthy blood pressure and cholesterol levels
  • early detection and management of blood pressure, cholesterol and diabetes.

Regular monitoring and treatment can reduce the likelihood of serious cardiovascular events.

Example: A middle-aged adult with a family history of heart disease cannot change that non-modifiable risk factor, but they can reduce overall risk by quitting smoking, improving diet, increasing physical activity, and managing blood pressure early.

3 Where and for whom is cardiovascular disease changing?

The overall Australian pattern is one of falling death rates over time. Long-term improvements in prevention, treatment and survival have reduced mortality across adult age groups. However, progress appears to have slowed in some younger adult groups, partly because of opposing trends such as rising overweight and obesity and growing type 2 diabetes risk.

There are also clear and persistent inequities in CVD burden.

Aboriginal and Torres Strait Islander peoples

Aboriginal and Torres Strait Islander peoples experience a much higher burden of cardiovascular disease than non-Indigenous Australians. Key differences include:

  • higher prevalence
  • much higher mortality after adjusting for age
  • serious cardiovascular events occurring at younger ages.

This earlier onset has major effects on long-term health and life expectancy.

Regional and remote areas

People living in regional and remote areas also experience a higher burden of CVD than those in major cities. In some data, prevalence differences are less pronounced than mortality differences, but outcomes are still worse because of reduced access to:

  • emergency treatment.
  • timely prevention
  • diagnosis
  • specialist care

Socioeconomic disadvantage

Socioeconomic disadvantage is also strongly linked to poorer cardiovascular outcomes. People living in the most disadvantaged areas are more likely to die from CVD than those in the least disadvantaged areas. This reflects differences in:

  • risk factor exposure
  • access to healthcare
  • the cost of ongoing management
  • the broader social conditions that shape health behaviours and long-term disease risk.

Cancer

Cancer is a group of diseases in which abnormal cells grow uncontrollably, invade nearby tissue, and may spread to other parts of the body. In Australia, cancer is the leading cause of death and a major cause of illness. It includes many different diseases, so patterns of risk, survival and treatment vary by cancer type. However, national reports still show clear overall trends that allow cancer to be examined as one broad condition category.

In the previous PDHPE syllabus, students were required to learn the nature of the issue, which often meant memorising specific conditions and terms related to cancer such as as benign and malignant tumours, metastasis and carcinogens, etc. These were commonly assessed through multiple-choice questions that focused on definitions and recall.

In the current syllabus, the wording suggests the focus has shifted to interpreting health data. Students are expected to examine:
• mortality and morbidity, and prevalence and incidence
• risk and protective factors
• where and for whom conditions are changing
This reflects a stronger emphasis on data analysis and trends.

Do you still need to know specific terms?
We have not yet seen a Health and Movement Science HSC exam, so it is still useful to recognise key terms. These may appear in questions and are commonly used in Australia’s Health and other reports. For instance, cancer is a broad disease category, but reports often refer to terms such as tumours, malignant, benign, metastasis, screening and early detection. Understanding these terms may help you interpret data and identify where trends are occurring.

Uncontrolled cell growth

Cancer begins when cells grow and divide in an abnormal and uncontrolled way. Instead of following the body’s normal pattern of growth, repair and replacement, these cells continue multiplying. This can interfere with the normal function of the tissue or organ where the cancer develops.

Benign tumours

A tumour is a mass of abnormal cells. A benign tumour is not cancerous and does not spread to other parts of the body.

Malignant tumours

A tumour is a mass of abnormal cells. A malignant tumour is cancerous. It can invade nearby tissue and may spread further through the body. This difference matters because malignant tumours are the ones that create the major disease burden discussed in health reports.

Metastasis

Metastasis is the spread of cancer cells from the original site to another part of the body. When cancer spreads, it becomes harder to treat and is more likely to contribute to serious morbidity and mortality. This helps explain why early detection is so important in cancer prevention and treatment.

Carcinogens

A carcinogen is something that increases the risk of cancer by damaging cells or affecting how they grow. Common examples include tobacco smoke, UV radiation, asbestos, some chemicals and some infections. These help explain why several cancer risk factors are modifiable, and why prevention strategies can reduce future cancer burden.

Common cancers in Australian reports

Australian reports often refer to prostate, breast, melanoma, colorectal and lung cancer because they are among the most commonly diagnosed or most significant in mortality data. You do not need to treat these as separate main sections unless your resource chooses to do so, but it helps to recognise them because they are often used to show how cancer patterns differ by sex, age, and risk exposure.

