Last partial update: September 2019 - Please read disclaimer before proceeding
15 to 44: The 'defining' age group
This is a very broad age group, extending from the very onset of adult life to the age when many people have well established working and emotional lives and have, in many cases, established their own families.
It is a very important period because during this phase of their lives people are:
- making important educational decisions
- deciding on and establishing careers
- entering into the world of close intimate relationships
- selecting life-long (hopefully) partners
- establishing and bringing up the next generation.
- and, in the case of older members of this group, entering positions of responsibility that help determine the path Australia is to take, including in the area of health-care.
At 'first sight', the broad nature of this grouping might appear a little perplexing and it is not unreasonable to ask what a 17 year old has in common with a 42 year old. However, the illnesses that affect this broad range of ages are fairly similar and are primarily related to mental health issues; primarily, anxiety and depression, suicide, schizophrenia, and alcohol and illicit substance abuse.
Looking at this age group with regard to health, there are two important general points that need to be mentioned.
A. Attitudes to personal health
Firstly, it is fair to say that many people in this age grouping feel well most of the time and most would consider that they are in good health. Unfortunately, this not unreasonable attitude is responsible for the two main problems associated with looking after this age group medically, which are as follows
- People in this age group are probably the least likely group to seek help when a medical problem arises. This is especially the case with men and with mental health issues.
- People in this age group are less likely to initiate healthy lifestyle practices to help prevent future illness.
Two other factors contribute to these problems. Firstly, most serious disease, especially cancer and heart disease, seems a very long way off; and secondly, most young people have too much on their plate already (see above) and often have insufficient time to adequately attend to health and illness issues.
B. Care of children
People who choose to become parents need to embrace a comprehensive approach to bringing up healthy children. There are several factors involved in this process.
- Education about child health. There are many health issues associated with bringing up children and it is unlikely that these were learned adequately during the parent's own childhood. Parents therefore need to learn about child health throughout the different stages of their children's lives, beginning before pregnancy occurs. (This web site includes a comprehensive section on Preparation for pregnancy.)
- Setting a good example by living a healthy lifestyle. Children copy what parents do rather than do what parents say / request. Practicing good thinking / problem solving skills (see section on Achieving lifestyle change), and maintaining a healthy lifestyle make the task of bringing up healthy children much easier. It is worth noting here that the task of changing long entreched 'less than perfect' behaviours is very difficult and should be tackled as soon as possible. Leaving making changes until children come along might be leaving it too late as stresses in life tend to increase when children arrive, making achieving change more difficult. (And these stresses stay until children leave, and beyond).
- Change modifiable parental factors that directly harm children: Some parental practices and illnesses can directly affect the health of children. An obvious example of such a factor is smoking in the home but there are less obvious ones too. For example, it is well recognised that parents who suffer from depression, especially if untreated, are more likely to have children who also suffer from this disease. It is less well known that treating the parent's depression and making the child aware of the issue by discussing the parent's illness openly can significantly reduce the child's risk. (See section on Preventing anxiety and depresion in children.)
Leading causes of burden of disease in Australians according to age (2015) |
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| Males | % of total disease burden | Females | % of total disease burden |
| Under 5 year age group | Under 5 year age group | ||
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| 5 to 14 year age group | 5 to 14 year age group | ||
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| 15 to 24 year age group | 15 to 24 year age group | ||
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| 25 to 44 year age group | 25 to 44 year age group | ||
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| 45 to 54 year age group | 45 to 54 year age group | ||
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| 55 to 64 year age group | 55 to 64 year age group | ||
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| 65 to 74 year age group | 65 to 74 year age group | ||
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| 75 to 84 year age group | 75 to 84 year age group | ||
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| Over 84 year age group | Over 84 year age group | ||
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Source: Adapted from Australian Institiute of Health and Welfare Burden of Disease Study 2015
Mental illness (including alcohol / illicit substance use) - The main health issue in people aged 15 to 45
From the above table it is fairly obvious that mental health issues are the by far the greatest health issue for young adult Australians. And the figures are even worse if one considers Australians in the 15 to 25 year age group. The following extracts are from an article written by noted psychiatrist and recent Australian of the Year, Professor Patrick McGorry.
