Randall D A, Jorm L R, Lujic S, Eades S J, Churches T R, O'Loughlin A J, Leyland A H
Centre for Health Research, School of Medicine, Blg 3 Campbelltown Campus, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
Centre for Health Research, School of Medicine, Blg 3 Campbelltown Campus, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia; The Sax Institute, PO Box K617, Haymarket, NSW 1240, Australia.
Health Place. 2014 Jul;28:58-66. doi: 10.1016/j.healthplace.2014.03.009. Epub 2014 Apr 19.
We investigated disparities in rates of acute myocardial infarction (AMI) between Aboriginal and non-Aboriginal people in the 199 Statistical Local Areas (SLAs) in New South Wales, Australia. Using routinely collected and linked hospital and mortality data from 2002 to 2007, we developed multilevel Poisson regression models to estimate the relative rates of first AMI events in the study period accounting for area of residence. Rates of AMI in Aboriginal people were more than two times that in non-Aboriginal people, with the disparity greatest in more disadvantaged and remote areas. AMI rates in Aboriginal people varied significantly by SLA, as did the Aboriginal to non-Aboriginal rate ratio. We identified almost 30 priority areas for universal and targeted preventive interventions that had both high rates of AMI for Aboriginal people and large disparities in rates.
我们研究了澳大利亚新南威尔士州199个统计地区（SLA）中，原住民与非原住民急性心肌梗死（AMI）发病率的差异。利用2002年至2007年常规收集并关联的医院和死亡率数据，我们建立了多层次泊松回归模型，以估计研究期间首次发生AMI事件的相对发病率，并考虑居住地区因素。原住民的AMI发病率是非原住民的两倍多，在处境更不利和偏远的地区，这种差异最为明显。不同SLA的原住民AMI发病率差异显著，原住民与非原住民的发病率之比也存在显著差异。我们确定了近30个重点地区，用于开展普遍和有针对性的预防性干预措施，这些地区的原住民AMI发病率较高，且发病率差异较大。
