Exploring disparities in acute myocardial infarction events between Aboriginal and non-Aboriginal Australians: roles of age, gender, geography and area-level disadvantage

D A Randall; L R Jorm; S Lujic; S J Eades; T R Churches; A J O'Loughlin; A H Leyland

doi:10.1016/j.healthplace.2014.03.009

Exploring disparities in acute myocardial infarction events between Aboriginal and non-Aboriginal Australians: roles of age, gender, geography and area-level disadvantage

Health Place. 2014 Jul:28:58-66. doi: 10.1016/j.healthplace.2014.03.009. Epub 2014 Apr 19.

Authors

D A Randall¹, L R Jorm², S Lujic³, S J Eades⁴, T R Churches⁵, A J O'Loughlin⁶, A H Leyland⁷

Affiliations

¹ Centre for Health Research, School of Medicine, Blg 3 Campbelltown Campus, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: d.randall@uws.edu.au.
² Centre for Health Research, School of Medicine, Blg 3 Campbelltown Campus, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia; The Sax Institute, PO Box K617, Haymarket, NSW 1240, Australia.
³ Centre for Health Research, School of Medicine, Blg 3 Campbelltown Campus, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
⁴ Sydney School of Public Health, Sydney Medical School, Edward Ford Building (A27), The University of Sydney, Sydney, NSW 2006, Australia; Baker IDI Heart and Diabetes Institute, PO Box 6492, St Kilda Road Central, Melbourne, VIC 8008, Australia.
⁵ The Sax Institute, PO Box K617, Haymarket, NSW 1240, Australia.
⁶ School of Medicine, Blg 30 Campbelltown Campus, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
⁷ MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow, G12 8RZ, UK.

PMID: 24751666
DOI: 10.1016/j.healthplace.2014.03.009

Abstract

We investigated disparities in rates of acute myocardial infarction (AMI) between Aboriginal and non-Aboriginal people in the 199 Statistical Local Areas (SLAs) in New South Wales, Australia. Using routinely collected and linked hospital and mortality data from 2002 to 2007, we developed multilevel Poisson regression models to estimate the relative rates of first AMI events in the study period accounting for area of residence. Rates of AMI in Aboriginal people were more than two times that in non-Aboriginal people, with the disparity greatest in more disadvantaged and remote areas. AMI rates in Aboriginal people varied significantly by SLA, as did the Aboriginal to non-Aboriginal rate ratio. We identified almost 30 priority areas for universal and targeted preventive interventions that had both high rates of AMI for Aboriginal people and large disparities in rates.

Keywords: Aboriginal health; Acute myocardial infarction; Data linkage; Multilevel modeling.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Distribution
Aged
Aged, 80 and over
Female
Geography
Health Status Disparities*
Humans
Male
Middle Aged
Myocardial Infarction / epidemiology*
Myocardial Infarction / ethnology
Native Hawaiian or Other Pacific Islander / statistics & numerical data*
New South Wales / epidemiology
Poisson Distribution
Registries
Rural Population / statistics & numerical data
Sex Distribution
Urban Population / statistics & numerical data

Abstract

Publication types

MeSH terms

Grants and funding