Trends in socioeconomic inequalities in mortality from ischaemic heart disease and stroke in Australia, 1979-2006

Page, Andrew, Lane, Amanda, Taylor, Richard and Dobson, Annette (2012) Trends in socioeconomic inequalities in mortality from ischaemic heart disease and stroke in Australia, 1979-2006. European Journal of Cardiovascular Prevention and Rehabilitation, 19 6: 1281-1289. doi:10.1177/1741826711427505

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Author Page, Andrew
Lane, Amanda
Taylor, Richard
Dobson, Annette
Title Trends in socioeconomic inequalities in mortality from ischaemic heart disease and stroke in Australia, 1979-2006
Journal name European Journal of Cardiovascular Prevention and Rehabilitation   Check publisher's open access policy
ISSN 1350-6277
1741-8267
1741-8275
Publication date 2012-12-01
Year available 2011
Sub-type Article (original research)
DOI 10.1177/1741826711427505
Open Access Status DOI
Volume 19
Issue 6
Start page 1281
End page 1289
Total pages 9
Place of publication London, U.K.
Publisher Sage Publications
Language eng
Subject 2713 Epidemiology
2705 Cardiology and Cardiovascular Medicine
Abstract Background: This study investigates secular trends in ischaemic heart disease (IHD) and stroke mortality by socioeconomic status (SES) in Australia to determine if absolute and relative differences between low and high SES areas have changed over time. Methods: IHD and stroke mortality data for adults aged 35-74 years and corresponding population data from Australian censuses for 1979-2006 were stratified into quintiles using an area-based measure of SES and analysed by quinquennia (and 2004-06). IHD and stroke (rates per 100,000) adjusted for age, country of birth, and rurality were compared across SES strata (separately by sex) using Poisson regression.Results: Mortality declined monotonically over the study period in all SES groups and both sexes. Absolute differences between low and high SES groups narrowed for IHD in females (27 to 23 per 100,000) and stroke in males and females (16 to 13, and 13 to 7 per 100,000, respectively), although absolute differences widened for IHD in males (52 to 63 per 100,000). Relative declines were greater in high compared to low SES groups for IHD (28% average quinquennial decline in high SES; compared with 21% in low SES for males; 30% and 21% for females), and for stroke (25% average quinquennial decline in high SES; 21% in low SES for males; 26% and 23% for females). Conclusion: Differences in mortality rates between lower and higher SES groups narrowed for both IHD (in females) and stroke (in males and females) from 1979-2006, indicating that the epidemic decline is now at a late stage when low SES groups are benefiting more, in absolute terms, than high SES groups. However males in the lower SES groups are still at an earlier stage of the epidemic decline in IHD mortality.
Formatted abstract
Background: This study investigates secular trends in ischaemic heart disease (IHD) and stroke mortality by socioeconomic status (SES) in Australia to determine if absolute and relative differences between low and high SES areas have changed over time.

Methods: IHD and stroke mortality data for adults aged 35–74 years and corresponding population data from Australian censuses for 1979–2006 were stratified into quintiles using an area-based measure of SES and analysed by quinquennia (and 2004–06). IHD and stroke (rates per 100,000) adjusted for age, country of birth, and rurality were compared across SES strata (separately by sex) using Poisson regression.

Results: Mortality declined monotonically over the study period in all SES groups and both sexes. Absolute differences between low and high SES groups narrowed for IHD in females (27 to 23 per 100,000) and stroke in males and females (16 to 13, and 13 to 7 per 100,000, respectively), although absolute differences widened for IHD in males (52 to 63 per 100,000). Relative declines were greater in high compared to low SES groups for IHD (28% average quinquennial decline in high SES; compared with 21% in low SES for males; 30% and 21% for females), and for stroke (25% average quinquennial decline in high SES; 21% in low SES for males; 26% and 23% for females).

Conclusion: Differences in mortality rates between lower and higher SES groups narrowed for both IHD (in females) and stroke (in males and females) from 1979–2006, indicating that the epidemic decline is now at a late stage when low SES groups are benefiting more, in absolute terms, than high SES groups. However males in the lower SES groups are still at an earlier stage of the epidemic decline in IHD mortality.
Keyword Cardiovascular disease
Ischaemic heart disease
Socioeconomic status
Stroke
Trends
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online before print October 17, 2011.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
 
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Created: Wed, 21 Mar 2012, 00:09:08 EST by Geraldine Fitzgerald on behalf of School of Public Health