Recent patterns in chronic disease mortality in remote living Indigenous Australians.
BACKGROUND
Despite the well-recognised Indigenous-non-Indigenous health disparity, some reports suggest improvements in Indigenous mortality. Our aim was to quantify Indigenous mortality in Outer Regional (OR), Remote (R), and Very Remote (VR) areas in New South Wales, Queensland, South Australia, Western Australia, and the Northern Territory and changes in mortality from 1998 to 2005.


METHODS
We calculated rates, standardized mortality ratios (SMRs) and percentage change in annual rates of Indigenous cardiovascular, diabetes and renal mortality mentioned anywhere on the death certificate by using ICD-10 codes and the 2001 total Australian population as the reference population.


RESULTS
In 1998-2001, Indigenous SMRs for all-cause mortality were 241%, 421% and 220% in OR, R and VR, respectively. In 2001-03, corresponding SMRs were 202%, 331% and 176%. Percentage changes (95% confidence interval) in annual all-cause mortality were -3.0% (-5.3%, -0.7%) in OR, -4.2% (-7.4%, -0.9%) in R and -0.5 (-9.1%, -0.7%) in VR. In 2002-2005, compared with 1998-2001, changes in the number of Indigenous deaths were -147, -195, and -197 in OR, R and VR, respectively. Similar patterns and trends were observed for cardiovascular mortality.


CONCLUSIONS
Mortality was elevated about 2-fold in OR, 4-fold in R and 2-fold in VR areas. The downward trend in mortality regardless of remoteness of residence was partly attributable to a decrease in the absolute number of deaths. These patterns were observed for each of the states/territories individually.
Andreasyan
K
K
Centre for Chronic Disease, The University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. k.andreasyn@uq.edu.au
Hoy
W E
WE
D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002423:Cause of Death / Q000639:trends; D002908:Chronic Disease / Q000453:epidemiology / Q000208:ethnology* / Q000401:mortality*; D016001:Confidence Intervals; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012424:Rural Population / Q000706:statistics & numerical data* / Q000639:trends