Taylor R, Quine S, Lyle D, Bilton A
Department of Public Health, University of Sydney, NSW.
Aust J Public Health. 1992 Sep;16(3):305-14. doi: 10.1111/j.1753-6405.1992.tb00071.x.
To determine the magnitude of differentials in mortality and hospital morbidity by Local Government Area (LGA) in Sydney (1985-1988), and to correlate these with LGA indicators of socioeconomic status.
Cross-sectional group-based comparative study of mortality and hospital separations, and a group-based correlations analysis in relation to socioeconomic indicators.
Mortality--life expectancy at birth, infant mortality, 0- to 4-year mortality, age-standardised 15- to 64-year mortality (all-cause and various causes), sex-specific (except infant and 0- to 4-year mortality). Hospital morbidity rates--0- to 4-year hospital separations, age-standardised 15- to 64-year hospital separations (all-cause and various causes), sex-specific.
Census-derived LGA proportions of immigrants, Aborigines, professionals, unskilled workers, unemployed persons, those with a university degree and those having no qualifications, and the composite Ross Indicator.
Considerable differences in mortality and hospital morbidity by LGA in Sydney were found. Males had higher mortality and lower rates of hospital separation than females. LGA differentials were most obvious for adults, with little variation noted for infants or children. Most socioeconomic indicators were highly correlated with adult mortality and hospital morbidity in the expected direction, particularly indicators of low socioeconomic status. The unemployment rate, proportion Aboriginal, proportion unskilled, proportion unqualified, and the Ross Indicator were the most highly correlated variables.
There are persistent differentials by LGA in mortality and hospital morbidity in Sydney which are strongly associated with socioeconomic status. The Ross Indicator was found to be a useful composite indicator. The high correlations of mortality and hospital morbidity with the unemployment rate raise the question of to what extent this is due to illness and premature mortality in the unemployed. Monitoring of health status differentials needs to continue if progress towards Health For All targets is to be evaluated.
确定悉尼各地方政府区域（LGA）在1985 - 1988年间死亡率和医院发病率的差异程度，并将这些差异与LGA的社会经济地位指标相关联。
基于群组的死亡率和医院出院情况横断面比较研究，以及与社会经济指标相关的基于群组的相关性分析。
死亡率——出生时预期寿命、婴儿死亡率、0至4岁死亡率、年龄标准化的15至64岁死亡率（全因及各种病因）、特定性别的死亡率（婴儿和0至4岁死亡率除外）。医院发病率——0至4岁的医院出院率、年龄标准化的15至64岁医院出院率（全因及各种病因）、特定性别的出院率。
根据人口普查得出的LGA中移民、原住民、专业人员、非技术工人、失业人员、拥有大学学位者和无学历者的比例，以及综合罗斯指标。
发现悉尼各LGA在死亡率和医院发病率方面存在显著差异。男性的死亡率高于女性，而医院出院率低于女性。LGA差异在成年人中最为明显，婴儿或儿童的差异较小。大多数社会经济指标与成人死亡率和医院发病率在预期方向上高度相关，特别是社会经济地位较低的指标。失业率、原住民比例、非技术工人比例、无学历比例和罗斯指标是相关性最高的变量。
悉尼各LGA在死亡率和医院发病率方面存在持续差异，这些差异与社会经济地位密切相关。罗斯指标是一个有用的综合指标。死亡率和医院发病率与失业率的高度相关性引发了一个问题，即这在多大程度上是由于失业者的疾病和过早死亡所致。如果要评估在实现全民健康目标方面的进展，就需要继续监测健康状况差异。
