Australia is one of the healthiest nations in the world, taking great strides in many health areas-but there are groups whose health still lags behind, according to the Australian Institute of Health and Welfare's latest national report card on health.

AIHW Director Dr Penny Allbon said that Australia's status 'at or near the top of world health had been achieved efficiently, with per-person health spending being in the middle of the health spending tables for developed nations'.

The report, Australia's health 2008, launched on 24 June 2008 by Health Minister Nicola Roxon at the 'Australia's health 2008' conference in Canberra, shows falling death rates for cancer, heart disease, strokes, and injury.

The report also shows that Australians enjoy one of the highest life expectancies in the world-an average of 81.4 years, second only to Japan.

Australian men reaching the age of 65 can now expect to live to about 83 years, and women to 86 years-about 6 years more than their counterparts a century ago.

This is partly due to declines in Australia's smoking rates, which are now among the lowest in the world. In 2007, about one in six Australian adults were daily smokers.

Australia is also a leader in vaccinating children, and in vaccinating older people against influenza. Over 90 per cent of children are fully vaccinated against major preventable childhood diseases at 2 years of age.

Most migrants enjoy health that is as good as, or better than, that of the Australian-born population-often with lower rates of death, hospitalisation, disability and disease risk factors.

Indigenous people, on the other hand, die at much younger ages, and have a greater disease burden, more disability and a lower quality of life than other Australians. Despite improvements in Indigenous death rates, the overall gap between Indigenous and non-Indigenous rates appears to be widening. However, the gap in death rates between Indigenous infants and other Australian infants is narrowing.

In general, people living in rural and remote areas also tend to have shorter lives and higher levels of illness and disease risk factors than people in major cities. These findings are influenced, but not fully explained, by the relatively high proportion of Indigenous Australians in remote and very remote areas.

Disadvantaged Australians, wherever they live, are more likely to have shorter lives, higher levels of disease risk factors and lower use of preventive health services.

Dr Allbon said it was clear from the report that there was great scope for health improvements through tackling the so-called 'lifestyle' health risk factors.

'In rank order, the greatest improvements can be achieved through reductions in tobacco smoking, high blood pressure, overweight/obesity, physical inactivity, high blood cholesterol and excessive alcohol consumption.'

'The prevalence of diabetes, which is strongly related to these risk factors, has doubled in the past two decades', Dr Allbon said.

'Of similar concern is that 7.4 million adults were overweight in 2004-05, with over 30 per cent of those being obese. And close to 3 in 10 children and young people are overweight or obese.'

'Excessive alcohol consumption not only brings costs in terms of personal health, but tangible social costs in terms of lost productivity, health care costs, road accident costs and crime-related costs that have been estimated at $10.8 billion in 2004-05.'