Socio-economic, migrant and geographic differentials in coronary heart disease occurrence in New South Wales
Article first published online: 13 MAY 2008
Australian and New Zealand Journal of Public Health
Volume 23, Issue 1, pages 20–26, February 1999
How to Cite
Taylor, R., Chey, T., Bauman, A. and Webster, I. (1999), Socio-economic, migrant and geographic differentials in coronary heart disease occurrence in New South Wales. Australian and New Zealand Journal of Public Health, 23: 20–26. doi: 10.1111/j.1467-842X.1999.tb01200.x
- Issue published online: 13 MAY 2008
- Article first published online: 13 MAY 2008
Objective: This study examines the variation in coronary heart disease (CHD) mortality and acute myocardial infarction (AMI) by socio-economic status (SES), country of birth (COB) and geography (urban/rural) in the total population of New South Wales (Australia) in 1991-95.
Method: CHD deaths and AMI are from complete enumerations of deaths and hospital admissions, respectively; and population denominators are from census information. Data are examined separately by sex, and comparisons of SES groups (based on municipalities), COB and region are analysed using Poisson regression, after adjustment for age.
Results: The study identified higher risk for AMI admissions and CHD mortality in lower SES populations with significant linear trends, for both sexes, adjusted for age, region and COB. According to the population attributable fractions (PAF), 23–41 % of the risk of CHD occurrence is due to SES lower than the highest quartile. The higher age-adjusted risk for CHD occurrence in rural and remote populations for both sexes, compared with urban communities, was lessened by adjustment for COB, and all but abolished when also adjusted for SES. COB analysis indicated significantly lower age-adjusted AMI admissions and CHD mortality compared with the Australian-born.
Conclusions: Higher risks for CHD in rural populations compared with the capital city (Sydney) are due, in part, to lower SES, lesser migrant composition.
Implications: Strategies for reducing CHD differentials should consider demographic factors and the fundamental need to reduce socio-economic inequalities, as well as targeting appropriate prevention measures.