Myocardial infarction in Québec rural and urban populations between 1995 and 1997.
BACKGROUND
There is abundant evidence of health inequities between urban and rural populations. The purpose of this paper is to describe the socioeconomic characteristics of Québec urban and rural populations and the relation between rurality and incidence of myocardial infarction (MI), care management and outcomes.


METHODS
Socioeconomic data by census subdivisions were available from the 1996 Canadian census, representing 7,137,245 individuals. Data on patients with MI were taken from the provincial administrative health database (MED-ECHO), which is managed by the Ministry of Health and contains clinical and demographic information collected when patients are released from acute care hospitals in Québec.


RESULTS
We included a total of 37,678 cases compiled over the 3 years of follow-up in the analyses. Residents of rural areas with low urban influence have higher MI incidence rates than all of the other populations in the study. In comparison with urban populations, their observed rural counterparts are at a disadvantage with regard to education, employment and income. Although angioplasty and coronary artery bypass graft surgery rates were higher in more urban areas, the survival rate was lower than in rural areas.


CONCLUSIONS
This study revealed geographic heterogeneity of MI incidence, revascularization rates and survival rates among urban and rural populations.
Loslier
Julie
J
The PRIMUS Group, Clinical Research Centre, Sherbrooke University Hospital, Sherbrooke, Québec, Canada.
Vanasse
Alain
A
Niyonsenga
Théophile
T
Courteau
Josiane
J
Orzanco
Gabriela
G
Hemiari
Abbas
A
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D011792:Quebec / Q000453:epidemiology; D012424:Rural Population; D012959:Socioeconomic Factors; D013997:Time Factors; D014505:Urban Population