title: A comparison of Australian rural and metropolitan cardiovascular risk and mortality: the Greater Green Triangle and North West Adelaide population surveys.
abstract: OBJECTIVE
  Cardiovascular (CVD) mortality disparities between rural/regional and urban-dwelling residents of Australia are persistent. Unavailability of biomedical CVD risk factor data has, until now, limited efforts to understand the causes of the disparity. This study aimed to further investigate such disparities.
  
  
  METHODS
  Comparison of (1) CVD risk measures between a regional (Greater Green Triangle Risk Factor Study (GGT RFS, cross-sectional study, 2004-2006) and an urban population (North West Adelaide Health Study (NWAHS, longitudinal cohort study, 2004-2006); (2) Australian Bureau of Statistics (ABS) CVD mortality rates between these and other Australian regions; and (3) ABS CVD mortality rates by an area-level indicator of socioeconomic status, the Index of Relative Socioeconomic Disadvantage (IRSD).
  
  
  METHODS
  Greater Green Triangle (GGT, Limestone Coast, Wimmera and Corangamite Shires) of South-Western Victoria and North-West Adelaide (NWA).
  
  
  METHODS
  1563 GGT RFS and 3036 NWAHS stage 2 participants (aged 25-74) provided some information (self-administered questionnaire +/- anthropometric and biomedical measurements).
  
  
  METHODS
  Age-group specific measures of absolute CVD risk, ABS CVD mortality rates by study group and Australian Standard Geographical Classification (ASGC) region.
  
  
  RESULTS
  Few significant differences in CVD risk between the study regions, with mean absolute CVD risk ranging from approximately 1% in the age group 35-39 years to 14% in the age group 70-74 years. [corrected]. Similar mean 2003-2007 (crude) mortality rates in GGT (98, 95% CI 87 to 111), NWA (103, 95% CI 96 to 110) and regional Australia (92, 95% CI 91 to 94). NWA mortality rates exceeded that of other city areas (70, 95% CI 69 to 71). Lower measures of socioeconomic status were associated with worse CVD outcomes regardless of geographic location.
  
  
  CONCLUSIONS
  Metropolitan areas do not always have better CVD risk factor profiles and outcomes than rural/regional areas. Needs assessments are required for different settings to elucidate relative contributions of the multiple determinants of risk and appropriate cardiac healthcare strategies to improve outcomes.
authors: Integrated Cardiovascular Clinical Network, Country Health SA Local Health Network, Flinders Medical Centre, Adelaide, Australia.
authors: Philip
authors: P
authors: Tideman
authors: Anne W
authors: AW
authors: Taylor
authors: Edward
authors: E
authors: Janus
authors: Ben
authors: B
authors: Philpot
authors: Robyn
authors: R
authors: Clark
authors: Elizabeth
authors: E
authors: Peach
authors: Tiina
authors: T
authors: Laatikainen
authors: Erkki
authors: E
authors: Vartiainen
authors: Rosy
authors: R
authors: Tirimacco
authors: Alicia
authors: A
authors: Montgomerie
authors: Janet
authors: J
authors: Grant
authors: Vincent
authors: V
authors: Versace
authors: James A
authors: JA
authors: Dunbar
keywords: Epidemiology; Public Health
references: Epidemiol Perspect Innov. 2006 Apr 12;3:4
references: 16608529
references: Med J Aust. 2000 Aug 21;173(4):173-4
references: 11008586
references: Aust N Z J Med. 1995 Aug;25(4):290-6
references: 8540868
references: Med J Aust. 2000 Apr 17;172(8):360-1
references: 10840485
references: Med J Aust. 2000 Mar 6;172(5):208-12
references: 10776391
references: Int J Epidemiol. 2009 Dec;38(6):1479-86
references: 19074192
references: Aust N Z J Public Health. 1999 Feb;23(1):61-6
references: 10083691
references: Intern Med J. 2008 Dec;38(12):879-86
references: 18284462
references: Med J Aust. 2000 Apr 17;172(8):370-4
references: 10840488
references: Med J Aust. 2010 Feb 1;192(3):127-32
references: 20121678
references: Med J Aust. 2007 Aug 6;187(3):147-52
references: 17680739
references: BMC Public Health. 2006 Jan 23;6:11
references: 16426463