Quantifying the role of modifiable risk factors in the differences in cardiovascular disease mortality rates between metropolitan and rural populations in Australia: a macrosimulation modelling study
| Autor: | Steven Allender, Melanie Nichols, Jane Jacobs, Karen Louise Peterson, Laura Alston |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Rural Population Gerontology medicine.medical_specialty Adolescent Urban Population Myocardial Ischemia Disease 030204 cardiovascular system & hematology preventive medicine Young Adult 03 medical and health sciences Age Distribution 0302 clinical medicine Rurality Risk Factors Environmental health medicine Humans cardiovascular diseases 030212 general & internal medicine Sex Distribution coronary heart disease Risk factor Aged Preventive healthcare Aged 80 and over business.industry Research Mortality rate Public health Australia General Medicine Middle Aged Metropolitan area 3. Good health Female Self Report Public Health Rural area business |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesThe study aimed (1) to quantify differences in modifiable risk factors between urban and rural populations, and (2) to determine the number of rural cardiovascular disease (CVD) and ischaemic heart disease (IHD) deaths that could be averted or delayed if risk factor levels in rural areas were equivalent to metropolitan areas.SettingNational population estimates, risk factor prevalence, CVD and IHD deaths data were analysed by rurality using a macrosimulation Preventable Risk Integrated Model for chronic disease risk. Uncertainty analysis was conducted using a Monte Carlo simulation of 10 000 iterations to calculate 95% credible intervals (CIs).ParticipantsNational data sets of men and women over the age of 18 years living in urban and rural Australia.ResultsIf people living in rural Australia had the same levels of risk factors as those in metropolitan areas, approximately 1461 (95% CI 1107 to 1791) deaths could be delayed from CVD annually. Of these CVD deaths, 793 (95% CI 506 to 1065) would be from IHD. The IHD mortality gap between metropolitan and rural populations would be reduced by 38.2% (95% CI 24.4% to 50.6%).ConclusionsA significant portion of deaths from CVD and IHD could be averted with improvements in risk factors; more than one-third of the excess IHD deaths in rural Australia were attributed to differences in risk factors. As much as two-thirds of the increased IHD mortality rate in rural areas could not be accounted for by modifiable risk factors, however, and this requires further investigation. |
| Databáze: | OpenAIRE |
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