Health in a 'post-transition' Australia: adding years to life or life to years?

Objective. To explore the likely impact of future trajectories of morbidity and mortality in Australia. Methods. Estimates of mortality and morbidity were obtained from a previous assessment of Australia's health from 1993 to 2003, including projections to 2023. Outcomes of interest were the difference between life expectancy (LE0) and health-adjusted life expectancy (i.e. absolute lost health expectancy (ALHE(0))), ALHE(0) as a proportion of LE0 and the partitioning of changes in ALHE(0) into additive contributions from changes in age-and cause-specific mortality and morbidity. Results. Actual and projected trajectories of mortality and morbidity resulted in an expansion of ALHE(0) of 1.22 years between 1993 and 2023, which was equivalent to a relative expansion of 0.7% in morbidity over the life course. Most (93.8%) of this expansion was accounted for by cardiovascular disease, diabetes and cancer; of these, the only unfavourable trend of any note was increasing morbidity from diabetes. Conclusions. Time spent with morbidity will most likely increase in terms of numbers of years lived and as a proportion of the average life span. This conclusion is based on the expectation that gains in LE0 will continue to exceed gains in ALHE(0), and has important implications for public policy.