A new snapshot of the nation’s health, released today by the Australian Institute of Health and Welfare (AIHW), reveals that Australians are living longer than in previous decades. However, the average time spent in poor health has also increased since 2003.
Life Expectancy Gains Offset by Health Decline
Australia’s long-term life expectancy growth is hailed as one of the great successes of modern medicine, public health and improved living conditions. But living longer does not necessarily mean living well. The AIHW report shows that while life expectancy has risen, the number of years spent in less than full health has also grown.
A previous AIHW report found that a man born in 2024 could expect to live 71.7 years in “full health”, despite a life expectancy of 81.6 years. A woman born in 2024 could expect to live in full health for an average of 73.8 years, despite an average life expectancy of 85.5 years. This means Australians can expect to live around 87% of their lives in full health.
What Does ‘Full Health’ Mean?
The World Health Organization defines “healthy life expectancy” as the average number of years a person can expect to live in “full health”, after accounting for years lived with disease or injury. This does not mean living without ever becoming sick or needing medication. It is a population measure that combines information about longevity with data on disease, injury and disability.
Like life expectancy, healthy life expectancy is an average and does not predict individual outcomes. Australia experienced a small decline in life expectancy during the COVID-19 pandemic between 2019 and 2022, but more recent AIHW data show life expectancy has since recovered to 81.6 years for men and 85.5 years for women.
Illness Does Not Preclude a Good Life
One misconception is that years lived in “less than full health” are inevitably unhappy or dependent. Many Australians live with chronic conditions while continuing to work, volunteer, travel, exercise and contribute to their communities. The WHO’s healthy ageing framework defines healthy ageing as developing and maintaining the “functional ability” that enables wellbeing in older age, including meeting basic needs, mobility, decision-making, relationships and social participation.
When researchers estimate the global burden of disease, they consider both the prevalence of conditions and their impact on daily life. These conditions range from arthritis, asthma and diabetes to cancer, heart disease, depression, dementia and traumatic brain injury.
Self-Rated Health and Social Connection Matter
Health is more than the absence of disease. Quality of life includes physical health, psychological health, social relationships and environmental factors such as safety, financial resources, access to health care, transport and housing. A review of 27 community studies found that people’s self-rated health predicted death, even after accounting for other factors like income, housing and ethnicity.
Social connection also plays a critical role. A major meta-analysis found that people with stronger social relationships had a lower risk of early death, highlighting that social health is an integral part of overall health.
Health Means Different Things to Different People
For Aboriginal and Torres Strait Islander peoples, social and emotional wellbeing is understood holistically through relationships between individuals, family, kin and community. The AIHW’s Indigenous Health Performance Framework describes social and emotional wellbeing as a foundation for physical and mental health. Many Indigenous organisations emphasise that health extends beyond physical and mental illness to include connection to Country, culture, family and community, aspects not always captured by conventional health measures.
Can We Increase Our Healthy Years?
Yes. Many conditions that reduce healthy years can be prevented, delayed or better managed through behaviours such as not smoking, physical activity, nutritious diet and limiting alcohol. However, health also depends on health care, housing, education, transport, safe neighbourhoods and opportunities for social connection.
Australian health policy increasingly supports people to remain at home in older years, shifting care to family and friends. But the new report indicates support systems are not keeping pace with carers’ needs and expectations. Australia has achieved a major public health milestone by helping people live longer. The next challenge is integrating care and support systems to meet growing demand, helping more people live those extra years with the health, independence, connection and support they need.
