Laura Alston1, Steven Allender2, Karen Peterson2, Jane Jacobs2, Melanie Nichols2. 1. World Health Organisation Collaborating Centre for Obesity Prevention, Deakin University, Geelong Waterfront campus, Geelong, Vic, Australia. Electronic address: laura.alston@deakin.edu.au. 2. World Health Organisation Collaborating Centre for Obesity Prevention, Deakin University, Geelong Waterfront campus, Geelong, Vic, Australia.
Abstract
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.
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.
Authors: Hannah Beks; Sandra Walsh; Laura Alston; Martin Jones; Tony Smith; Darryl Maybery; Keith Sutton; Vincent L Versace Journal: Int J Environ Res Public Health Date: 2022-01-27 Impact factor: 3.390
Authors: Tracy L Schumacher; Laura Alston; Luke Wakely; Rachel Latter; Kelly Squires; Susan Heaney; Leanne J Brown Journal: Int J Environ Res Public Health Date: 2022-03-04 Impact factor: 3.390
Authors: Katherine Kent; Laura Alston; Sandra Murray; Bonnie Honeychurch; Denis Visentin Journal: Int J Environ Res Public Health Date: 2022-03-09 Impact factor: 3.390