Every two years, the Australian Institute of Health and Welfare (AIHW) issues a statistics-packed document billed as the nation’s report card on health.
Releasing Australia’s health 2026 this week, the AIHW said it “charts our nation’s progress while also informing priorities for future improvement”.
However, in some areas, the report raises more questions than it answers.
Its lack of in-depth engagement with critical determinants of health, ranging from the climate crisis to institutionalised poverty and wider political and social trends, ensures a narrower focus than might be useful for supporting cross-portfolio action for health.
It is passing strange to read a health report card that doesn’t explicitly address the wide-ranging health impacts of the climate crisis, especially at a time when thousands of people are dying from extreme heat in the Northern Hemisphere.
Likewise, it reports on declining immunisation rates but does not discuss issues such as misinformation and disinformation, or global trends that are undermining public health.
Perhaps for future editions it would be helpful to have a range of experts and community members providing commentary and context around some of the data and graphics put forward. Or perhaps this might be too much like a political hot potato.
The report underscores well known inequalities, including around access to dental care, for those living in rural and remote areas, and for people with complex health and social needs, including people who are homeless or using drug and alcohol treatment services.
It also draws attention to Australia’s policy failures in prevention, with modifiable risk factors, such as tobacco use, overweight, physical inactivity, alcohol use and unhealthy diet, together accounting for 36 percent of Australia’s total disease burden.
Commenting on the report in The Conversation, public health expert Professor Kathryn Backholer said: “Urgent action is needed to create healthier environments that make it easier for Australians to choose healthy foods and stay physically active.”
Perhaps some future version of the report card will address the impact of fossil fuels, inadequate income support, excessive corporate power, regulatory failure, and structural racism as “modifiable risk factors”.
Below are some takeaways under the themes: key areas of interest; questions and concerns; good news, with caveats; and gaps.
Key areas of interest
The report says the AIHW is working in partnership with a First Nations Expert Committee on Health System Metrics to assess the effectiveness of health system reforms for First Nations people under the National Health Reform Agreement 2026–2031.
“Work is underway to review and develop health system measures, with a focus on indicators relating to access, health outcomes, cultural safety and racism, social and emotional wellbeing, and equity across the health system for First Nations people. A data dashboard will be developed to track progress against agreed metrics.”
The report makes clear the need for greater investment and attention to primary care reform.
It highlights the importance of primary care in managing chronic diseases. Around three in five Australians and most Australians aged 85 and over (94%) are living with one or more chronic conditions, including physical, neurodevelopmental and mental health conditions.
Yet the gap between expenditure on hospital services and primary health care (including public health) as a share of total health spending continues to widen.
In 2023–24, hospital care accounted for the largest share of total health spending ($113.8 billion, or 42 percent), while primary healthcare (including public health) accounted for $89.1 billion, or 33 percent.
“Access to primary care can be difficult for some people with chronic conditions, particularly when timely appointments with a regular GP are not available or a long way from home,” says the report.
“While GPs often play a central role in assessment, care coordination and ongoing management, some aspects of care require access to other health professionals, services or timely referrals, which may not always be readily available.
“Cost is also a substantial barrier to care. People with one or more chronic conditions are more likely to delay or forgo needed health services due to cost than those without a long-term health condition (9.2% compared with 5.5%), highlighting ongoing affordability pressures.”
The report says that nationally consistent primary healthcare data is a known information gap, “limiting our understanding of how chronic conditions are managed and the outcomes for patients”.
“General practice and other community based primary care services account for the majority of healthcare encounters in Australia, yet historically have not been included in comprehensive, nationally consistent data sets,” says the report.
“This has limited our ability to understand patterns of access, quality, outcomes, and unmet needs outside hospital settings.
“Better chronic condition data help decision-makers invest in prevention, funding and delivery of care and support services that meet people’s needs.”
The AIHW is working towards a National Primary Health Care Data Collection.
Questions and concerns
The report says there has been a large increase in young people experiencing a mental disorder. Around one in five (22%) Australians aged 16–85 experienced a mental health condition (such as anxiety or depression) in the previous 12 months during 2020–2022.
The environment for young people has likely only become more complex and challenging since that time.
While the report brings encouraging news about increasing five-year survival rates for cancer, it highlights concerns about increasing diagnoses in younger people.
Between 2000 and 2025, cancer diagnoses among people in their 30s and 40s increased from 121 to an estimated 135 cases per 100,000 for people in their 30s; and from 280 to an estimated 313 cases per 100,000 for people in their 40s.