Screening and early detection

Some cancers can be detected earlier through screening, which can improve treatment outcomes and reduce mortality. This is one reason cancer can show a rising number of diagnoses while age-standardised death rates improve. More cancers may be found because detection is better, not simply because the disease is getting worse.

Linking this background back to the dot point

Cancer data can show high incidence, rising prevalence, and falling age-standardised mortality at the same time. Screening, vaccination, and reducing exposure to major risk factors are such important protective strategies.

1. What does the data tell us about the mortality and morbidity, prevalence and incidence rates of cancer?

Australian cancer data show a large and ongoing burden. The number of diagnoses has increased over time, while mortality rates have generally fallen and survival has improved. This means more people are being diagnosed, but more people are also living longer after diagnosis. Australia’s ageing population is a major reason the total number of cases and deaths remains high.

1.1 Mortality and morbidity

Mortality

Cancer accounts for roughly three in every ten deaths in Australia. In 2022, around 49,000 to 50,000 Australians died from cancer, making it the leading cause of mortality nationally. Although the total number of deaths is high, the broader trend in age-standardised mortality has improved over time, which shows that cancer outcomes have become better even while the population has grown and aged.

Morbidity

Cancer also causes substantial morbidity. It contributes heavily to Australia’s total disease burden through both premature death and the years people live with illness, treatment effects and reduced functioning. Many people experience long-term impacts such as:

  • fatigue
  • pain
  • reduced physical capacity
  • psychological stress
  • the need for ongoing monitoring or follow-up care after treatment.

1.2 Prevalence and incidence

Prevalence

Prevalence is high and continues to rise because more people are surviving cancer and living with a previous diagnosis. This is important for the health system because increasing prevalence means growing demand for:

  • follow-up care
  • monitoring
  • rehabilitation
  • management of long-term effects.

In cancer reporting, prevalence often refers to the number of people alive who have been diagnosed within a set period, so it is especially useful for showing the long-term service burden created by improving survival.

Incidence

Incidence of cancer is also high. In 2022, around 162,000 new cases were estimated to be diagnosed in Australia. The rising number of cases is largely explained by:

  • population growth
  • ageing, because cancer becomes more common in older age groups.

The age-standardised incidence rate has been more stable, which means much of the increase in case numbers reflects demographic change rather than a simple rise in age-adjusted risk.

The most commonly diagnosed cancers in Australia include:

  • Prostate cancer: Cancer that begins in the prostate gland (part of the male reproductive system). It often grows slowly, especially in older males.
  • Breast cancer: Cancer that begins in breast tissue (most often in ducts or lobules). It is far more common in females, but it can occur in males.
  • Melanoma: A serious skin cancer that starts in melanocytes (cells that make pigment). It is strongly linked to UV exposure.
  • Colorectal cancer: Cancer that begins in the colon or rectum (large intestine). It is more common with increasing age and can sometimes be detected early through screening.
  • Lung cancer: Cancer that begins in lung tissue. It is strongly linked to tobacco smoking, although it can also occur in non-smokers.

These common cancers help explain many of the broad national patterns seen in incidence and mortality data. For instance, some cancers have high survival and therefore add strongly to prevalence, while others remain major contributors to death.

A key pattern in the data is that more diagnoses do not automatically mean worse outcomes. In cancer, rising case numbers can occur alongside falling death rates because:

  • screening identifies more cancers
  • earlier detection finds cancer sooner
  • better reporting captures more diagnosed cases
  • improved treatment helps more people survive longer.

Example: If a national bowel screening program finds more cancers at an earlier stage, the number of diagnoses can rise while death rates fall because treatment starts sooner.

2. What are the risk and protective factors for cancer?

Cancer risk is shaped by both modifiable and non-modifiable factors. Many cancers are linked to exposures that can be reduced, although risk also increases with age and can be influenced by sex, genetics and family history. Risk factors also vary by cancer type, which is why broad cancer patterns are best understood through shared major risks rather than memorising every cancer separately.

2.1 Risk factors

Modifiable risk factors

Non-modifiable risk factors

Key modifiable risk factors include:

  • tobacco smoking
  • alcohol
  • poor diet
  • physical inactivity
  • overweight and obesity
  • UV exposure.

Tobacco smoking is strongly linked to lung cancer and several other cancers. UV exposure is especially important in Australia because of the high burden of skin cancer, including melanoma. Some cancers are also linked to:

  • occupational or environmental carcinogens such as asbestos.
  • infections, such as HPV and hepatitis viruses

Important non-modifiable risk factors include:

  • age
  • sex
  • family history or inherited mutations.

