3303.0 - Causes of Death, Australia, 2013 Quality Declaration 
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SUMMARY OF FINDINGS

About Causes of Death Statistics

Causes of death data are a significant and important input to health and social policy formulation and planning as well as health related research and analysis. For example, causes of death data provides insight into the diseases and factors contributing to life expectancy, potentially avoidable deaths, years of life lost and leading causes of death. Causes of death statistics, together with statistics pertaining to births and deaths, make up the ’vital statistics’ component of Australia's civil registration system, providing an important foundation for both population statistics as well as health statistics. Australia, as a member state of the World Health Organization (WHO), supplies data annually to the WHO on deaths by age, sex and cause of death, as compiled from the civil registration system by the Australian Bureau of Statistics.

This publication presents statistics on the number of deaths for reference year by state or territory of usual residence, sex, selected age groups, and causes of death classified to the WHO's International Statistical Classification of Diseases and Health Related Problems (ICD). Introduced in 1999, Version 10 of the ICD has been used to code causes of death data for the reference years 1997 onwards. For further information see Explanatory Notes 22-26.

In Australia, causes of death statistics are recorded as both underlying cause and multiple cause. The underlying cause is the disease or injury which initiated the train of morbid events leading directly to death. Multiple causes are all causes and conditions reported on the death certificate that contributed to, were associated with or were the underlying cause of the death (see Glossary for further details). Multiple causes of death data allow access to a greater range of detail in relation to some causes of death. Analysis of multiple causes of death data complements analyses of underlying cause and offers greater insight into the morbid processes at the end of life.


Deaths

In 2013, there were 147,678 deaths registered in Australia, 580 (0.4%) more than the number registered in 2012 (147,098). The standardised death rate (SDR) decreased to 5.4 deaths per 1,000 standard population in 2013, down from 5.5 in 2012. Standardised death rates are calculated using the 2001 Australian standard population (see Glossary for more information).

In 2013, males accounted for 51.3% (75,782) of registered deaths, a slightly higher proportion than females, who accounted for 48.7% of registered deaths (71,896).

The number of deaths for both males and females has increased compared with 2004 (68,395 and 64,113 respectively), but the increase has been larger for females. In 2004 there were 107 male deaths per 100 females. In 2013 this sex ratio dropped to 105 male deaths per 100 females.

Further details on numbers of deaths registered can be found in Deaths, Australia, 2013 (cat. no. 3302.0).
Leading Causes of Death

Ranking causes of death is a useful method of describing patterns of mortality in a population. The ABS ranks leading causes of death in this publication based on research presented in the Bulletin of the World Health Organization, Volume 84, Number 4, April 2006, 297-304, which provides a standard approach to presenting leading cause data and allows for international comparisons. For further information see Explanatory Notes 34-35.

In 2013, Ischaemic heart disease, defined as ICD-10 codes I20-I25, was the leading underlying cause of death in Australia. Ischaemic heart disease includes angina, blocked arteries (heart) and heart attacks. It was the underlying cause of 13.4% (19,766) of all registered deaths in Australia, accounting for 14.5% (11,016) of all male deaths, and 12.2% (8,750) of all female deaths registered in 2013. Ischaemic heart disease has been the leading cause of death in Australia since 2000, however, the proportion of deaths due to this cause has decreased from 18.5% (24,576) in 2004.

Dementia and Alzheimer's disease (F01, F03, G30) was the second leading cause of death, accounting for 7.4% (10,933) of deaths in 2013, while Cerebrovascular diseases (I60-I69) was the third leading cause, accounting for 7.1% (10,549) of deaths. The fourth leading cause of death was Malignant neoplasm of trachea, bronchus and lung (C33, C34), accounting for 5.6% (8,217) of deaths in 2013, while Chronic lower respiratory diseases (J40-J47) was the fifth leading cause, accounting for 4.8% (7.148) of deaths.

The graph below shows the top 5 leading causes of death for males, females and persons from 2004 to 2013. Further information on leading cause of death for 2013 is presented in the Leading Causes of Death section of this publication.

Graph Image for WHO Leading Causes of Death, Persons, Males and Females, 2004-2013(a)(b)(c)

Footnote(s): (a) Causes of death data for 2013 are preliminary and subject to a revisions process. See Explanatory Notes 52-54 and Technical Notes, Causes of Death Revisions 2006, in Causes of Death, Australia, 2010 (cat. no. 3303.0) and Causes of Death Revisions 2011 and 2012 in this publication.;(b) The causes listed in this graph are the five leading causes of death for males, females and total persons, based on the WHO recommended tabulation of leading causes. See Explanatory Notes 34-35 for further information.;(c) See Explanatory Notes 70-95 for further information on issues for consideration when interpreting time-series and 2013 data.

