Low death rate, almost no flu but more alcohol-induced deaths in 2021: Australia

The death rate remained low in the second year of the COVID-19 pandemic, according to data released today by the Australian Bureau of Statistics (ABS).

Lauren Moran, Director of Mortality Statistics at the ABS, said, "There were 171,469 deaths registered in 2021 at a rate of 507 deaths per 100,000 people. This was 3.2 per cent higher than 2020 but lower than the 2019 pre-pandemic death rate (522 per 100,000)."

Heart disease was the leading cause of death in 2021, with dementia (including Alzheimer's disease), stroke, lung cancer and chronic lower respiratory diseases making up the top five causes. Heart disease was the leading cause of male deaths while dementia was the leading cause among females.

"Deaths from respiratory diseases remained low in 2021, with the mortality rate of 39.1 deaths per 100,000 people being the second lowest on record. This included just two deaths from influenza. COVID-19 public health measures appeared to supress the transmission of many common respiratory illnesses in 2020, and this continued in 2021," Ms Moran said.

"COVID-19 was the 34th ranked cause in 2021, with 1,122 deaths, most of which were associated with the Delta wave. COVID-19 deaths in 2021 had a younger median age than in 2020 (79.1 compared to 86.9) and a higher tendency to have pre-existing chronic cardiac conditions. In 2020, the most common pre-existing condition among those who died from COVID-19 was dementia (including Alzheimer's disease).

"In 2021, alcohol-induced deaths increased 5.8 per cent compared to 2020 and was the highest rate recorded in the past 10 years. This was driven by an 8.1 per cent increase in deaths among males," Ms Moran said.

The suicide rate was 12.0 per 100,000 people, similar to that recorded in 2020 (12.1 per 100,000 people). Common risk factors included psychosocial stressors, mental health conditions, chronic diseases and substance use disorders.

Comprehensive data and analysis can be found in Causes of Death Australia, available for free download from the ABS website.

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Causes of Death 2021 audio grabs

Transcript +

Transcript

Grab 1.

So today we've released the Causes of Death publication for 2021, and what we've seen is that in the second year of the pandemic, we're still maintaining a low mortality rate, which we saw also in 2020. So, our mortality rate was around 507 deaths for every 100,000 people, and although it looks like it's a bit of an increase from 2020, we actually saw statistically significant decreased mortality in that year. So, the mortality rate in 2021 is still well below that of pre-pandemic rates, and the second lowest on record.

Grab 2.

For the leading causes of death, it's ischaemic heart disease, so that's been our leading cause of death in Australia for a long time now, but dementia is now the second leading cause, and with those, what we've seen over time is that the rate difference is really narrowing. So, 10 years ago it used to be about a 30 percent difference, and we're down to about a 9 percent difference, so dementia is the leading cause for death for females, but ischaemic heart disease is still the leading cause for death for males.

Grab 3.

So, what follows those is cerebrovascular diseases, lung cancer and chronic lower respiratory conditions, and they're things like emphysema and chronic bronchitis. So, for those, quite similar, we've seen a really small increase compared to 2020, but of course, when we compare those to the pre-pandemic rate, we're still seeing very low mortality rates, and part of that is due to the fact that we still have very low rates of circulating respiratory infections such as influenza and pneumonia. So, in 2021, our death rate from respiratory diseases was around 39 for every 100,000 people, that's also the second lowest on record that we've got for respiratory diseases, only 2020 was lower, and we had such big decreases in 2020 because of some of the public health measures in place to stop the spread of COVID (-19). Interestingly though, our deaths from influenza in 2021, only 2 were recorded, that's the lowest we've got on record. It compares to 55 in 2020, and compared to years such as 2017 and 2019, where we had over 1,000 deaths, so record breaking with those flu deaths this year.

Grab 4.

So, we registered 1,122 deaths due to COVID-19 in 2021, so it ended up being the 34th leading cause of death, this compares to the 38th leading cause of death in 2020, and obviously we've seen some big changes in 2022, but for 2021, most of them happened during the delta wave. So, with the Delta wave, what we saw was some really quite interesting differences to wave 1 and wave 2, we had a much lower median age at death. So, it was around 79, whereas in wave 2 in Victoria, it was up around 87, and the difference there is that we had a lot of transmission of COVID through nursing homes in wave 2 in Victoria, where with the Delta wave, a lot more community transmission, we saw deaths in Victoria and New South Wales also recorded a really high number of deaths, and with that change in age profile, what we also saw was a difference in the co-morbidities. So, in wave 1, really equalling that high median age at death and the nursing home cohort, dementia was the most common pre-existing chronic condition, whereas in 2021, chronic cardiac conditions and other things such as diabetes were slightly more prominent.

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