'Mental ill-health is by far the key health issue facing young Australians today. While the physical health of young people has improved in recent decades, it is a worrying paradox that their mental health seems to have worsened. Mental health and substance use disorders now account for over 50% of the burden of disease in the 15 to 25 year age group and 75% of mental health disorders that will affect people across the lifespan will have emerged for the first time by age 25 years....
Mental Ill-health is all too often accepted as a ‘normal’ feature of adolescence – a form of emotional growing pains. Somehow we have come to regard it as acceptable for young people to be distressed and struggling for significant periods without recognising their need for understanding and effective support and care. Mental ill-health is not a trivial or transient threat. There are many negative short term and long term consequences. These include:
- Impaired social functioning
- Poor educational achievement
- Unemployment
- Substance abuse
- Self-harm
- Suicide
- Violence
These consequences lead to a cycle of dysfunction and disadvantage that is hard to break. There is good evidence to suggest that mental ill-health in young people produces distress and disability that extends many years into their future. However, they are reluctant to seek help, particularly for their emotional concerns.'
McGorry P and Goldstone S. Is this normal? Assessing mental health in young people. Australian Family Physician. Volume 40: No 3 March 2011, pp 94-97.
It is vital that young people do not ignore the signs of mental illness, including illness associated with alcohol and illicit substance use. Such illness affects not only the suffers but those around them and those in their care, especially children of affected parents. Please see your doctor or other appropriate health professional if mental illness is affecting you or someone you know / love. (This web site has a large amount of information about these topics and provides links to many helpful mental health sites, such as the Beyond Blue site which is dedicated to helping people with depression.)
Other preventive health issues
- Important lifestyle issues: Smoking, diet and physical activity: These are dealt with in detail in this web site and are briefly discussed later in this section.
- Osteoporosis prevention and diagnosis / treatment: Osteoporosis is very common, especially women, and is often undiagnosed and under treatedand keeping bones healthy needs to be a lifetime project.
- Immunisations Immunisations are important in all age groups.
- Hearing impairment: Hearing is a precious sense that needs to be protected. Unfortunately it is something that we take for granted and a huge number of people, especially men, suffer from hearing impairment due to excessive noise exposure throughout their lives. Hearing loss is the seventh most common cause of illness overall in men, ahead of well-recognised illnesses such as prostate cancer, colon cancer and road traffic accidents. I can not count the number of times I have driven past men mowing lawns without any hearing (or sight!!) protection. Not being able to hear music or loved ones properly is a huge burden to bear later in life. Please read the section on hearing loss!
- Illness associated with medical treatment Health workers are not perfect and occasionally mistakes happen and all treatments are associated with side effects and / or complications. The health system is doing its best to reduce these events but it is important that people are aware of what they can do to reduce unnecessary suffering due to medical treatment.
- Genetic predisposition to disease: It is iomportant to talk to GP about your famiy history of illness. This is usually done at the initial consulation. If you missed out, then you should bring it up at a convenient time in the near future. An important time to consider genetic diseases is when starting a family. This topic (jcluding preventing Down Syndrome) is dealt with in detail in the section on Preparation for Pregnancy. Many diseases can be inherited to some extent. Important ones include:
- Cancers: Breast, bowel, prostate and ovarian cancers and melanoma are particularly important
- Diabetes
- Heart disease
- Bleeding disorders
- High blood cholesterol levels
- Haemochromatosis
The rest of this section contains some general informationa about the Australian incidence of illness that can be at least partially prevented.
Preventable disease in Australia
The duration of people’s lives and the degree of disability, both mental and physical, that they endure are very important factors in determining their achievements and their level of happiness. Fortunately Australians have access to a high standard of public health and one of the world’s best health systems and it is thus not surprising that most of us enjoy a long and healthy life. Life expectancies are continuing to increase and people born in 2016 have one of the longest life expectancies in the Western world, being 80.4 years for men and 84.6 years for women. (This has risen from 51 for men and 57 for women at the beginning of Federation; 1901.) For those aged 65 years in 20, the life expectancy was 19.6 years for men and 22.3 years for women.