Some cancers are sex-specific because the organ only exists in one sex. In Australia, this includes:

  • prostate cancer (males)
  • testicular cancer (males)
  • cervical cancer (females)
  • ovarian cancer (females)
  • uterine/endometrial cancer (females).

Other cancers are not sex-specific but are more common in one sex due to a mix of biological and risk-exposure differences. Broad Australian patterns commonly reported include:

  • breast cancer is far more common in females, but can occur in males
  • lung cancer has historically been higher in males (reflecting past smoking patterns), with rates in females changing over time
  • melanoma is often higher in males overall, especially at older ages
  • colorectal cancer is often slightly higher in males.

These sex differences sit alongside the strong effect of age, because cancer risk rises sharply in older age groups as cumulative exposure and cellular damage increase over time.

2.2 Protective factors

Protective factors include:

  • not smoking
  • limiting alcohol
  • maintaining a healthy weight
  • being physically active
  • eating well
  • using effective sun protection
  • participating in screening
  • participating in vaccination programs where relevant.

In Australia, screening and vaccination programs are especially important for breast screening, cervical screening and bowel screening. This is because these are proven, population-wide programs that prevent disease or detect it early. Many other cancers and health risks do not have an effective vaccine or an accurate, safe screening test suitable for whole-population use.

3. Where and for whom is cancer changing?

Cancer patterns are changing over time and vary across population groups. The overall number of cases has increased because more Australians are living into older age groups where cancer is more common. At the same time, age-standardised mortality has fallen, reflecting improvements in prevention, screening, diagnosis and treatment. This means the cancer burden is growing in total numbers, but outcomes have improved when age is taken into account.

Sex: Males vs females

There are clear sex differences in cancer burden. Men have higher age-standardised incidence and mortality rates than women for all cancers combined, and they also face a higher lifetime risk of diagnosis. These overall differences are influenced by the mix of cancer types affecting males and females, as well as differences in exposure to risk factors.

Aboriginal and Torres Strait Islander peoples

There are also strong inequities. Aboriginal and Torres Strait Islander peoples experience a different cancer profile, including higher rates of some preventable cancers and poorer outcomes overall. These patterns are influenced by:

  • lower screening participation
  • later diagnosis
  • higher levels of comorbidity
  • barriers to timely, culturally safe care

Socioeconomic disadvantage

Socioeconomic disadvantage is also associated with poorer cancer outcomes. Some cancers linked to smoking, alcohol and other risk exposures are more common in disadvantaged groups, and cancer mortality is generally higher where disadvantage is greater. Differences in screening participation, early detection and treatment access all contribute to these poorer outcomes.

Regional and remote areas

People in regional and remote areas often experience worse outcomes for some cancers because of barriers in accessing screening, diagnosis and specialist care. Survival is generally better in major cities than in very remote areas, showing how location can influence cancer outcomes even when the condition itself is the same.

Different cancers

Cancer trends also differ by cancer type. For instance:

  • Lung cancer has fallen in men over time as smoking declined, and has more recently plateaued or declined in women.
  • Cervical cancer incidence and mortality have fallen substantially due to screening and HPV vaccination.
  • Melanoma has declined in younger groups while remaining high in older groups, reflecting historical exposure patterns.
  • Some cancers such as liver cancer have increased.

These differences show why cancer must be understood both as a broad national burden and as a condition category made up of many diseases with different patterns of change.

Diabetes

Diabetes is a chronic condition in which the body cannot regulate blood glucose effectively. In Australian health reporting, most of the population burden relates to type 2 diabetes, although type 1 diabetes and gestational diabetes are also important. Diabetes is a major health issue because it increases the risk of cardiovascular disease and can lead to long-term complications affecting the eyes, kidneys, nerves and circulation.

In the previous PDHPE syllabus, students were required to learn the nature of the issue, which often meant memorising specific conditions and terms related to diabetes such as benign and malignant tumours, metastasis and carcinogens, etc. This would not usually happen unless a short answer had asked about the ‘nature of the issue”.

In the current syllabus, the wording suggests the focus has shifted to interpreting health data. Students are expected to examine:
• mortality and morbidity, and prevalence and incidence
• risk and protective factors
• where and for whom conditions are changing
This reflects a stronger emphasis on data analysis and trends.

