Living longer with a greater health burden – changes in the burden of disease and injury in the Northern Territory Indigenous population between 1994–1998 and 1999–2003

摘要

Objective: To measure changes over time in the burden of disease for Northern Territory (NT) Indigenous and non-Indigenous population.Methods: The numbers, and crude and age-adjusted rates of disability adjusted life years (DALY) were calculated for periods 1994–1998 and 1999–2003. A measure of information bias was developed to adjust for the tendency of years lost to disability (a component of DALY) to increase over time because of increasing data availability. The jackknife method was used for DALY uncertainty assessment.Results: The all-cause DALY rate was stable for the non-Indigenous population, but increased for the Indigenous population. For both populations, the burden of premature death decreased while the burden of disability increased. For the Indigenous population, there were substantial increases in DALY rates for type 2 diabetes, depression, nephritisephrosis, suicide and sense organ disorders.Conclusions: The burden of disease for Indigenous people increased over the study periods, with improvement in the burden of fatal outcomes more than offset by substantial increase in the prevalence and severity of non-fatal conditions.Implications: The paradoxical shift of living longer with a greater health burden has not been previously reported for Indigenous Australians, and highlights the critical importance of prevention for sustaining life expectancy improvement and managing escalation of health costs. This study also demonstrated the usefulness of the DALY to monitor population health.