Unfortunately, some of this long life will be spent with some form of disability and, unlike longevity, the level of disability is not currently diminishing. (Over the 15 years from 1988 to 2003, the increase in life expectancy that occurred was accompanied by a similar increase in the number of years spent with disability and severe disability.) On average in 2011, women spend 9.9 years of their lives with some form of significant disability/ ill health. For men, the figure is 9.0 years. People aged 65 years can expect suffer some form of disability in about 55 per cent of their remaining years and spend about 20 per cent of their remaining years with a severe disability.
Our long lifespan with many years spent free of disability is probably adequate for most of us to achieve that which we need to / want to in our lives. However, many do not share in this ‘wealth of health’; they die prematurely or suffer unnecessary disability due to diseases that can often be prevented by living a healthy lifestyle. In 2000, 27 per cent of males and 16 per cent of females died before the age of 65.
The aim of this book is to provide the information needed to maximize people’s chance of avoiding preventable illness and thus provide the best chance of achieving a long stay on this mortal coil and staying well while enjoying it.
While this book provides much information that can be used by the individual, it was written with the partnership between general practitioner (GP) and patient in mind, as many aspects of illness prevention require the assistance of a supportive GP. Together, patient and doctor should be able to identify and coordinate the preventative measures required to minimise medical problems. Through regular GP visits, a management plan can be monitored and modified as necessary to address any changing circumstances. All this is very difficult to achieve alone.
Approaching illness prevention - Modifying risk factors and achieving change
Achieving change
Most people know many of the issues that they need to address but choose not to do so or do so in a haphazard, unhelpful manner. Continually assessing life, deciding on priorities, setting goals to achieve these priorities and planning how to achieve goals is fundamental to living well. Failure to set aside enough time to do these things (or failure to do them at all) is the major reason for living poorly. This topic is fundamental to good health and is dealt with in detail in the section on entitled Achieving change. Make sure you read it.
Illness and modifiable risk factors
Burden of disease values have also been calculated for modifiable illness risk factors and it was estimated in 2015 that adopting poor lifestyle health options was responsible for 36% of all burden of disease. (The figure is slightly greater for men and slightly smaller for women.) This is a huge amount. The graph below provides a breakdown of which modifiable risk factors are most responsible for disease burden in both males and females. (Note that the total of all the risk factor burden mentioned in the graph is greater than 36% as some are mentioned twice and there is some overlap as some risk factors act on other risk factors (e.g. physicalactivity acting on obesity)).
Together, these modifiable risk factors are responsible for about;
- 33% of burden of disease due to cancers,
- 85% of the burden of disease due to ischaemic heart disease (heart attacks),
- 27% of the burden of disease due to anxiety and depression,
- 32% of the burden of disease due to injury and
- 60% of the burden of disease due to type 2 diabetes.
Not all of this illness is preventable as these risk factors cannot be completely eliminated. However, by modifying these risk factors people can significantly reduce both premature death and the length of time that they are likely to suffer from disability. Most significant disability occurs in the final twelve years of life and it is estimated that living a healthy life can reduce this period by almost half. Sounds good!
Source: Adapted from Australian Institute of Health and Welfare, 2015
Illness rates through life
As one might expect, disease rates increase throughout adult life; although interestingly you are still at less risk now than when you were in the womb / first year of life. (See graph below.) While the burden of disease per 1000 people continues to increase after the 65 to 69 year age group, the total burden of disease starts to decrease because there are fewer people living.
18 preventative health questions young adults need to address
- Do you have a family GP that you see regularly for check ups? When is your next check up due?
- Are your vaccinations up to date?
- Have you talked with your GP about cancer screening strategies that are appropriate for you, particuarly with regard to bowel cancer, breast cance , skin cancer and cervical cancer? Some prople are at higher risk for these diseases and need to start screening early on?
