Background: Complex temporal variations in coronary deaths, including diurnal, weekly, and seasonal trends, have been reported worldwide. Objective: To describe the magnitude of seasonal changes in coronary artery deaths in New South Wales, Australia. Design: Hospital morbidity data, mortality statistics, and meteorological data were modelled using time series techniques to determine seasonality of coronary deaths. Data were also analysed to determine whether there was an increase in deaths before or after the Christmas and New Year holidays. Results: A clear seasonality of coronary deaths was shown, with a peak in July. A mean of 2.8 excess coronary deaths per 100 deaths was estimated to occur from June to August each year, with a mean annual excess of 224 winter deaths a year. Mortality data did not show an increase in coronary death ratios before (p = 0.626) or after (p = 0.813) the Christmas and New Year holidays in December. Conclusions: There is a higher incidence of coronary deaths in winter, which may reflect winter respiratory infections, the direct effect of cold, seasonal changes in lipid concentration, and other factors associated with winter. Hospitals should have contingency plans during the winter months to manage larger numbers of cardiac admissions.

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This study attempts to measure premature mortality, in addition to overall death rates, in order to provide more information that can be used to develop and monitor health programmes that are aimed at reducing premature (often preventable) mortality in New South Wales (NSW), Australia. Premature years of potential life lost (PYPLL) and valued years of potential life lost methods are applied for mortality data in NSW from 1990 to 2002. Variations in these measures for 2001 are studied further in terms of age, sex, urban/rural residence, and socio-economic status. PYPLL rates for all leading causes of death have declined. It is shown that the average male to female ratio of PYPLLs is highest for accidents, injury and poisoning (3.4:1) followed by mental disorders (2.7:1) and cardiovascular diseases (2.6:1). Although fewer women than men die of cardiovascular diseases, there is a greater proportionate importance of cerebrovascular mortality among women. In order to further reduce premature deaths, programs are required to improve the health of people living in lower socio-economic status areas, especially in rural NSW. Targeted regional or community level programs are required to reduce avoidable deaths due to accidents, injury and poisoning occasioned by motor vehicle accidents, poisoning and suicide among young adults.

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Objectives This study explores the contribution of sociodemographic factors to the geographic variation in coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) procedure rates in New South Wales, Australia.Methods With the utilisation of small area analysis and regression model techniques, the possible explanatory factors of the local government area (LGA) level variation in CABG and PCI rates in terms of coronary artery disease prevalence, supply and access to health-care services, socio-economic status and ethnic origin of the people were examined. Results Multivariate regression results show that distance to hospitals is negatively associated with LGA-specific CABG and PCI rates. The CABG rate is lower and PCI rate is higher in LGAs with higher percentages of Europeanborn residents. Higher proportions of surgeries were recorded for relatively younger people in the lowest socioeconomicLGAs.Conclusions The focus should be on educating people in the lowest socio-economic LGAs in lifestyle management in order to minimise surgical interventions at a younger age.