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Long-term health conditions

Information on long-term health conditions

Released
30/08/2022

Key findings

  • Over 8 million people had at least one long-term health condition, 31.7% of the Australian population.
  • Of those with a long-term health condition, 54.1% were female and 45.9% were male.
  • There is a strong link between age and incidence of long-term health conditions, as the proportion of those with a long-term health condition increases with age.
  • The most commonly reported long-term health conditions in the Australian population were a mental health condition (8.8%), arthritis (8.5%) and asthma (8.1%).

Overview

This article presents information about Australians who have one or more long-term health conditions and is based on data collected in the 2021 Census. It explores long-term health conditions in relation to other Census variables such as demographic and socio-economic characteristics; where people live; household composition; and cultural and linguistic diversity. This information is important in the planning and management of health services and targeted support for those living with long-term health conditions.

2021 was the first time that the long-term health conditions question was asked on the Census. In the past, the Census has helped with breakthrough health discoveries - the Australian Census was critical to discovering the link between rubella measles and congenital problems with unborn children. For more detail, see the health Census data stories.

More information about the long-term health conditions question, including definitions and levels of non-response, is provided at the end of this article in Methodology.

Demographic characteristics and long-term health conditions

There is a strong link between age and incidence of long-term health conditions, as the proportion of those with a long-term health condition increases with age.

This age pattern is likely to influence long-term health condition outcomes for other population groups in the Census, such as state or territory of residence, country of birth, household composition and household income. The average age profile of a person’s state or territory of usual residence or country of birth cohort is likely to impact on data for those groups, with older groups reporting long-term health conditions.

Statistical adjustments can be made to health data to account for the effect of age. The data in this article, however, is unadjusted.

According to the 2021 Census, approximately 8,064,000 people had at least one long-term health condition, 31.7% of the Australian population.

Rates of the long-term health conditions that were collected in the Census are calculated by dividing the total number of respondents with a particular condition, by the total population. These rates are:

  • mental health condition (8.8%)
  • arthritis (8.5%)
  • asthma (8.1%)
  • diabetes (4.7%)
  • heart disease (3.9%)
  • cancer (2.9%)
  • lung condition (1.7%)
  • stroke (0.9%)
  • kidney disease (0.9%)
  • dementia (0.7%).

The use of a single question in the Census to collect information on the complex and sensitive topic of long-term health conditions likely results in some underestimation of the number and proportion of people with long-term health conditions. This was observed particularly for mental health conditions. The benefit of Census data is the ability to compare small areas and communities, while surveys like the National Health Survey and the National Study of Mental Health and Wellbeing discuss prevalence of conditions at a broad level. For more information on data sources, see Comparing ABS long-term health conditions data sources.

Of those with a long-term health condition:

  • 54.1% were female (4,359,000 females)
  • 45.9% were male (3,705,000 males)
  • the median age was 55 years (compared to 38 years for all of Australia).

The proportion of those with a long-term health condition increased with age:

  • 11.7% of people aged 0-14 years had a long-term health condition
  • 29.1% of people aged 15-64 years had a long-term health condition
  • 61.4% of people aged 65-84 years had a long-term health condition
  • 73.1% of people aged 85 years and over had a long-term health condition.

Females were more likely to have long-term health conditions than males, which could also be influenced by age (median age of females was 39 years, median age of males was 37 years). They were also more likely to have multiple conditions:

  • 19.8% of females had one condition (compared to 17.9% of males)
  • 6.6% of females had two conditions (compared to 5.1% of males)
  • 3.4% of females had three or more conditions (compared to 2.7% of males).

Older people were more likely to have multiple long-term health conditions compared to younger people. 11.6% of people aged 65 years and over had three or more conditions compared to 1.6% of those aged 15-64 years. Of people with long-term health conditions:

  • 18.8% of people had one condition (median age 50 years)
  • 5.9% of people had two conditions (median age 63 years)
  • 3.0% of people had three or more conditions (median age 71 years).

Type of long-term health condition by male/female breakdown

The rate of the selected long-term health conditions varied between males and females. Females were more likely than males to have conditions such as arthritis, a mental health condition and dementia, while males were more likely than females to have conditions such as heart disease, diabetes and stroke.

