A comparison of Australian rural and metropolitan cardiovascular risk and mortality: the Greater Green Triangle and North West Adelaide population surveys

Tideman, Philip, Taylor, Anne W., Janus, Edward, Philpot, Benjamin, Clark, Robyn, Peach, Elizabeth, Laatikainen, Tiina, Vartianinen, Erkk, Tirimacco, Rosy, Montgomerie, Alicia, Grant, Janet, Versace, Vincent and Dunbar, James A 2013, A comparison of Australian rural and metropolitan cardiovascular risk and mortality: the Greater Green Triangle and North West Adelaide population surveys, BMJ Open, vol. 3, no. 8, Article e003203, pp. 1-9.

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Title A comparison of Australian rural and metropolitan cardiovascular risk and mortality: the Greater Green Triangle and North West Adelaide population surveys
Author(s) Tideman, Philip
Taylor, Anne W.
Janus, Edward
Philpot, Benjamin
Clark, Robyn
Peach, Elizabeth
Laatikainen, Tiina
Vartianinen, Erkk
Tirimacco, Rosy
Montgomerie, Alicia
Grant, Janet
Versace, Vincent
Dunbar, James A
Journal name BMJ Open
Volume number 3
Issue number 8
Season Article e003203
Start page 1
End page 9
Total pages 9
Publisher BMJ Group
Place of publication London, England
Publication date 2013
ISSN 2044-6055
Keyword(s) ischaemic heart disease
CVD mortality disparities
Summary Objectives:
Cardiovascular (CVD) mortality disparities 
between rural/regional and urban-dwelling residents of Australia are persistent. Unavailability of biomedical CVD risk factor data has, until now, limited efforts to understand the causes of the disparity. This study aimed to further investigate such disparities.
Design
Comparison of (1) CVD risk measures between a regional (Greater Green Triangle Risk Factor Study (GGT RFS, cross-sectional study, 2004–2006) and an urban population (North West Adelaide Health Study (NWAHS, longitudinal cohort study, 2004–2006); (2) Australian Bureau of Statistics (ABS) CVD mortality rates between these and other Australian regions; and (3) ABS CVD mortality rates by an arealevel indicator of socioeconomic status, the Index of Relative Socioeconomic Disadvantage (IRSD).
Setting
Greater Green Triangle (GGT, Limestone Coast, Wimmera and Corangamite Shires) of South-Western Victoria and North-West Adelaide (NWA).
Participants:
1563 GGT RFS and 3036 NWAHS stage 2 participants (aged 25–74) provided some information (self-administered questionnaire +/−anthropometric and biomedical measurements).
Primary and secondary outcome measures:
Age-group specific measures of absolute CVD risk, ABS CVD mortality rates by study group and Australian Standard Geographical Classification (ASGC) region.
Results:
Few significant differences in CVD risk between the study regions, with absolute CVD risk ranging from approximately 5% to 30% in the 35–39 and 70–74 age groups, respectively. Similar mean 2003–2007 (crude) mortality rates in GGT (98, 95% CI 87 to 111), NWA (103, 95% CI 96 to 110) and regional Australia (92, 95% CI 91 to 94). NWA mortality rates exceeded that of other city areas (70, 95% CI 69 to 71). Lower measures of socioeconomic status were associated with worse CVD outcomes regardless of geographic location.
Conclusions:
Metropolitan areas do not always have better CVD risk factor profiles and outcomes than rural/regional areas. Needs assessments are required for different settings to elucidate relative contributions of the multiple determinants of risk and appropriate cardiac healthcare strategies to improve outcomes.
Language eng
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
HERDC collection year 2013
Persistent URL http://hdl.handle.net/10536/DRO/DU:30056012

Document type: Journal Article
Collections: Population Health
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