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Mortality disparities between geographic regions : results from a risk percentiles model for coronary heart disease

conference contribution
posted on 2010-01-01, 00:00 authored by Christopher StevensonChristopher Stevenson, H Mannan, Anna PeetersAnna Peeters, H Walls, D Magliano, J McNeil
Background: Planning of disease prevention strategies requires information regarding the distribution of absolute risk in the population to allow targeting of people at high disease risk. It is well known that death rates from coronary heart disease (CHD) are higher in remote areas of Australia compared with major cities. Less well understood is the distribution of the absolute risk of CHD death within the different geographic regions. We present a mathematical model of CHD which projects the lifetime risk of death among individuals in different percentiles of CHD risk. We apply this to model the distribution of CHD risk within different geographic regions.

Methods: Using information from the Framingham1, MRFIT2 and AusDiab3 studies, the Australian population was divided into percentiles of CHD risk within age and gender groups by geographic location. Absolute mortality risk was determined at each percentile using current Australian mortality data. Survival curves were generated for each percentile using these risk estimates. Approximate confidence intervals were derived using bootstrap methods.

Conclusions: The difference in life expectancy at age 25 between those in the lowest decile of CHD risk compared to the highest was 5.8 years (95%CI:4.7,6.7) in major cities compared to 8.5 years (95%CI:7.6,9.7) in remote areas. The difference in risk of premature death (before age 75) was 12% (95%CI:10%,14%) in major cities compared to 33% (95%CI:28%,38%) in remote areas.

History

Event

American Public Health Association. Meeting (138th : 2010 : Denver, Colo.)

Publisher

American Public Health Association

Location

Denver, Colo.

Place of publication

[Denver, Colo.]

Start date

2010-11-06

End date

2010-11-10

Language

eng

Publication classification

E3.1 Extract of paper

Title of proceedings

APHA 2010 : Social justice : A public health imperative : Proceedings of the 138th Annual Meeting of the American Public Health Association