Type of long-term condition by median age

The median age of people with the different types of long-term health conditions varied. Those with asthma or a mental health condition had a lower median age (40 years and 42 years respectively) than those with stroke or dementia (73 years and 83 years respectively).

When examining long-term health condition in age cohorts, different trends can be seen for some conditions.

Rates of mental health conditions and asthma are more evenly distributed across age groups, suggesting these conditions are not linked to ageing. The majority of other listed long-term health conditions increase with age. Heart disease, cancer, diabetes and stroke begin to decrease from 80 and 90 years, suggesting that people with these conditions have a shorter life span than those with other conditions.

Profile: Baby boomers (aged 55-74 years) with long-term health conditions

According to the 2021 Census, baby boomers (aged 55-74 years) represented 21.5% of the Australian population and accounted for more than one third (34.2%) of those who had at least one long-term health condition.

Half of baby boomers (50.4%) had a long-term health condition compared to one third (31.7%) of the total population.

Baby boomers were more than twice as likely to report having arthritis (19.8% compared to 8.5%) and diabetes (11.2% compared to 4.7%) than the total population.

For baby boomers who had a core need for assistance, 93.4% also reported a long-term health condition.

Baby boomers in the Greater Hobart area had the highest proportion of one or more long-term health conditions compared to the other Greater Capital Cities (GCCSAs), with 54.4% of Greater Hobart baby boomers reporting they had a long-term health condition.

Comorbidity of long-term health conditions

Many people with long-term health conditions have more than one condition. This may result in more complex health care needs and require management and coordination of care across multiple parts of the health system(1). The 2021 Census has 12 output variables for the most commonly reported comorbidities. A list of these variables can be found in the 2021 Census dictionary.

In the 2021 Census, the most common comorbidities reported were:

  • arthritis and mental health condition (1.7% of the total population or approximately 423,000 people)
  • arthritis and asthma (1.5% or approximately 380,000 people)
  • arthritis and heart disease (1.4% or 348,000 people).

Comorbidity of conditions varied between males and females. Males most commonly reported arthritis and heart disease (1.3%), whereas females most commonly reported arthritis and mental health condition (2.2%).

Top 5 - Comorbidity of long-term health conditions by sex, 2021
 All personsMalesFemales
1Arthritis and mental health condition (1.7%)Arthritis and heart disease (1.3%)Arthritis and mental health condition (2.2%)
2Arthritis and asthma (1.5%)Diabetes and heart disease (1.2%)Arthritis and asthma (2.1%)
3Arthritis and heart disease (1.4%)Arthritis and mental health condition (1.1%)Arthritis and diabetes (1.4%)
4Arthritis and diabetes (1.3%)Arthritis and diabetes (1.1%)Arthritis and heart disease (1.4%)
5Diabetes and heart disease (0.9%)Arthritis and asthma (0.9%)Asthma and lung condition (0.7%)

State or territory and long-term health conditions

According to the 2021 Census 37.5% of people living in Tasmania had a long-term health condition, compared to 31.7% of Australians, and 23.4% of those living in the Northern Territory. This is likely a reflection of the age profiles of these states and territories (the median age of people living in the Northern Territory was 33 years compared to 42 years for those living in Tasmania).

The rate of types of long-term health conditions varied between states and territories. The most commonly reported long-term health condition in VIC, QLD, WA and the ACT was a mental health condition, whereas in NSW, SA and TAS it was arthritis. In the NT the mostly commonly reported condition was asthma. 

