Piers Leonard S, Carson Norman J, Brown Kaye, Ansari Zahid
Chronic Disease Surveillance and Epidemiology Section, Public Health Branch, Department of Human Services, Melbourne, Victoria.
Aust N Z J Public Health. 2007 Feb;31(1):5-12. doi: 10.1111/j.1753-6405.2007.00002.x.
To describe trends in avoidable mortality (AM) in Victoria by sex, degree of socio-economic disadvantage and remoteness.
The analysis is based on mortality and population data for 1979-2001 supplied by the Australian Bureau of Statistics (ABS) for Victoria. Total and disease-specific AM rates were age standardised using the direct method. For the period between 1997 and 2001, comparisons of total AM rates by sex were made between metropolitan and rural local government areas (LGAs), and between LGAs grouped into quintiles based on socio-economic disadvantage and categories of remoteness.
Total AM rates declined significantly (p < 0.05) in both males and females between 1979 and 2001, but were significantly higher in males compared with females. Total AM rates were significantly higher in rural compared with metropolitan LGAs, from 1997 to 2001 in males and in 1998 in females. Total AM rates in the least disadvantaged quintile were significantly lower than those in the most disadvantaged quintile over the entire five-year period in males and in three years in females. Total AM rates were highest in remote LGAs and lowest in highly accessible LGAs. There were significant declines in ischaemic heart disease, stroke and road traffic accident AM rates among males. In females, IHD, stroke, breast and colon cancer AM rates declined significantly.
Despite large declines in AM in Victoria, there are significant differences in rates between the sexes and in the population based on socio-economic status or remoteness. These results provide opportunities for policy makers to prioritise public health and health services interventions, targeting population groups and specific disease conditions to reduce health inequalities.
按性别、社会经济劣势程度和偏远程度描述维多利亚州可避免死亡率（AM）的趋势。
分析基于澳大利亚统计局（ABS）提供的1979 - 2001年维多利亚州的死亡率和人口数据。采用直接法对总AM率和疾病特异性AM率进行年龄标准化。在1997年至2001年期间，比较了大城市和农村地方政府区域（LGA）之间以及根据社会经济劣势和偏远类别分为五等份的LGA之间按性别的总AM率。
1979年至2001年期间，男性和女性的总AM率均显著下降（p < 0.05），但男性的总AM率显著高于女性。1997年至2001年男性以及1998年女性中，农村LGA的总AM率显著高于大城市LGA。在整个五年期间，男性中最不弱势五分位数的总AM率显著低于最弱势五分位数，女性中则为三年。偏远LGA的总AM率最高，交通便利的LGA最低。男性中缺血性心脏病、中风和道路交通事故的AM率显著下降。女性中，缺血性心脏病、中风、乳腺癌和结肠癌的AM率显著下降。
尽管维多利亚州的AM大幅下降，但基于性别以及社会经济地位或偏远程度的人口之间，AM率仍存在显著差异。这些结果为政策制定者提供了机会，可优先考虑公共卫生和卫生服务干预措施，针对特定人群和特定疾病状况，以减少健康不平等。
