Widening inequalities in premature mortality in Australia, 2006-16

Background Increases in Australia’s life expectancy have slowed since 2003. Within this context, it is important to analyse whether socio-economic and geographic inequalities in premature mortality have changed in recent years. Aim The aim is to measure the extent of and change in inequalities in premature mortality (under 75 years) by area socio-economic status and remoteness in Australia from 2006-16. Data and methods This study uses Australian death registration data from 2006-16. We identify area socio-economic quintile (Q1 lowest to Q5 highest) and remoteness (major cities, inner regional, outer regional/ remote/very remote) for each decedent. Age-standardised death rates (ASDR) at ages 35-74 and 0-34 years are calculated and smoothed over time. Results ASDR decline at ages 35-74 years has slowed markedly, and from 2011-16 Q1 ASDRs stagnated. The Q1:Q5 ASDR ratio for females rose from 2011-16 for males (1.97 to 2.11) and females (1.78 to 1.98), and also widened in the Q2:Q5 and Q3:Q5 comparisons for females. ASDRs outside major cities stagnated from 2011-16 and inequalities compared with major cities widened to be 40% higher in 2016. ASDR declines at 0-34 years were quicker than for 35-74 years and inequalities widened slightly. Conclusions Slowing declines in premature mortality in Australia are accompanied by substantial and widening socioeconomic and geographic inequalities. Without reductions in mortality in lower socio-economic groups and outside capital cities, future life expectancy growth in Australia will likely be hampered.