 

 

Top 5 - State or territory by type of long-term health condition, 2021
 New South WalesVictoriaQueenslandSouth AustraliaWestern AustraliaTasmaniaNorthern TerritoryAustralian Capital Territory
1Arthritis (8.4%)Mental health condition (8.8%)Mental health condition (9.6%)Arthritis (10.1%)Mental health condition (8.3%)Arthritis (12.2%)Any other long-term health condition(s) (6.1%)Mental health condition (10.0%)
2Mental health condition (8.0%)Asthma (8.4%)Arthritis (8.8%)Mental health condition (9.8%)Arthritis (7.6%)Mental health condition (11.5%)Asthma (5.6%)Any other long-term health condition(s) (9.7%)
3Any other long-term health condition(s) (7.8%)Any other long-term health condition(s) (8.0%)Asthma (8.5%)Asthma (8.9%)Any other long-term health condition(s) (7.4%)Asthma (9.4%)Mental health condition (5.1%)Asthma (9.0%)
4Asthma (7.8%)Arthritis (8.0%)Any other long-term health condition(s) (8.4%)Any other long-term health condition(s) (8.8%)Asthma (7.3%)Any other long-term health condition(s) (8.9%)Arthritis (4.5%)Arthritis (7.7%)
5Diabetes (4.8%)Diabetes (4.7%)Diabetes (4.5%)Diabetes (5.7%)Diabetes (4.4%)Diabetes (5.1%)Diabetes (4.3%)Diabetes (3.9%)

 

Greater Capital City Statistical Areas (GCCSA) and long-term health conditions

Apart from in the NT and WA, people living outside Greater Capital Cities in the Rest of State areas were more likely to have a long-term health condition than those living in Greater Capital Cities.

The rate of the different long-term health conditions varied between those living in Greater Capital Cities and those living in Rest of State areas. For example, in Greater Melbourne, Brisbane, Adelaide, Perth and Hobart the most commonly reported long-term health condition was a mental health condition. For those living in the Rest of State areas, the most commonly reported long-term health condition was arthritis.

Dwelling and household characteristics and long-term health conditions

Dwelling type

36.0% of people living in non-private dwellings, such as nursing homes or hospitals, had a long-term health condition compared to 31.6% of those who were living in private dwellings. This reflects the age profile of people living in different dwelling types. People living in non-private dwellings had a median age of 51 years, compared to a median age of 38 years for those living in private dwellings.

Over three quarters of people living in nursing homes (77.1%) and those living in accommodation for the retired or aged that wasn't self-contained (76.7%) had a long-term health condition.

People living in non-private dwellings were also more likely to have multiple long-term health conditions than those living in private dwellings:

  • 8.7% of people living in non-private dwellings had two conditions (compared to 5.8% of those living in private dwellings)
  • 9.2% of people living in non-private dwellings had three or more conditions (compared to 2.9% of those living in private dwellings).

The rate of all the long-term health conditions apart from asthma was higher for those living in non-private dwellings compared to those living in private dwellings.

Type of long-term health condition(a) by dwelling type, 2021
Type of long-term health conditionLiving in non-private dwellings (%)Living in private dwellings (%)
Arthritis11.28.4
Asthma5.48.2
Cancer4.02.8
Dementia11.30.4
Diabetes5.64.7
Heart disease7.53.8
Kidney disease2.00.9
Lung condition 2.81.7
Mental health condition13.48.6
Stroke3.10.9
Any other long-term health condition(s)13.27.9

(a) Respondents had the option to record multiple long-term health conditions therefore aggregations of percentages will not equal 100%.

More than four in ten (43.0%) people with dementia were living in non-private dwellings.

Household composition

More than half (51.5%) of people living in lone person households had a long-term health condition compared to 29.4% of those living in other types of households. This is likely a reflection of the age profile of the different types of households. People living in lone person households had a higher median age of 60 years compared to median ages of 36 years for people living in one family households and 30 years for people living in group households.

(a) This table uses Household composition (HHCD). The one, two and three or more family categories include both households with family members only present, and households with non-family members present.

People living in lone person households were more likely to have multiple long-term health conditions than those living in other types households:

  • 27.5% of those living in lone person households had one condition (compared to 18.0% of those living in other types of households)
  • 12.1% of those living in lone person households had two conditions (compared to 5.1% of those living in other types of households)
  • 7.6% of those living in lone person households had three or more conditions (compared to 2.3% of those living in other types of households).

People in lone person households had the highest rates of all of the selected long-term health conditions. Excluding asthma and any other long-term health condition(s), they were twice as likely to report most long-term conditions compared with people living in family and group households. 20.3% of people living in a lone household reported having arthritis, compared with 7.3% of people who lived in family or group households.