However, cancer survival has improved and cancer death rates have generally declined in these age groups.
In response to increasing rates of early onset cancer, Cancer Australia has commissioned a review to identify risk factors, research gaps and inform interventions, alongside updating general practitioner guidance to support earlier diagnosis of people with signs and symptoms of cancer. Early onset cancer is also a strategic research priority under the Cancer Australia Research Initiative.
In discussing the increasing prevalence of obesity and overweight, the report araises questions about weight-loss medicines, such as glucagon-like peptide-1 (GLP-1) receptor agonists like semaglutide (for example, Ozempic), whose use has increased rapidly.
“Evidence suggests these medications are only effective during treatment, with discontinuation commonly leading to weight regain and recurrence of weight-related comorbidities and more evidence is needed on long-term safety, effectiveness and side effects,” says the report.
Dementia overtook coronary heart disease as Australia’s leading cause of death in 2024. This marked the first change in Australia’s leading cause of death since the early 20th century, reflecting a major change in the pattern of illness and death as Australians live longer.
However, patterns vary by remoteness; dementia was the leading cause of death in major cities and inner regional areas, while coronary heart disease remained the leading cause in outer regional, remote and very remote areas.
The AIHW is working with the University of Queensland to develop new methods for estimating the number of people living with dementia using linked Census, hospital and aged care data.
The AIHW is also working to produce a more accurate estimate of prevalence and the indirect costs of migraine, which is the most common neurological condition in Australia and disproportionately affects women and people of working age.
Good news, with caveats
The report brings encouraging news on First Nations health, while also acknowledging ongoing inequalities.
The burden of disease among First Nations people decreased by 6.3 percent between 2011 and 2022 (from 455 to 430 disability-adjusted life years per 1,000 people, after adjusting for age). This was driven by declines in premature deaths from cardiovascular diseases, while deaths from diabetes also fell.
Long-term ear or hearing problems among First Nations children also fell, and some determinants of health improved, including education and income.
“Recent improvements in population health outcomes for First Nations people reflect progress across key social determinants of health, alongside the expansion of culturally safe, First Nations-led care,” says the report.
In other good news, targeted government initiatives have led to substantial reductions in younger people in permanent residential aged care.
Between 30 September 2018 and 31 December 2025, the number of younger people living in permanent residential aged care:
- decreased by 86%, from 5,513 to 776 people (excluding First Nations people aged 50–64)
- decreased by 44% for First Nations people aged 50–64, from 361 to 203 .
However, the report says: “Nationally, there is limited understanding of how well younger people do after leaving permanent residential aged care, including whether their community living is stable and if services are sufficient.
“Linked-data analyses showed that historically many younger individuals did not move into age-appropriate accommodation. This underscores the need for outcome-focused monitoring of younger people with disability in Australia.”
Meanwhile, international comparisons on Australians’ health are mixed: some good news, and some not-so-good news.
Gaps
The report highlights a number of data gaps. For First Nations people, these include:
- uncertainty around the size and composition of the First Nations population
- a need for more accurate identification of First Nations people in data collections to improve the quality of all key health measures, including mortality and morbidity
- a lack of data reflecting key health issues for First Nations people, such as access to culturally safe health services and experience of family violence.
As Australia’s data infrastructure becomes more interconnected, the report says that aligning data development efforts with First Nations data governance principles is critical to ensure that whole-of-system view of performance is both analytically robust and socially legitimate.
“Doing so supports better policy decisions, clearer accountability, and progress toward more equitable health outcomes for First Nations people,” says the report.
It also highlights gaps in mental health data, including for psychosocial support services outside of the NDIS, mental health services contracted by Primary Health Networks, other NGO services, mental health services delivered in educational settings and services covered under private health insurance.
A significant gap identified in the report is the level of support and services available to carers.
As Australians are living longer with chronic conditions, disability and age-related care needs – and as policy increasingly supports people to remain at home – family members and friends are taking on a growing share of care through informal, unpaid roles.
In 2022, around three million Australians provided informal care, including 1.2 million primary carers.
Unpaid carers experience poorer health and wellbeing than the general adult population. “Without better-coordinated and more responsive formal support, pressures on unpaid carers may intensify,” says the report.
Further reading
- The Conversation: Mental illness is up in young people, dementia is now the biggest killer: Australia’s health in 2026
- The Conversation: Australians live longer than previous decades but spend more years in poorer health
See Croakey’s archive of articles on primary healthcare
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