Source(s): WHO Leading Causes - Persons; WHO Leading Causes - Males; WHO Leading Causes - Females



Underlying Causes of Death

The table below presents summary causes of death data for each major chapter of the ICD-10. Almost one third (29.5%) of all deaths in 2013 were assigned to the Diseases of the circulatory system (I00-I99) chapter, which accounted for 43,603 deaths. Neoplasms (C00-D48) also accounted for almost one third (30.3%) of deaths (44,674).


1.1 DEATHS, BY ICD-10 CHAPTER LEVEL - 2013(a)(b)

Number
Proportion of total deaths
Median Age
Standardised Death Rate(c)
Cause of death and ICD code
no.
%
yrs.
rate

Certain infectious and parasitic diseases (A00-B99)
2 676
1.8
81.9
9.8
Neoplasms (C00-D48)
44 674
30.3
75.5
168.2
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
500
0.3
82.9
1.8
Endocrine, nutritional and metabolic diseases (E00-E90)
6 101
4.1
81.9
22.4
Mental and behavioural disorders (F00-F99)
8 200
5.6
88.3
27.9
Diseases of the nervous system (G00-G99)
7 513
5.1
83.2
27.3
Diseases of the circulatory system (I00-I99)
43 603
29.5
85.5
153.8
Diseases of the respiratory system (J00-J99)
12 465
8.4
83.4
45.1
Diseases of the digestive system (K00-K93)
5 423
3.7
80.5
19.9
Diseases of the skin and subcutaneous tissue (L00-L99)
435
0.3
85.7
1.5
Diseases of the musculoskeletal system and connective tissue (M00-M99)
1 181
0.8
84.9
4.2
Diseases of the genitourinary system (N00-N99)
3 110
2.1
86.0
10.9
Certain conditions originating in the perinatal period (P00-P96)
562
0.4
0.5
2.4
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
620
0.4
14.3
2.5
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
1 460
1.0
78.2
5.5
External causes of morbidity and mortality (V01-Y98)
9 136
6.2
56.4
36.6
All Causes(d)
147 678
100.0
81.7
539.8

(a) Causes of death data for 2013 are preliminary and subject to a revisions process. See Explanatory Notes 52-54 and Technical Notes, Causes of Death Revisions, 2011 and 2012.
(b) See Explanatory Notes 70-95 for further information on specific issues relating to 2013 data.
(c) Standardised Death Rate per 100,000 persons. See Glossary for further information.
(d) Includes deaths due to Diseases of the eye and adnexa (H00-H59), Diseases of the ear and mastoid processes (H60-H95) and Pregnancy, childbirth and the puerperium (O00-O99).


2013 is the first year that the number of deaths due to neoplasms (C00-D48) is higher than the number of deaths due to Diseases of the circulatory system (I00-I99). This change in underlying cause of death by ICD-10 chapter for neoplasms and diseases of the circulatory system can be seen in the graph below.

Graph Image for Neoplasms and Circulatory diseases, Proportions of deaths, 2004-2013(a)

Footnote(s): (a) All causes of death data from 2006 onward are subject to a revisions process - once data for a reference year are 'final', they are no longer revised. Affected data in this table are: 2006-2011 (final), 2012 (revised), 2013 (preliminary). See Explanatory Notes 52-54 and Technical Notes, Causes of Death Revisions, 2006 in Causes of Death, Australia, 2010 (cat. 3303.0) and Causes of Death Revisions, 2011 and 2012 in this publication.

Source(s): Causes of Death, Australia


Multiple Causes of Death

Multiple causes of death include all causes and conditions reported on the death certificate (i.e. both underlying and associated causes; see Glossary for further details). For the 147,678 deaths registered in Australia in 2013, there were 489,425 causes reported giving a mean of 3.3 causes per death. The mean number of causes reported per death varies with age, sex and underlying cause of death. In 17.5% of all deaths, only one cause was reported, while 39.8% of deaths were reported with three or more causes.


Important Notes

The ABS has made a number of changes relevant to the 2013 reference year. A new autocoding system was introduced in conjunction with improvements to coding practices and updates to the ICD-10. This has led to changes in the mortality dataset.

There have also been changes to the coding of perinatal deaths with no underlying cause of death being derived for neonatal deaths in the 2013 dataset. An expanded range of neonatal death data has been made available in the Perinatal deaths datacube to assist data users in the short term while a solution to this issue is sought in the medium term.

Technical Note 1, ABS Implementation of the Iris Software: Understanding Coding and Process Improvements, provides details on both the ICD and coding changes.

Further information on changes to the perinatal dataset can be found in Technical Note 2, Changes to Perinatal Death Coding.

All coroner certified deaths registered after 1 January 2006 are subject to a revisions process. For further information, see Explanatory Notes 52-54 and Technical Notes, Causes of Death Revisions, 2011 and 2012.

For information regarding data quality, see Quality Declaration - Causes of Death Data, Summary, Quality Declaration - Perinatal Data, Summary and Deaths of Aboriginal and Torres Strait Islander Persons.