Burden of Stroke in Indigenous Western Australians

Abstract

Background and Purpose-Despite the disproportionate burden of cardiovascular disease among indigenous Australians, information on stroke is sparse. This article documents the incidence and burden of stroke (in disability-adjusted life years) in indigenous and non-indigenous people in Western Australia (1997)(1998)(1999)(2000)(2001)(2002), a state resident to 15% of indigenous Australians comprising 3.4% of the population of Western Australia. Methods-Indigenous and non-indigenous stroke incidence and excess mortality rates were estimated from linked hospital and mortality data, with adjustment for nonadmitted events. Nonfatal burden was calculated from nonfatal incidence, duration (modeled from incidence, excess mortality, and remission), and disability weights. Stroke death counts formed the basis of fatal burden. Nonfatal and fatal burden were summed to obtain disability-adjusted life years, by indigenous status. Results-The total burden was 55 099 and 2134 disability-adjusted life years in non-indigenous and indigenous WesternAustralians, respectively. The indigenous to non-indigenous age-standardized stroke incidence rate ratio (Ն15 years) was 2.6 in males (95% CI, 2.3-3.0) and 3.0 (95% CI, 2.6 -3.5) in females, with similar rate ratios of disability-adjusted life years. The burden profile differed substantially between populations, with rate ratios being highest at younger ages. Conclusions-The differential between indigenous and non-indigenous stroke burden is considerable, highlighting the need for comprehensive intersectoral interventions to reduce indigenous stroke incidence and improve outcomes.

Underuse and overuse of anticoagulation for atrial fibrillation: A study in Indigenous and non-Indigenous Australians

“…It has been previously reported that Indigenous Australians face a disproportionate burden of stroke [9]. Data show that the ageadjusted incidence rate of stroke in Indigenous people is approximately three-times that of other Australians [9].…”

“…Data show that the ageadjusted incidence rate of stroke in Indigenous people is approximately three-times that of other Australians [9]. National hospitalisation rates for stroke are subsequently two-times greater and associated with a reduced quality of inpatient care and outcomes [9,10].…”

“…Data show that the ageadjusted incidence rate of stroke in Indigenous people is approximately three-times that of other Australians [9]. National hospitalisation rates for stroke are subsequently two-times greater and associated with a reduced quality of inpatient care and outcomes [9,10]. As a result, death attributable to stroke in Indigenous International Journal of Cardiology 191 (2015) 20-24 ☆ Statement of authorship: All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.…”

Communication disorders after stroke in Aboriginal Australians

“…They also have ongoing issues related to social isolation, lack of employment prospects, reduced ability to engage in everyday activities and significant family disruption [2]. While data are available on incidence, mortality and risk factors for stroke in Aboriginal Australians [3][4][5], relatively little information is available on functional consequences in this group. Exceptions to this lack of information include an article related to the stories of three Aboriginal men with aphasia after stroke [6].…”

Excess Risk of Stroke in Australia's Aboriginal and Torres Strait Islander Populations

“…However, given the paucity of reliable data in this area, these data provide the best available evidence and the disparities in stroke burden reported in this issue of Stroke are alarming enough. 3 The excess risk of stroke in Indigenous Australians originates from a number of different factors. 8 These factors include those originating from relative social, economic, and educational disadvantage, those associated with physiological factors such as from intergenerational changes, 9 as well as those arising from psychological factors.…”