A new report released May 25 by the Australian Institute of Health and Welfare (AIHW), examines levels of death and disability from a variety of diseases, injuries and health risks to determine the total 'burden of disease' in Australia.

The report, The burden of disease and injury in Australia 2003, showed that cancer (19%) and cardiovascular disease (18%) were the two leading causes of the burden of disease in 2003.

'Cancer has overtaken cardiovascular disease as the leading cause of burden, largely because of Australia's success in reducing the burden of cardiovascular disease. Cardiovascular disease burden rates dropped by 35% in the 10 years prior to 2003,' said John Goss of the AIHW's Economics and Health Services Group.

'Burden of disease analysis goes beyond the mortality impact of a disease, as it also looks at the impact of illness and disability. This non-fatal burden (the amount of healthy life years lost due to disability from disease and injury) made up 51% of the total,' he said.

The five leading causes of non-fatal burden of disease were anxiety and depression (14% of the non-fatal burden), Type 2 diabetes (8%), dementia (5%), adult-onset hearing loss (5%) and asthma (4%).

For those 75 years and over, the leading causes of non-fatal burden were dementia (23%), ischemic heart disease (8%), Type 2 diabetes (7%) and adult-onset hearing loss (5%).

'With the ageing of Australia's population, more people will have diseases more common in older ages - diseases such as dementia, heart disease, and hearing and vision loss, all of which will increase demand for care services.

Of the 14 preventable health risks examined in the report, tobacco was responsible for the greatest burden (7.8% of the total burden) in Australia.

Other leading risks in 2003 were high blood pressure (7.6% of the total burden), high body mass (7.5%), physical inactivity (6.6%) and high blood cholesterol (6.2%).

Alcohol, low fruit & vegetable consumption, illicit drugs, occupational exposures & hazards, intimate partner violence, child sexual abuse, urban air pollution, unsafe sex and osteoporosis were also risk factors.

These 14 risks together accounted for 32% of the total burden of disease and injury in 2003.

The report also showed that a strong upsurge in the number of people with diabetes is likely, mostly due to higher levels of obesity.

'Paradoxically, it is the success of the health system in improving survival that will mean an increased risk of people developing other largely non-fatal but disabling consequences of diabetes,' Mr Goss said.