Multimorbidity is an Australia's health topic

Having a chronic condition becomes more common with increasing age. At the same time, Australia’s ageing population and improvements in medical care mean more people are living for longer with chronic conditions. This increases the likelihood of a person living with multiple chronic conditions, a state of health known as multimorbidity.

People living with multiple chronic conditions often have complex health needs and report poorer overall quality of life than those without multimorbidity. This makes managing multimorbidity an important health concern for all Australians.

This page highlights how common living with multiple conditions is and shows how the chronic conditions that occur together vary by age and sex. The impact of living with multiple conditions is described, as well as how care is co-ordinated for people with multimorbidity.

Estimates of multimorbidity on this page are from AIHW analysis of the Australian Bureau of Statistics (ABS) 2022 National Health Survey (NHS) (ABS 2023a), unless otherwise stated. Estimates are based on analysis of 72 long-term health conditions self-reported to the NHS (Table 1) and will differ from estimates based on different data sources and sets of conditions (see Multimorbidity estimates vary).

How common is multimorbidity?

Multimorbidity is common and becomes more common with increasing age. 

It is estimated that 38% of Australians (9.7 million people) had 2 or more of the selected long-term health conditions in 2022. This ranged from 11% of people aged 0–14 to 79% of people aged 85 and over (Figure 1).

In 2022, multimorbidity was more common among females than males. An estimated 4.6 million males (37%) and 5.0 million females (39%) were living with multimorbidity.

Of the 5 most common long-term health conditions, females had a higher prevalence (see glossary) than males for: 

  • anxiety (22% and 15% respectively)
  • depression (14% and 11%)
  • asthma (12% and 9.4%).

However, females had a lower prevalence than males for:

  • back problems (15% and 16%)
  • deafness and hearing loss (7.4% and 12%).

The higher prevalence for females for some of the most common conditions contributes to the higher multimorbidity among females.

For more information on the prevalence of chronic conditions see Chronic conditions.

Figure 1: Proportion of people with 0, 1 and 2 or more selected long-term health conditions by age, 2022

This figure shows that 72% of people aged 0–14, compared with 5.8% of those aged 85 and over, did not report living with a long-term health condition.

Variation between population groups

Certain groups of people are more likely to experience multiple conditions than others.

Multimorbidity becomes more common with increasing socioeconomic disadvantage (Figure 2). In 2022, the estimated prevalence of multimorbidity was:

  • 31% in the areas of least disadvantage (the highest socioeconomic areas)
  • 44% in areas of most disadvantage (the lowest socioeconomic areas).

By remoteness area, the prevalence of multimorbidity was higher in Inner regional (46%) and Outer regional areas (45%) than in Major cities (35%). For more information on the health of these population groups, see Rural and remote health. 

These differences remained after adjusting for differences in the age structure of the socioeconomic and remoteness area populations.

Figure 2: Proportion of people with 0, 1 and 2 or more selected long-term health conditions by socioeconomic and remoteness areas, 2022

This figure shows 44% of people living in areas of least disadvantage and 37% in areas of most disadvantage did not report living with a long-term health condition.

Patterns of multimorbidity

Chronic conditions can occur together in an individual by chance (because they are common) or because there is an underlying association between them. Associations between conditions may occur where they are commonly diagnosed together, share common risk factors, or where one condition is a risk factor for another.

In 2022, the selected long-term health conditions that most commonly co-occurred varied by age and sex (Figure 3). 

Long-term health conditions more commonly diagnosed in childhood (such as ADHD and autism) feature in multimorbidity at younger age groups while conditions that develop over the life-course (such as back problems, osteoarthritis and deafness or hearing loss) feature more with increasing age.

In 2022, an estimated 1.9 million people (15%) were living with anxiety. Anxiety commonly occurred together with other conditions among people aged under 65. For example, anxiety and depression were estimated to co-occur among:

  • 197,000 males (4.9%) and 323,000 females (8.5%) aged 0–24
  • 311,000 males (8.7%) and 483,000 females (13%) aged 25–44
  • 331,000 males (10.9%) and 367,000 females (11.6%) aged 45–64.

