Dementia has overtaken coronary heart disease as Australia's leading cause of death, the first change at the top of the national mortality table since the early 20th century, the Australian Institute of Health and Welfare reported on Thursday in its two-yearly stocktake, Australia's health 2026.
Dementia, including Alzheimer's disease, killed 17,550 Australians in 2024, up 39 per cent from 12,641 in 2015, and now accounts for almost one death in ten. Coronary heart disease deaths fell 18 per cent over the same decade, from 19,926 to 16,326. Heart disease still claims more men, at one in ten male deaths, while dementia is the leading cause for women, at one in eight.
The report, the institute's 20th, lands on a system spending more than ever. Health spending reached $270.5 billion in 2023-24, or $10,037 per person and 10.1 per cent of GDP, with hospitals taking $113.8 billion of it. Australians are living longer for that money: life expectancy is 81.1 years for males and 85.1 for females on the 2022-2024 figures.
They are also living sicker. Three in five Australians have at least one chronic condition and 38 per cent have two or more. Two thirds of adults are overweight or obese. Among people aged 16 to 24, the share with a mental disorder rose from 26 per cent in 2007 to 39 per cent in 2020-2022, and 2.8 million people received Medicare-subsidised mental health services in 2024-25.
Patients are carrying more of the bill. Out-of-pocket health costs total $44 billion a year, or $1,634 per person, and have grown 1.4 per cent a year in real terms since 2013-14. The share of people who needed a GP but delayed or skipped the visit because of cost reached 7.7 per cent, nearly double the rate of a decade ago.
On the institute's own numbers, about a third of the disease burden never had to happen. "Around 36 per cent of Australia's total disease burden in 2024 could have been prevented or reduced by addressing risk and environmental factors," AIHW spokesperson Louise Gates said. Separate AIHW expenditure data puts government spending on prevention and public health at $5.4 billion in 2023-24, about $201 per person and 2.9 per cent of government health spending, short of the 5 per cent target in the National Preventive Health Strategy.
Sayan Mitra of the University of Sydney's Charles Perkins Centre put the arithmetic bluntly in comments to SBS. "Australia cannot treat its way out of chronic disease, and acting as though it can will only make the burden larger," he said. "Many chronic diseases begin years before a clinical diagnosis."
The gains are real where the system does invest early: five-year cancer survival has risen from 50 per cent in the late 1980s and early 1990s to 72 per cent, and coronary deaths keep falling. The gaps are just as measurable. Death rates run about 1.5 times higher in the lowest socioeconomic areas than the highest, and First Nations life expectancy sits at 71.9 years for men and 75.6 for women. The institute publishes this stocktake every two years. The 2.9 per cent prevention share is the figure the 2028 edition will test.
