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Download fileRural inequalities in the Australian burden of ischaemic heart disease: a systematic review
journal contribution
posted on 2017-02-01, 00:00 authored by Laura AlstonLaura Alston, Steven AllenderSteven Allender, Karen Peterson, Jane JacobsJane Jacobs, Melanie NicholsMelanie NicholsOBJECTIVE: 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.
History
Journal
Heart lung and circulationVolume
26Issue
2Pagination
122 - 133Publisher
ElsevierLocation
Amsterdam, The NetherlandsPublisher DOI
Link to full text
eISSN
1444-2892Language
engPublication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
2016, Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)Usage metrics
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Categories
Keywords
BurdenHeart diseaseInequalityRuralScience & TechnologyLife Sciences & BiomedicineCardiac & Cardiovascular SystemsCardiovascular System & CardiologyACUTE MYOCARDIAL-INFARCTIONNEW-SOUTH-WALESINDIGENOUS AUSTRALIANSCARDIOVASCULAR-DISEASENONABORIGINAL PEOPLEMORTALITYEVENTSDIFFERENTIALSDISADVANTAGEMETROPOLITAN