Profile: People with long-term health conditions living in lone person households

People living in lone person households represented 10.6% of the Australian population and accounted for 16.7% of those who had at least one long-term health condition. 

Over half of people who lived in lone person households (51.5%) had at least one long-term health condition, compared with nearly one third (30.5%) of people who lived in family and group households. This has a strong correlation to the age profile of those living in lone person households. The graph below indicates that there are more instances of older people living alone than those in younger age groups.

People in lone person households reported rates of arthritis (20.3%) at more than double the rate of the total population (8.5%). Mental health conditions were also significantly higher (14.6% compared to 8.8%).

Cultural diversity and long-term health conditions

There is no single way to define what it means to be from a culturally and linguistically diverse background. For example, it can refer to people who were not born in Australia; whose language used at home is a language other than English; or those who do not speak English well (referred to as English language proficiency). It can also include Aboriginal or Torres Strait Islander people – or can comprise a mix of these(2).

Aspects of cultural and linguistic diversity may influence long-term health conditions outcomes and impact a person’s ability to access health care services.

However, the following analysis of Census long-term health conditions data by these types of variables also supports the concept of the ‘healthy migrant effect’ (i.e. health requirements and eligibility criteria ensuring that generally those in good health migrate to Australia). Although immigrants come from diverse regions of the world, almost all demonstrate good, if not better, health on arrival and for some years following than the Australian-born population. This better health is reflected in longer life expectancy, lower death and hospitalisation rates, and a lower prevalence of some lifestyle-related risk factors(3).

Country of birth of person

Of those who had a long-term health condition, 73.7% were born in Australia and 26.2% were born overseas (excluding those who did not respond to this question). This was higher than the total Australian population with 70.5% reporting being born in Australia and 29.5% reporting being born overseas.

    Over half of people in Australia who were born in Greece (56.1%) and Italy (53.7%) had a long-term health condition. Rates of people with a long-term health condition were also high for those in Australia born in Scotland (47.9%), England (45.5%) and Germany (44.9%).

    These proportions are likely to be impacted by the age profiles of the populations born in these countries. For example, the median age of those born in Greece was 74 years and the median age of those born in Italy was 72 years.

    People in Australia who were born in Italy and Greece were most likely to have multiple long-term health conditions.

    Rates of long-term health conditions in other common countries of birth in Australia include:

    • Of the people who were born in New Zealand 34.7% had a long-term condition.
    • Of the people who were born in China (excludes SARs and Taiwan) 16.1% had a long-term condition.
    • Of the people who were born in India 14.2% had a long-term condition.

    (a) Total used to calculate proportions includes Not stated.

    (b) Top 10 countries of birth based on who reported having one or more long-term health condition(s).

    People born in the following countries also had high rates of the selected long-term health conditions:

    • Scotland - arthritis (17.6%), cancer (6.4%) and lung condition (4.6%)
    • Australia - asthma (9.9%)
    • Lebanon - diabetes (14.2%) and kidney disease (1.9%)
    • Germany - heart disease (9.9%), dementia (2.5%) and stroke (2.4%)

    Language used at home and proficiency in spoken English

    Access to affordable and decent quality health care services is an important social determinant of health. A person who either does not speak the local language, or has a limited ability to communicate in the local language, may be disadvantaged when trying to access health care services, which may result in poorer health outcomes.

    According to the 2021 Census, of those who had a long-term health condition:

    • 83.5% spoke English only (compared to 72.0% of the total population)
    • 15.9% used a language other than English at home (compared to 22.5% of the total population)
    • Aside from English the most common languages spoken at home were Italian (7.7% compared to 3.2% of the total population), Arabic (7.3% compared to 5.2% of the total population) and Mandarin (6.8% compared to 9.6% of the total population).

    Of the people who spoke English only, 36.8% had a long-term health condition, compared to 22.4% of people who used a language other than English at home. One third (33.1%) of people who spoke a language other than English and did not speak English well or at all had a long-term health condition, compared to 20.4% of people who spoke English very well or well.

