Rural inequalities in the Australian burden of ischaemic heart disease: a systematic review

Alston, Laura, Allender, Steven, Peterson, Karen, Jacobs, Jane and Nichols, Melanie 2017, Rural inequalities in the Australian burden of ischaemic heart disease: a systematic review, Heart lung and circulation, vol. 26, no. 2, pp. 122-133, doi: 10.1016/j.hlc.2016.06.1213.

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Title Rural inequalities in the Australian burden of ischaemic heart disease: a systematic review
Author(s) Alston, Laura
Allender, StevenORCID iD for Allender, Steven
Peterson, KarenORCID iD for Peterson, Karen
Jacobs, Jane
Nichols, MelanieORCID iD for Nichols, Melanie
Journal name Heart lung and circulation
Volume number 26
Issue number 2
Start page 122
End page 133
Total pages 12
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2017-02
ISSN 1444-2892
Keyword(s) Burden
Heart disease
Summary OBJECTIVE: To summarise all available evidence on the differences in burden of ischaemic heart disease (IHD) between metropolitan and rural communities of Australia.

METHODS: Systematic review of peer-reviewed literature published between 1990 and 2014. Search terms were derived from the four major topics: (1) rural; (2) ischaemic heart disease; (3) Australia; and (4) burden of disease. Terms were adapted for six databases and two independent researchers screened results. Studies were included if they compared outcomes related to IHD in adults aged 18 years and over, between (at least) two areas of differing remoteness, at the same point in time.

RESULTS: Twenty studies were included and presented data collected between 1969 and 2010. Seventeen studies showed a clear disparity in IHD outcomes between major cities and regional and remote areas, with a consistently higher burden observed outside major cities. Among Aboriginal and Torres Strait Islander populations, fewer differences were observed and some IHD outcomes were not associated with remoteness.

CONCLUSIONS: Populations outside of major cities in Australia bear a disproportionately high burden of ill health due to IHD, yet the majority of the rural populations are yet to be investigated in terms of burden of disease outcomes from IHD.

IMPLICATIONS: Remoteness is a key determinant of IHD burden in Australia. The reasons for increased IHD burden in rural compared to metropolitan communities of Australia are poorly understood, which has implications for the design of targeted interventions to reduce geographical inequalities.
Language eng
DOI 10.1016/j.hlc.2016.06.1213
Field of Research 111708 Health and Community Services
1102 Cardiovascular Medicine And Haematology
1117 Public Health And Health Services
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)
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Document type: Journal Article
Collections: Faculty of Health
Population Health
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