Volume 224 - Issue 1

Inequity Is Our Biggest Killer: Looking Upstream to Tackle the Burden of Disease in Australia

Authors:  Saman Khalatbari-Soltani, Edward Jegasothy, Seye Abimbola, Anita van Zwieten

Correspondence: saman.khalatbarisoltani@sydney.edu.au

Med J Aust 2026 || doi: 10.5694/mja2.70119
Published online: 18 December 2025

Abstract

The burden of disease estimates from the Australian Institute of Health and Welfare are influential in driving priorities for actions across research, policy and practice. Following the latest estimates in 2024, much attention focused on top risk factors including obesity, tobacco and diet. Meanwhile, upstream social, economic and political drivers were overlooked. In this perspective, we argue that to effectively move the dial on disease burden, we must shift our focus from downstream action on individual-level risk factors to upstream action on structural causes. Failure to do so represents a missed opportunity to improve population health and tackle health inequity.