Early during the coronavirus pandemic, some leaders pooh-poohed the idea that the disease was very deadly.
United States President Donald Trump compared COVID-19 with “the common flu”, which kills about 35,000 Americans per year.
“Nothing is shut down, life and the economy go on … Think about that,” he said.
Billionaire entrepreneur Elon Musk told his staff “the coronavirus panic is dumb” and the risk of dying was “vastly less than the risk of death from driving your car home”.
In just three months, and despite lockdowns, the illness had killed about three times as many Americans as would usually die from either influenza or road crashes in an entire year.
Epidemiologists are still learning about COVID-19, but they estimate it is about 15 to 60 times as deadly as the seasonal flu.
In Australia, the disease killed just over 100 people in three months, thanks to an unprecedented effort to contain it.
Who’s dying who shouldn’t be?
As deadly as COVID-19 has been — and acknowledging the immense efforts to lesson its impact — 100 specific ailments and incidents kill more Australians over the same period, on average.
And about half of these causes are classified as “potentially avoidable” — deaths that, with effort, we could substantially reduce, as we did with COVID-19.
So what are they and who is more likely to die in ways that ideally should not happen in a healthy, safe society?
The cause of every death in Australia is recorded, when it can be determined.
The Australian Institute of Health and Welfare then sorts which deaths were potentially avoidable from those which weren’t.
The map above shows the rate of these deaths between 2015 and 2017, weighted for age.
The institute said, according to the data:
- Indigenous Australians were more than three times more likely to die from a “potentially avoidable” cause.
- Men were almost twice as likely to die in these ways than were women.
- The deaths were most concentrated in east Arnhem Land (Northern Territory), and least likely in Manly (in Sydney).
What kills Australians prematurely?
Despite Mr Trump and Mr Musk’s concerns, neither the flu nor cars are among Australia’s top killers.
The leading causes of avoidable death are chronic health conditions that are often linked to poor lifestyle (such as smoking, excessive alcohol use and poor diet):
Not all these deaths are avoidable, but a significant share could have been prevented, whether through early medical intervention, healthier living or a safer, more supportive society.
The top causes change for different age groups.
For example, cars are a major killer of younger Australians (those under 35 years), as is suicide.
Poisoning kills many young adults (25 to 44). Treatable cancers, such as breast cancer, are a greater cause of death among middle-age women.
‘There’s no single fix’: epidemiologist
Few Australians have studied death as much as Rosemary Korda, an associate professor at the Australian National University’s national centre for epidemiology and population health.
She was among the first researchers given access to linked census and death registration data.
One fact about death became clear to her: education levels are an extremely strong predictor of whether someone will die early.
“Education is a marker — there’s nothing magical about it that makes you less likely to die,” she says.
Dr Korda says the education-mortality link holds true across demographic groups and different types of death.
Her past research has suggested that, if there were no education-related inequalities in Australia, the death rate would be 30 per cent lower.
She points to heart disease, a leading cause of avoidable death.
“We’ve done really well in recent years — cardiovascular disease death rates are going down, and some people have asked, ‘Have we reached the limit? How much further can we go?’
Effective solutions, however, are more difficult to isolate than the causes.
“There’s no single fix,” Dr Korda says.
Reducing avoidable deaths among advantaged Australians could involve measures such as tax incentives, more green spaces in cities and better housing, she says.
Yet among some disadvantaged groups, tobacco continues to wreak havoc.
“We know smoking is a huge contributor to heart disease, and we’ve done really well in Australia,” Dr Korda says.
“But there’s still a really huge variation by education level. We need to ask, ‘Should we do more targeting in our campaigns?'”
Ultimately, Dr Korda says the factors that cause the greatest disease burden are the same factors that contribute to inequality.
“So almost by definition, we could avoid many of these deaths by reducing inequality.”