Quantifying the role of modifiable risk factors in the differences in cardiovascular disease mortality rates between metropolitan and rural populations in Australia: a macrosimulation modelling study

Alston, Laura; Peterson, Karen L.; Jacobs, Jane; Allender, Steven; Nichols, Melanie

doi:10.1136/bmjopen-2017-018307

Cited by 36 publications

(50 citation statements)

References 20 publications

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“…Those living outside of major cities also have higher proportions of CVD risk factors, such as obesity, smoking, high‐risk alcohol use and inadequate physical activity, 2,37 with a national study finding that 38.2% of the gap in IHD death rates between urban and rural populations could be attributed to differences in modifiable risk factors 49 . However, it is difficult to attribute these differential risk factor profiles to remoteness alone, as many of the same factors are associated with socioeconomic disadvantage 10…”

Section: Discussionmentioning

confidence: 99%

Regional variation in cardiovascular mortality in Australia 2009–2012: the impact of remoteness and socioeconomic status

Jacobs

Peterson

Allender

et al. 2018

Australian and New Zealand Journal of Public Health

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Socioeconomic status explained a substantial proportion of the association between where a person resides and CVD mortality rates; however, remoteness has an effect above and beyond SES for a number of subpopulations. Implications for public health: This study highlights the need to focus on both socioeconomic disadvantage and accessibility to reduce CVD mortality in regional and remote Australia.

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Section: Discussionmentioning

confidence: 99%

Regional variation in cardiovascular mortality in Australia 2009–2012: the impact of remoteness and socioeconomic status

Jacobs

Peterson

Allender

et al. 2018

Australian and New Zealand Journal of Public Health

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“…There is a known higher prevalence of risk factors, such as rates of alcohol consumption and obesity in rural Australia [24]. Alston and colleagues have reported that one-third of the excess CVD deaths in rural residents were due to risk factors, and that approximately 1461 deaths from CVD could be delayed annually, reducing the rural-urban mortality gap by 38.2% if rural Australian residents had the same levels of risk factors as those in metropolitan areas [25].…”

Section: Preventionmentioning

confidence: 99%

Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

Thompson

Nedkoff

Katzenellenbogen

et al. 2019

IJERPH

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This narrative review explores relevant literature that is related to the challenges in implementing evidence-based management for clinicians in rural and remote areas, while primarily focussing on management of acute coronary syndrome (ACS) and follow up care. A targeted literature search around rural/urban differences in the management of ACS, cardiovascular disease, and cardiac rehabilitation identified multiple issues that are related to access, including the ability to pay, transport and geographic distances, delays in patients seeking care, access to diagnostic testing, and timely treatment in an appropriate facility. Workforce shortages or lack of ready access to relevant expertise, cultural differences, and complexity that arises from comorbidities and from geographical isolation amplified diagnostic challenges. Given the urgency in management of ACS, rural clinicians must act quickly to achieve optimal patient outcomes. New technologies and quality improvement approaches enable better access to rapid diagnosis, as well as specialist input and care. Achieving an uptake of cardiac rehabilitation in rural and remote settings poses challenges that may reduce with the use of alternative models to centre-based rehabilitation and use of modern technologies. Expediting improvement in cardiovascular outcomes and reducing rural disparities requires system changes and that clinicians embrace attention to prevention, emergency management, and follow up care in rural contexts.

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“…Globally, these rural inequalities have been associated with poorer access to health care, geographical isolation, lower incomes, reduced access to healthy foods, and differences in modifiable behavioural risk factors such as smoking 3-6 . A recent Australian study found that if rural Australians could achieve the same levels of dietary intake, smoking cessation, alcohol intake and physical activity as their metropolitan counterparts, the rural–metropolitan disparity in ischaemic heart disease mortality would decrease by 38% 7 . About 7 million Australians live in rural, regional and remote areas, as defined by the Australian Statistical Geography Standard (ASGS), with evidence of poor diet and increased disease burden 8,9…”

Section: Chapter 1 Retail Initiatives To Improve the Healthiness Of Fmentioning

confidence: 99%

Beyond the black stump: rapid reviews of health research issues affecting regional, rural and remote Australia

Osborne¹,

Piper²,

Alston³

et al. 2020

Medical Journal of Australia

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Chapter 1: Retail initiatives to improve the healthiness of food environments in rural, regional and remote communities Objective: To synthesise the evidence for effectiveness of initiatives aimed at improving food retail environments and consumer dietary behaviour in rural, regional and remote populations in Australia and comparable countries, and to discuss the implications for future food environment initiatives for rural, regional and remote areas of Australia. Study design: Rapid review of articles published between January 2000 and May 2020. Data sources: We searched MEDLINE (EBSCOhost), Health and Society Database (Informit) and Rural and Remote Health Database (Informit), and included studies undertaken in rural food environment settings in Australia and other countries. Data synthesis: Twenty‐one articles met the inclusion criteria, including five conducted in Australia. Four of the Australian studies were conducted in very remote populations and in grocery stores, and one was conducted in regional Australia. All of the overseas studies were conducted in rural North America. All of them revealed a positive influence on food environment or consumer behaviour, and all were conducted in disadvantaged, rural communities. Positive outcomes were consistently revealed by studies of initiatives that focused on promotion and awareness of healthy foods and included co‐design to generate community ownership and branding. Conclusion: Initiatives aimed at improving rural food retail environments were effective and, when implemented in different rural settings, may encourage improvements in population diets. The paucity of studies over the past 20 years in Australia shows a need for more research into effective food retail environment initiatives, modelled on examples from overseas, with studies needed across all levels of remoteness in Australia. Several retail initiatives that were undertaken in rural North America could be replicated in rural Australia and could underpin future research. Chapter 2: Which interventions best support the health and wellbeing needs of rural populations experiencing natural disasters? Objective: To explore and evaluate health and social care interventions delivered to rural and remote communities experiencing natural disasters in Australia and other high income countries. Study design: We used systematic rapid review methods. First we identified a test set of citations and generated a frequency table of Medical Subject Headings (MeSH) to index articles. Then we used combinations of MeSH terms and keywords to search the MEDLINE (Ovid) database, and screened the titles and abstracts of the retrieved references. Data sources: We identified 1438 articles via database searches, and a further 62 articles via hand searching of key journals and reference lists. We also found four relevant grey literature resources. After removing duplicates and undertaking two stages of screening, we included 28 studies in a synthesis of qualitative evidence. Data synthesis: Four of us read and assesse...

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Quantifying the role of modifiable risk factors in the differences in cardiovascular disease mortality rates between metropolitan and rural populations in Australia: a macrosimulation modelling study

Cited by 36 publications

References 20 publications

Regional variation in cardiovascular mortality in Australia 2009–2012: the impact of remoteness and socioeconomic status

Regional variation in cardiovascular mortality in Australia 2009–2012: the impact of remoteness and socioeconomic status

Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

Beyond the black stump: rapid reviews of health research issues affecting regional, rural and remote Australia

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