Regional variation in cardiovascular mortality in Australia 2009–2012: the impact of remoteness and socioeconomic status

Jane Jacobs, Karen Peterson, Steven Allender, Laura Veronica Alston, Melanie Nichols

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To assess the extent to which socioeconomic status (SES) contributes to geographic disparity in cardiovascular disease (CVD) mortality. Methods: An ecological study assessed the association between remoteness and CVD mortality rates, and the mediating effect of SES on this relationship, using Australia-wide data from 2009 to 2012. Results: Socioeconomic status explained approximately one-quarter of the increased CVD mortality rates for females in inner and outer regional areas, and more than half of the increased CVD mortality rates in inner regional and remote/very remote areas for males, compared to major cities. After allowing for the mediating effect of SES, females living in inner regional areas and males living in remote/very remote areas had the greatest CVD mortality rates (Mortality Rate Ratio: 1.12, 95%CI 1.07–1.17; MRR: 1.15, 95%CI 1.05–1.25, respectively) compared to those in major cities. Conclusion: Socioeconomic status explained a substantial proportion of the association between where a person resides and CVD mortality rates; however, remoteness has an effect above and beyond SES for a number of subpopulations. Implications for public health: This study highlights the need to focus on both socioeconomic disadvantage and accessibility to reduce CVD mortality in regional and remote Australia.

LanguageEnglish
Pages467-473
Number of pages7
JournalAustralian and New Zealand journal of public health
Volume42
Issue number5
DOIs
Publication statusPublished - 1 Oct 2018

Keywords

  • cardiovascular disease
  • epidemiology
  • health inequalities
  • rural health
  • socioeconomic status

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Jacobs, Jane ; Peterson, Karen ; Allender, Steven ; Alston, Laura Veronica ; Nichols, Melanie. / Regional variation in cardiovascular mortality in Australia 2009–2012 : the impact of remoteness and socioeconomic status. In: Australian and New Zealand journal of public health. 2018 ; Vol. 42, No. 5. pp. 467-473.
@article{d13916ad75e84d3cb9b0256e2327ffd0,
title = "Regional variation in cardiovascular mortality in Australia 2009–2012: the impact of remoteness and socioeconomic status",
abstract = "Objective: To assess the extent to which socioeconomic status (SES) contributes to geographic disparity in cardiovascular disease (CVD) mortality. Methods: An ecological study assessed the association between remoteness and CVD mortality rates, and the mediating effect of SES on this relationship, using Australia-wide data from 2009 to 2012. Results: Socioeconomic status explained approximately one-quarter of the increased CVD mortality rates for females in inner and outer regional areas, and more than half of the increased CVD mortality rates in inner regional and remote/very remote areas for males, compared to major cities. After allowing for the mediating effect of SES, females living in inner regional areas and males living in remote/very remote areas had the greatest CVD mortality rates (Mortality Rate Ratio: 1.12, 95{\%}CI 1.07–1.17; MRR: 1.15, 95{\%}CI 1.05–1.25, respectively) compared to those in major cities. Conclusion: Socioeconomic status explained a substantial proportion of the association between where a person resides and CVD mortality rates; however, remoteness has an effect above and beyond SES for a number of subpopulations. Implications for public health: This study highlights the need to focus on both socioeconomic disadvantage and accessibility to reduce CVD mortality in regional and remote Australia.",
keywords = "cardiovascular disease, epidemiology, health inequalities, rural health, socioeconomic status",
author = "Jane Jacobs and Karen Peterson and Steven Allender and Alston, {Laura Veronica} and Melanie Nichols",
year = "2018",
month = "10",
day = "1",
doi = "10.1111/1753-6405.12807",
language = "English",
volume = "42",
pages = "467--473",
journal = "Community Health Studies",
issn = "1326-0200",
publisher = "Public Health Association of Australia Inc.",
number = "5",

}

Regional variation in cardiovascular mortality in Australia 2009–2012 : the impact of remoteness and socioeconomic status. / Jacobs, Jane; Peterson, Karen; Allender, Steven; Alston, Laura Veronica; Nichols, Melanie.

In: Australian and New Zealand journal of public health, Vol. 42, No. 5, 01.10.2018, p. 467-473.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Regional variation in cardiovascular mortality in Australia 2009–2012

T2 - Community Health Studies

AU - Jacobs, Jane

AU - Peterson, Karen

AU - Allender, Steven

AU - Alston, Laura Veronica

AU - Nichols, Melanie

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Objective: To assess the extent to which socioeconomic status (SES) contributes to geographic disparity in cardiovascular disease (CVD) mortality. Methods: An ecological study assessed the association between remoteness and CVD mortality rates, and the mediating effect of SES on this relationship, using Australia-wide data from 2009 to 2012. Results: Socioeconomic status explained approximately one-quarter of the increased CVD mortality rates for females in inner and outer regional areas, and more than half of the increased CVD mortality rates in inner regional and remote/very remote areas for males, compared to major cities. After allowing for the mediating effect of SES, females living in inner regional areas and males living in remote/very remote areas had the greatest CVD mortality rates (Mortality Rate Ratio: 1.12, 95%CI 1.07–1.17; MRR: 1.15, 95%CI 1.05–1.25, respectively) compared to those in major cities. Conclusion: Socioeconomic status explained a substantial proportion of the association between where a person resides and CVD mortality rates; however, remoteness has an effect above and beyond SES for a number of subpopulations. Implications for public health: This study highlights the need to focus on both socioeconomic disadvantage and accessibility to reduce CVD mortality in regional and remote Australia.

AB - Objective: To assess the extent to which socioeconomic status (SES) contributes to geographic disparity in cardiovascular disease (CVD) mortality. Methods: An ecological study assessed the association between remoteness and CVD mortality rates, and the mediating effect of SES on this relationship, using Australia-wide data from 2009 to 2012. Results: Socioeconomic status explained approximately one-quarter of the increased CVD mortality rates for females in inner and outer regional areas, and more than half of the increased CVD mortality rates in inner regional and remote/very remote areas for males, compared to major cities. After allowing for the mediating effect of SES, females living in inner regional areas and males living in remote/very remote areas had the greatest CVD mortality rates (Mortality Rate Ratio: 1.12, 95%CI 1.07–1.17; MRR: 1.15, 95%CI 1.05–1.25, respectively) compared to those in major cities. Conclusion: Socioeconomic status explained a substantial proportion of the association between where a person resides and CVD mortality rates; however, remoteness has an effect above and beyond SES for a number of subpopulations. Implications for public health: This study highlights the need to focus on both socioeconomic disadvantage and accessibility to reduce CVD mortality in regional and remote Australia.

KW - cardiovascular disease

KW - epidemiology

KW - health inequalities

KW - rural health

KW - socioeconomic status

UR - http://www.scopus.com/inward/record.url?scp=85050567231&partnerID=8YFLogxK

U2 - 10.1111/1753-6405.12807

DO - 10.1111/1753-6405.12807

M3 - Article

VL - 42

SP - 467

EP - 473

JO - Community Health Studies

JF - Community Health Studies

SN - 1326-0200

IS - 5

ER -