- Does your GP inspect your body for skin cancers at your regular check ups?
- Does your GP check your urine at your regular check ups?
- Do you know if you are a healthy weight? If you are overweight, have you sought advice regarding weight reduction?
- Do you eat well?
- Do you partake in adequate physical activity?
- Do you have a healthy blood pressure level? (The target level varies according to overall risk factors for heart disease.) Has it been tested within the last two years?
- Are you aware of the symptoms of depression? Is there someone you feel might be depressed for whom you should seek help; yourself, a relative or a friend?
- Are you or is a member of your family being adversely affected by alcohol consumption? Do you consume alcohol at safe levels and have at least two alcohol free days each week? Do you pass the AUDIT alcohol test?
- If you smoke or take illegal drugs, have you looked into stopping them? If you smoke, have you had your lung function checked? Smoking is probably already affecting your breathing ability, making you short of breath, and greatly increases your risk of heart attack and lung cancer.
- Do you spend time each day thinking about issues relating to improving relationships with family and friends? Do you suffer abuse in your relationship? If so, you need to tell your GP. (See Relationships section)
- Do you have a family medical history that may increase your risk of any disease, especially cancer, heart disease, diabetes, cystic fibrosis, thalassaemia or haemochromatosis? If so, have you discussed this with your GP.
- If you are female and have had sexual intercourse, do you have regular Pap smears?
- Have you assessed your work and hobbies with regard to any specific health risks they may pose?
- Do you take precautions to protect your hearing when exposed to high noise levels? Hearing loss is the seventh most important cause of illness in men and the eleventh in women.
- Do you spend time planning your future activities?
What important illnesses are commonly overlooked in Australia?
- Depression - About 50% remain undiagnosed.
- Diabetes - 50% of cases remain undiagnosed.
- High blood pressure - 50% remain undiagnosed and 25% of those who receive treatment are under-treated
- Heart failure - About 50% remain undiagnosed
- Chronic kidney failure - About 50% remain undiagnosed.
- Osteoporosis - Many people with osteoporosis are unaware they have the condition. (This includes a large number of people with spinal fractures that often occur with minimal symptoms.)
- Hearing loss - Most are undiagnosed.
- Obesity and physical activity - Many people are unaware that they are overweight / do not do sufficient physical activity.
All these illnesses are covered in this web site.
Burden of disease
The table below shows the 20 leading causes of death and disability (or burden of disease) in Australia, most of which are significantly preventable. The figures used in this book to grade the death and disability caused by each illness are derived from information gathered and interpreted by the Australian Institute of Health and Welfare (AIHW). When assessing the importance of an illness, the AIHW does not just to look at its incidence. It also measures carefully the extent to which the illness causes premature death and the length and degree of disability the illness causes. Diseases that on average occur earlier in life, and thus cause earlier deaths or lengthier periods of disability, are given a higher rating. Both the disability and death caused by the particular illness are given a value in terms of years of healthy life lost, and, when added together, give an overall ‘burden of disease’ rating for the illness; expressed as ‘disability-adjusted life years or DALYs. The use of DALYs allows a comparison of the harm caused by all illnesses, whether they cause predominantly death or disability.
At present (2019) about 360 illnesses and 80 risk factors for illness are assessed in this manner. To ensure this colpex task is done accurately requires a staff of hundreds of people and a huge amount of time. Thus, assessments are only at infrequent intervals and usually are released several years after the information is gathered. (This can mean that it looks a bit out of date but medicine really changes slowly and being accurate is of paramount importance as National health policy (and funding) is determined by this data.
In 2015, the burden of disease was equally distributed between years of life lost due to death and years of life lost due to disability.
What are the most common causes of illness in Australia?
The leading causes of burden of disease in Australia (2015) |
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Cause - Males |
% of total burden of disease |
Cause - Females |
% of total burden of disease |
Coronary artery disease (heart attacks) |
8.6 |
Coronary artery disease |
5.0 |
*The figure for alcohol combines the harmful effects, which mainly occur in younger people, with the beneficial cardiovascular effects which occur mostly in older people. |
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