An estimated 2.1 million people (16%) were living with back problems (including sciatica, disc disorders and curvature of the spine) in 2022. Back problems commonly occurred with other conditions among people aged 45–64 and those aged 65 and over. For example, in 2022 an estimated:

  • 169,000 males aged 45–64 (5.6%) and 289,000 males aged 65 and over (15%) were living with back problems and deafness or hearing loss
  • 173,000 females aged 45–64 (5.5%) and 272,000 females aged 65 and over (12%) were living with back problems and osteoarthritis.

Figure 3: Prevalence of the most common pairs of co-occurring conditions by sex and age group, 2022

This figure shows that the co-occurrence of long-term health conditions differs by sex and becomes more common with increasing age.

Impact

Living with multimorbidity can have a substantial impact on an individual’s health, affect their quality of life and have social and economic effects.

In 2022, compared with people with no long-term health conditions of the same age, people aged 18 and over 
with multimorbidity reported experiencing higher levels of:

  • disability, restriction or limitation (41% of people with multimorbidity experienced this compared with 2.0% of people with no long-term health conditions)
  • moderate to very severe bodily pain in the previous 4 weeks (41% compared with 8.2%)
  • fair or poor health (28% compared with 3.2%) (Figure 4).

Based on self-reported data from the 2022 NHS, people with multimorbidity were less likely to be in the labour force (working or seeking work) than people with no chronic conditions.

In 2022, the proportion of people aged 18–64 who were working or seeking work was:

  • 77% for those with multimorbidity
  • 87% for those with no chronic conditions.

These differences remained statistically significant after adjusting for differences in the age structure of the populations being compared.

Figure 4: Impact of long-term health conditions, people aged 18 and over, 2022

This figure shows that among people aged 18 and over, the proportion who reported good or excellent health became less common with the increasing number of long-term health conditions.

Treatment and management

People living with multimorbidity have more frequent and longer medical appointments and more medications to manage than those without multimorbidity (RACGP 2023). This increases the complexity of patient care and can require ongoing management and co-ordination of care across multiple parts of the health system.

Co-ordinated care for people with chronic and complex health conditions and multimorbidity is supported by:

  • Medicare-subsidised chronic disease management services – in 2022–23, 16% of the Australian population
    (4.1 million people) accessed multidisciplinary care (see glossary) through a general practitioner (GP) chronic disease management plan (AIHW 2024).
  • medication reviews (see glossary) for people taking 5 or more medications – there were 152,000 medication review services provided in 2022–23 (Services Australia 2023).
  • the MyMedicare voluntary patient registration model that gives patients access to greater continuity of care by providing additional funding to their nominated regular care team to manage their care – as at 10 April 2024 there were over 1.0 million patients (3.9% of all patients) and 5,800 practices (91% of all practices) registered with MyMedicare (Department of Health and Aged Care, personal communication, 17 April 2024).

Multimorbidity estimates vary

Estimates of multimorbidity vary depending on the number and type of conditions included in analysis, as well as the source of data used.

Using self-reported NHS data, the ABS estimated that 22% of Australians (5.6 million people) had 2 or more of 10 selected chronic conditions in 2022 (ABS 2023b).

A more detailed list of conditions is used in analysis for this report that includes all chronic conditions from the Australian Burden of Disease study (AIHW 2021) that can be reasonably identified in the NHS data (72 conditions). This detailed list captures mental health conditions such as depression, anxiety and drug and alcohol problems individually so that an individual with more than one of these long-term health conditions is counted as having multimorbidity. It also includes conditions commonly diagnosed among younger people, such as attention deficit hyperactivity disorder (ADHD) and migraine to better describe multimorbidity across all ages.

Conditions are self-reported to the NHS and may differ from estimates based on different data sources and sets of conditions. The scope of the NHS will also affect estimates of multimorbidity compared with estimates from other sources. For instance, the NHS captures information on residents living in private dwellings, excluding those in residential aged care facilities, hospitals or prisons. This may exclude people likely to experience long-term health conditions or multimorbidity and lead to the underestimation of certain conditions, such as dementia. The NHS does not capture people living in very remote parts of Australia and discrete Aboriginal and Torres Strait Islander Communities. 

For more information see the National Health Survey methodology.

 

Where do I go for more information?

For further information on chronic conditions and multimorbidity see:

For more on this topic, visit the Australian Centre for Monitoring Population Health.