Do you still need to know specific terms?
We have not yet seen a Health and Movement Science HSC exam, so it is still useful to recognise key terms. These may appear in questions and are commonly used in Australia’s Health and other reports. For instance, diabetes is a broad condition category, but reports often refer to terms such as blood glucose, insulin, type 1 diabetes, type 2 diabetes, gestational diabetes, complications and comorbidity. Understanding these terms may help you interpret data and identify where trends are occurring.

Blood glucose and insulin

After food is digested, glucose enters the bloodstream. Insulin is the hormone that helps move this glucose from the blood into the body’s cells so it can be used for energy. Diabetes occurs when the body cannot produce enough insulin, cannot use insulin effectively, or both. When this happens, blood glucose remains too high.

Type 1 diabetes

Type 1 diabetes occurs when the body produces little or no insulin because the insulin-producing cells are damaged. It usually has a strong autoimmune and genetic basis and is not prevented through lifestyle change. It is important to recognise, but it accounts for a much smaller share of the total Australian diabetes burden than type 2 diabetes.

Type 2 diabetes

Type 2 diabetes is the most common form of diabetes. In this type, the body still produces insulin, but it is not used effectively, and over time the insulin supply may become insufficient. Type 2 diabetes is strongly linked to overweight and obesity, physical inactivity, and other long-term risk factors, which is why prevention is such an important theme in diabetes reporting.

Gestational diabetes

Gestational diabetes develops during pregnancy when the body cannot meet the increased demand for insulin. It often improves after birth, but it raises the risk of later type 2 diabetes in both the mother and the child. This is one reason rising gestational diabetes matters in long-term population health trends.

Short-term and long-term complications

Diabetes can lead to both short-term and long-term complications. Short-term problems are often linked to very high or very low blood glucose. Long-term complications develop gradually and are a major reason diabetes creates such high morbidity. These complications can affect the large blood vessels, increasing risk of coronary heart disease, stroke and peripheral vascular disease, and the small blood vessels, contributing to kidney disease, nerve damage and vision loss.

Comorbidity

Comorbidity means a person has more than one health condition at the same time. Diabetes often appears alongside cardiovascular disease, chronic kidney disease and other long-term conditions. This is why diabetes is frequently recorded as a contributing cause of death rather than the single underlying cause. It also helps explain why diabetes is linked to very high hospital use.

Undiagnosed diabetes

Not everyone with type 2 diabetes has been diagnosed. This means survey and registry data may underestimate the total number of people affected. This is important when interpreting prevalence data, because diagnosed cases show only part of the total burden.

Linking this background back to the dot point

Diabetes can have a lower profile in underlying-cause death rankings but still create very high morbidity, hospitalisations, and long-term health system burden. Type 2 diabetes prevention, early diagnosis, and complication management are so important when examining the condition in Australian health data.

1. What does the data tell us about the mortality and morbidity, prevalence and incidence rates of diabetes?

Australian health data show a substantial and growing diabetes burden. The clearest picture comes from combining mortality, morbidity, prevalence and incidence, because diabetes often contributes to illness and death through long-term complications rather than always being recorded as the single main cause. This is especially important when interpreting diabetes data alongside cardiovascular disease and kidney disease.

1.1 Mortality and morbidity

Mortality

Diabetes contributes strongly to morbidity because it is a long-term condition that commonly leads to complications and comorbidity. These complications include:

  • damage to large blood vessels, which increases the risk of coronary heart disease, stroke and other vascular disease
  • damage to small blood vessels, which can contribute to chronic kidney disease, nerve damage and vision loss.

Because many people live with diabetes for many years, the condition creates a large burden through ongoing treatment, monitoring, complications and repeated healthcare use.

This burden is clearly reflected in hospital data. In 2022, diabetes was associated with more than 1.3 million hospitalisations, either directly or as a comorbidity, representing about 10% of all hospital stays. This shows how often diabetes occurs alongside other serious conditions and how much it adds to overall health system demand.

Morbidity

Diabetes-related mortality is often understated if only the underlying cause of death is examined. This is because diabetes frequently contributes to deaths that are ultimately recorded under cardiovascular disease, kidney disease or other complications. In 2022, diabetes was an underlying or contributing cause in about 11% of all deaths. When it is counted only as the single underlying cause, its contribution appears much smaller than its real role in total disease burden.

Example: If a person with diabetes develops severe kidney disease and dies, the death may be recorded under kidney disease even though diabetes helped cause the damage.

