Working-age Australians receiving an income support payment died at nine times the rate of those who were not, according to a report the Australian Institute of Health and Welfare published on Thursday.
The analysis links Centrelink payment records to death registrations through the Australian Bureau of Statistics' Person Level Integrated Data Asset, covering deaths between 2012 and 2022 among people aged 22 to 64. It is the first time the AIHW has run the comparison across a full decade at the level of the individual rather than the postcode.
The headline figures are 610 deaths per 100,000 person-years among people receiving one of the selected payments, against 67 per 100,000 person-years among people who were not. Of the 287,000 working-age Australians who died over the period, 167,000, or 58.2 per cent, had received one of those payments in the year they died.
The AIHW states its limit plainly and more than once. The report "does not examine, nor does it provide evidence of a causal relationship between receiving an income support payment and death". What it describes, in the institute's words, is "the close relationship between socioeconomic disadvantage and health outcomes in Australia".
The rate varies sharply by payment. Disability Support Pension recipients died at 1,600 per 100,000 person-years, six times the rate for people on unemployment payments, which sat at 270. Carer Payment recipients were at 230 and parenting payment recipients at 57. The AIHW notes that some DSP deaths involve people granted the payment under manifest grants for terminal illness, describes its figures as the maximum possible proportion on that basis, and says separating those cases is work still to be done.
The direction of travel is the part that will be hardest to explain away. Among recipients, the rate rose from 540 per 100,000 person-years in 2012 to a peak of 570 in 2019, fell 23 per cent in 2020 as the pandemic roughly doubled the number of people on payment, then rose 13 per cent in 2021 and 8 per cent in 2022. Among non-recipients it moved the other way, from 72 in 2012 to 67 in 2022. The gap widened.
For people on unemployment payments the pre-pandemic trend was steeper again. Their death rate rose 48 per cent between 2012 and 2019, from 220 to 325 per 100,000 person-years.
The causes separate the groups as much as the totals do. Among recipients the leading underlying causes were coronary heart disease at 8.1 per cent of deaths, lung cancer at 7.9 per cent and suicide at 6.3 per cent. Recipients accounted for 51 per cent of all working-age deaths from coronary heart disease, 64 per cent of those from lung cancer and 43 per cent of those from suicide.
Deaths from suicide, alcohol and other drugs ran at 105 per 100,000 person-years among recipients against 11 among everyone else. Within that, accidental poisoning was 22 times higher, at 39 against 1.8. Alcoholic liver disease was 21 times higher, at 25 against 1.2. Suicide was five times higher, at 38 against 7.7. Among people aged 22 to 44, the alcoholic liver disease rate was 28 times higher.
Between 2012 and 2019, before the pandemic distorted the caseload, those causes rose 71 per cent among unemployment payment recipients. Accidental poisoning deaths nearly doubled, from 23 to 45 per 100,000 person-years. Alcoholic liver disease deaths rose 125 per cent. Suicide rose 41 per cent. All three fell in 2020 and had started rising again by 2022.
About 2.4 million Australians aged 16 to 64 were on income support as at 28 March 2025, roughly 14 per cent of that age group: 821,000 on JobSeeker, 670,000 on the Disability Support Pension, 387,000 on parenting payments and 256,000 on Carer Payment. Men on payment died at twice the rate of women on payment. Among non-recipients the male to female gap was 1.6 times.
Over the same decade the report covers, the DSP caseload fell from 804,000 people, or 5.4 per cent of the working-age population, in March 2012 to 670,000, or 3.8 per cent, in March 2025, the product of successive tightenings of eligibility. Whether people who left DSP moved onto unemployment payments, where poisoning and suicide deaths were rising fastest, is a question the linked data could answer. This report does not ask it.
The measured gap is also wider than the one national policy is written against. Australia's National Preventive Health Strategy 2021-2030, which the AIHW cites in its introduction, names low-income Australians a priority population and is built around a 5.9-year life expectancy gap between the highest and lowest socioeconomic groups. The AIHW's own July assessment now puts that gap at 7.6 years.
Responsibility for the outcome is split four ways. The Department of Social Services sets payment rates and eligibility, Services Australia administers them, the Department of Health, Disability and Ageing owns the preventive health strategy, and the AIHW measures the result. The institute issued no media release with the report and named no partner or timeline for the follow-up work it says is needed.
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