title: Demographic, seasonal, and spatial differences in acute myocardial infarction admissions to hospital in Melbourne Australia.
abstract: BACKGROUND
  Seasonal patterns in cardiac disease in the northern hemisphere are well described in the literature. More recently age and gender differences in cardiac mortality and to a lesser extent morbidity have been presented. To date spatial differences between the seasonal patterns of cardiac disease has not been presented. Literature relating to seasonal patterns in cardiac disease in the southern hemisphere and in Australia in particular is scarce. The aim of this paper is to describe the seasonal, age, gender, and spatial patterns of cardiac disease in Melbourne Australia by using acute myocardial infarction admissions to hospital as a marker of cardiac disease.
  
  
  RESULTS
  There were 33,165 Acute Myocardial Infarction (AMI) admissions over 2186 consecutive days. There is a seasonal pattern in AMI admissions with increased rates during the colder months. The peak month is July. The admissions rate is greater for males than for females, although this difference decreases with advancing age. The maximal AMI season for males extends from April to November. The difference between months of peak and minimum admissions was 33.7%. Increased female AMI admissions occur from May to November, with a variation between peak and minimum of 23.1%. Maps of seasonal AMI admissions demonstrate spatial differences. Analysis using Global and Local Moran's I showed increased spatial clustering during the warmer months. The Bivariate Moran's I statistic indicated a weaker relationship between AMI and age during the warmer months.
  
  
  CONCLUSIONS
  There are two distinct seasons with increased admissions during the colder part of the year. Males present a stronger seasonal pattern than females. There are spatial differences in AMI admissions throughout the year that cannot be explained by the age structure of the population. The seasonal difference in AMI admissions warrants further investigation. This includes detailing the prevalence of cardiac disease in the community and examining issues of social and environmental justice.
authors.affiliation: School of Geography and Environmental Science Monash University, Wellington Road Clayton, Australia. margaret.loughnan@arts.monash.edu.au
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Loughnan
authors.forename: Neville
authors.initials: N
authors.lastname: Nicholls
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Tapper
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008685:Meteorological Concepts; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D012621:Seasons; D017678:Sex Distribution; D014739:Victoria / Q000453:epidemiology