    Apart from asthma, rates of each type of long-term health condition were higher for people who did not speak English well or at all, compared to those who spoke English very well or well. This is likely driven by age with the median of all people who use another language at home and do not speak English well or at all being 52 years. The median age for people who use another language at home and speak English well or very well was 35 years.

    Distribution of people with long-term health condition by proficiency in spoken English(a), 2021
    Type of long-term health condition   
    Speaks English only (%)Uses other language and speaks English: Very well/Well (%)Uses other language and speaks English: Not well/Not at all (%)
    Arthritis10.14.39.3
    Asthma9.94.63.5
    Cancer3.51.52.6
    Dementia0.80.42.4
    Diabetes4.84.610.4
    Heart disease4.52.45.7
    Kidney disease1.00.61.7
    Lung condition2.20.61.4
    Mental health condition10.93.85.2
    Stroke1.00.51.8
    Any other long-term health condition(s)9.05.811.6
    No long-term health conditions59.677.064.0

    (a) Respondents had the option to record multiple long-term health conditions therefore aggregations of percentages will not equal 100%.

    Household income and long-term health conditions

    The level of household income may impact a person’s ability to afford and access health care services.

    Rates of people with a long-term health condition were highest in the bracket with an equivalised household income of $400-$499 per week (52.9%). The median age of those in this income bracket was 64 years, the highest median age in any household income bracket.

    Core activity need for assistance and long-term health conditions

    In 2021, close to nine in ten people (88.1%) with a need for assistance with core activities had a long-term health condition compared to three in ten (29.8%) people without a need for assistance.

    People with multiple long-term health conditions had a greater need for assistance from a person for core activities. 40.9% of people with three or more conditions had a need for assistance, compared to 20.4% with two conditions, 10.0% with one condition, and 2.1% of people with none of the selected conditions.

    Those with the following long-term health conditions had the greatest need for assistance with core activities:

    • 81.9% of people with dementia
    • 46.2% of people who had a stroke
    • 35.1% of people with kidney disease.
    Type of long-term health condition by core activity need for assistance(a), 2021
    Type of long-term health conditionHas a core activity need for assistance (%)Does not have a core activity need for assistance (%)
    Arthritis21.677.3
    Asthma10.089.3
    Cancer20.578.5
    Dementia81.914.4
    Diabetes21.078.0
    Heart disease26.272.6
    Kidney disease35.163.5
    Lung condition31.966.9
    Mental health condition19.279.9
    Stroke46.252.3
    Any other long-term health conditions(s)27.371.9

    (a) Respondents had the option to record multiple long-term health conditions therefore aggregations of percentages will not equal 100%.

    This suggests that particularly dementia and stroke may be more debilitating conditions that require more assistance.

    Profile: People with a need for assistance with long-term health conditions

    In Australia, those with a core need for assistance (5.8% of the population) accounted for 16.1% of people who had a long-term health condition.

    Nearly nine in ten (88.1%) people with a need for assistance reported having a long-term health condition. Those with a need for assistance were also three times more likely to have a long-term health condition than those that do not have a need for assistance (29.8%).

    The most common health conditions reported by those with a need for assistance (compared to the those that do not need assistance) were other long-term health conditions (38.0% compared to 6.5%); arthritis (31.7% compared to 7.4%); mental health conditions (29.3% compared to 7.9%); heart disease (17.8% compared to 3.2%); and diabetes (17.2% compared to 4.2%).

    Those with a need for assistance had higher rates of multiple conditions than those without a need for assistance:

    • 32.6% of those with a need for assistance had one condition (compared to 19.0% of those without a need for assistance)
    • 20.8% of those with a need for assistance had two conditions (compared to 5.2% of those without a need for assistance)
    • 21.5% of those with a need for assistance had three or more conditions (compared to 2.0% of those without a need for assistance).

    More data related to health can be found in the Data downloads on the Health: Census page. 

    Sources

    1. Australian Institute of Health and Welfare, Chronic conditions and multimorbidity
    2. Australian Institute of Health and Welfare, Older Australians, Culturally and linguistically diverse older people
    3. Australian Institute of Health and Welfare, Australian health inequalities: birthplace

    Methodology

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