Preventing chronic disease to close the gap in life expectancy for Indigenous Australians.

Prevention of disease is a major aim of the Australian health system. Chronic diseasesare responsible for approximately 80% of the burden of disease and injury in Australia,account for around 70% of total health expenditure, form part of 50% of GP consultations, and are associated with more than 500 000 person/years of lost full-time employment each year [1]. A small number of modifiable risk factors are responsible for the major share of the burden of preventable chronic disease. This chapter focuses on chronickidney disease as an example of a preventable chronic disease that impacts heavily on theindigenous community, causing major morbidity and mortality. Key modifiable risk factorsfor chronic kidney disease include tobacco smoking, physical inactivity, poor nutrition,obesity and high blood pressure. Amongst Indigenous Australians, poor access to necessary preventative care, combined with the broader social determinants of health, acting across the life-course, contribute to the excess burden of chronic disease, including diabetesand chronic kidney disease. Improvements in maternal and early childhood health anddevelopment, educational attainment outcomes and access to safe and secure housing arecritical ‘building blocks’ in national efforts to reduce the burden of chronic disease and toclose the gap between the health status of Indigenous and non-indigenous Australians.