1.2 Prevalence and incidence

Prevalence

Prevalence of diabetes has increased over time. Around one in twenty Australians, or about 5%, have diagnosed diabetes. In 2022, this was about 1.3 million people. Prevalence is slightly higher in males than in females, and it rises strongly with age. Rates are especially high in older adults, which helps explain why population ageing continues to increase the total number of people living with diabetes.

The true burden is likely to be higher than diagnosed figures alone suggest, because some people live with undiagnosed type 2 diabetes. This matters when interpreting survey and registry data, as diagnosed prevalence can underestimate the total number of people affected.

Incidence

Incidence remains high for type 2 diabetes. In 2021, around 46,000 people were newly diagnosed, averaging about 125 new cases per day. Type 1 diabetes has a much lower incidence, while gestational diabetes has risen sharply and is now detected in a substantial proportion of pregnancies. In 2021 to 2022, almost one in five women who gave birth had gestational diabetes detected.

Rising prevalence reflects both sustained incidence and the fact that many people live for many years with diabetes and its complications. This means the overall burden can continue to grow even when some rates improve, because more people survive and require long-term management. The total number of Australians known to be living with diabetes has increased strongly over time, highlighting the growing importance of prevention and early identification.

Example: If gestational diabetes is detected more often during pregnancy, incidence rises immediately, and prevalence can continue to grow later if more women go on to develop type 2 diabetes.

2. What are the risk and protective factors for diabetes?

Risk and protective factors differ by type of diabetes, but the greatest population health burden comes from type 2 diabetes, which is strongly linked to modifiable risks. Type 1 diabetes is associated mainly with genetic and environmental influences and is not currently preventable through lifestyle change. By contrast, type 2 diabetes is closely linked to health behaviours and biomedical risk factors, which is why prevention and early action are so important.

2.1 Modifiable risk factors

Modifiable risk factors

Non-modifiable risk factors

The main modifiable risk factors for type 2 diabetes include:

  • overweight and obesity
  • physical inactivity
  • diet patterns that promote weight gain and poorer glucose regulation
  • smoking.

Of these, excess body fat is the most important modifiable factor and makes a very large contribution to the development of type 2 diabetes. The close relationship between diabetes risk and high blood pressure, poor diet and low activity levels is also important.

Important non-modifiable or partly modifiable risk factors include:

  • family history
  • age
  • history of gestational diabetes
  • pre-diabetes
  • higher risk in some population groups, including Aboriginal and Torres Strait Islander peoples and some migrant populations
  • PCOS, which is associated with increased type 2 diabetes risk in some women.

These factors help explain why diabetes clusters in certain groups and why risk rises across the life course.

2.2 Protective factors

Protective factors for type 2 diabetes focus on prevention and early intervention. These include:

  • maintaining a healthy weight
  • being physically active
  • following dietary patterns that support better glucose regulation
  • early action when risk is identified.

Even modest weight loss can significantly reduce risk in people who are overweight. For people already living with diabetes, protective factors focus on reducing complications through:

  • good glucose control
  • management of blood pressure
  • management of cholesterol
  • regular eye checks
  • regular foot checks
  • consistent access to education and care.

3. Where and for whom is diabetes changing?

Diabetes has increased over time and shows strong inequities across the population.

Age

Prevalence is highest in older adults, but an important recent shift is the increasing diagnosis of type 2 diabetes at younger ages. This earlier onset increases the total number of years a person may live with diabetes and therefore increases the risk of cumulative complications across the life course.

Aboriginal and Torres Strait Islander peoples

The burden is not shared equally. Aboriginal and Torres Strait Islander peoples are disproportionately affected, with much higher rates of diabetes and diabetes-related mortality than non-Indigenous Australians.

This reflects the interaction of:

  • risk factors
  • social determinants
  • access to prevention and care
  • the broader pattern of health inequity in Australia.

Socioeconomic disadvantage and regional and remote areas

Socioeconomic disadvantage is also strongly associated with higher diabetes mortality and poorer outcomes. People living in disadvantaged areas are more likely to die from diabetes, and people in regional and remote areas generally experience a higher burden and more complications.

This reflects barriers in access to:

  • healthcare
  • prevention services
  • ongoing monitoring
  • healthy food environments.

Pregnant women and their children

The increase in gestational diabetes is especially important because it raises the likelihood of later type 2 diabetes in both the mother and the child. This means diabetes burden is not only increasing within individuals across the life course, but can also contribute to ongoing risk across generations.

At the same time, progress in treatment and monitoring has reduced some complications, yet the total number of complications remains high because more people are living longer with diabetes.

Brief Summary

About the dot point and how to approach it

  • Chronic conditions, diseases and injuries are major causes of morbidity and mortality in Australia.
  • They create long-term demand on health services through ongoing treatment, rehabilitation, and management of risk factors.
  • National health reporting, including Australia’s Health, uses prevalence and incidence alongside patterns in hospitalisations and deaths to show impact across groups, change over time, and contribution to overall disease burden.
  • Directive verb examine means looking closely and carefully using evidence from Australia’s Health and other health reports, and identifying key patterns, differences and issues about burden and distribution.

Cardiovascular Disease (CVD)

1. What does the data tell us about the mortality and morbidity, prevalence and incidence rates of cardiovascular disease?

  • CVD remains a major cause of death and illness, even though long-term trends have improved.
  • Mortality: In 2022, around 45,000 Australians died from CVD (about 24% of all deaths).
  • Morbidity remains high because more people survive acute events and live long-term with CVD.
  • Prevalence rises sharply with age (around 1.2 million adults, about 6.2%).
  • Incidence of acute events has improved over time, but total hospital use can remain high; age-standardised rates can fall while the absolute burden stays high.

2. What are the risk and protective factors for cardiovascular disease?

  • Modifiable risks: smoking, poor diet, high blood pressure, high blood cholesterol, physical inactivity, overweight or obesity.
  • Non-modifiable risks: age, sex, family history or genetics.
  • Protective factors: not smoking, being active, healthy weight, healthy eating, and early detection and management of blood pressure, cholesterol and diabetes.

3. Where and for whom is cardiovascular disease changing?

  • Overall death rates have fallen over time, but progress has slowed in some younger adult groups.
  • Higher burden and worse outcomes for Aboriginal and Torres Strait Islander peoples, regional and remote populations, and people experiencing socioeconomic disadvantage.

Cancer

1. What does the data tell us about the mortality and morbidity, prevalence and incidence rates of cancer?

  • Cancer is the leading cause of death; in 2022 around 49,000 to 50,000 Australians died from cancer.
  • Age-standardised mortality has improved over time, and survival has improved.
  • Incidence is high (around 162,000 new cases in 2022), with rising numbers largely driven by population growth and ageing.
  • Prevalence is rising because more people are surviving and living longer after diagnosis, increasing service demand.

2. What are the risk and protective factors for cancer?

  • Modifiable risks: tobacco smoking, alcohol, poor diet, physical inactivity, overweight and obesity, UV exposure, infections (such as HPV), and carcinogens (such as asbestos).
  • Non-modifiable risks: age, sex, family history or inherited mutations.
  • Protective factors: not smoking, limiting alcohol, healthy weight, physical activity, sun protection, screening, and vaccination where relevant.

3. Where and for whom is cancer changing?

  • Case numbers have increased due to ageing, while age-standardised mortality has fallen.
  • Worse outcomes associated with Aboriginal and Torres Strait Islander peoples, socioeconomic disadvantage, and regional and remote areas.

Diabetes

1. What does the data tell us about the mortality and morbidity, prevalence and incidence rates of diabetes?

  • Diabetes burden is substantial and growing, and is best examined using combined measures.
  • Morbidity is high due to long-term complications and comorbidity; in 2022 diabetes was associated with more than 1.3 million hospitalisations (about 10% of all hospital stays).
  • Mortality is often understated in underlying-cause data; in 2022 diabetes was an underlying or contributing cause in about 11% of all deaths.
  • Prevalence: about 5% (around 1.3 million people in 2022), rises strongly with age, and is likely underestimated due to undiagnosed type 2 diabetes.
  • Incidence: around 46,000 newly diagnosed in 2021; gestational diabetes has risen sharply.

2. What are the risk and protective factors for diabetes?

  • Main modifiable risks for type 2 diabetes: overweight and obesity, physical inactivity, diet patterns that promote weight gain, and smoking.
  • Non-modifiable or partly modifiable risks: family history, age, history of gestational diabetes, pre-diabetes, and higher risk in some population groups.
  • Protective factors: healthy weight, physical activity, dietary patterns that support glucose regulation, and early action when risk is identified.

3. Where and for whom is diabetes changing?

  • Prevalence is highest in older adults, with increasing diagnosis of type 2 diabetes at younger ages.
  • Much higher burden for Aboriginal and Torres Strait Islander peoples, and higher mortality and poorer outcomes linked to socioeconomic disadvantage and regional and remote areas.
  • Rising gestational diabetes increases later type 2 diabetes risk for both mother and child.