NACCHO Aboriginal Health Heart Map : Our Indigenous Community Hurting in the Heart

Heart

“Aboriginal and Torres Strait Islander peoples are two-and-a-half times more likely to be admitted to hospital for heart events than non-Indigenous Australians.

For both sexes, Aboriginal and Torres Strait Islander peoples are more likely to have high blood pressure, be obese, smoke and a poor diet.

“Many of the hospital admissions for Aboriginal and Torres Strait Islander peoples are preventable and the Heart Foundation is committed to closing the gap in health outcomes for Aboriginal and Torres Strait Islander peoples.”

Heart Foundation National Chief Executive Officer Adjunct Professor John Kelly said these maps brought together for the first time a national picture of hospital admission rates for heart-related conditions at a national, state and regional level.

Or Download report and press release

Australian Heart Maps Report 2016

Australia’s Indigenous Community Hurting in the Heart

Aboriginal and Torres Strait Islander peoples are two-and-a-half times more likely to be admitted to hospital for heart events than non-Indigenous Australians.

Of all the four heart events (STEMI and NSTEMI, unstable angina and heart failure), admission rates for Aboriginal and Torres Strait Islander peoples is at least double that of non-Indigenous Australians.

“For all separations, Aboriginal and Torres Strait Islander peoples have a rate of 117.9 compared to non-Indigenous of 48.9,” Adj Prof John Kelly said.

“If Aboriginal and Torres Strait Islander peoples had the same rate of admissions, there would be 2300 fewer hospital admissions each year including close to 900 fewer admitted for a heart attack.

“For both sexes, Aboriginal and Torres Strait Islander peoples are more likely to have high blood pressure, be obese, smoke and a poor diet.

“Adding to the risk is they’re more likely to have comorbidities, which is having at least two or more conditions/illnesses such as heart disease, respiratory disease and kidney disease.

For almost every social indicator (education, income, housing security etc) Aboriginal and Torres Strait Islander peoples fare worse than their non-indigenous counterparts.

“These poorer social and economic conditions lead to higher rates of smoking, hypertension, and obesity for Aboriginal and Torres Strait Islander peoples.

“Yet, for historical, geographic and cultural reasons, primary healthcare services remain under-used by Aboriginal and Torres Strait Islander peoples.

“As a result, poorer health and lower quality of life becomes the “norm” until a critical event like a heart attack happens.

“Many of the hospital admissions for Aboriginal and Torres Strait Islander peoples are preventable and the Heart Foundation is committed to closing the gap in health outcomes for Aboriginal and Torres Strait Islander peoples.”

Mapping Out Australia’s Heart Health

MAP

 

View and Engage with Heart Map Here

New heart-related hospital admissions data mapped by the Heart Foundation reveals disturbing gaps between those living in the city and those in regional Australia.

A concerning trend among the hotspots was the correlation between access to services, particularly for those considered disadvantaged, and the rates of heart-related hospital admissions.

Heart Foundation has launched Australian Heart Maps, which is an online service highlighting how indicators for heart disease are distributed throughout Australia’s hospital network.

Queensland dominates the list of hotspots with 12 regions included in the top 20.

This compared to four from New South Wales, two from Northern Territory and one each from Western Australia and Victoria.

“This contrasts to areas with the lowest rates – particularly the northern suburbs of Sydney, where there is little disadvantage of the community.

“There is a five-fold difference of hospital admissions between Northern Territory Outback and the region with the lowest admission rates North Sydney & Hornsby, which highlights the association between remoteness, disadvantage and our heart health.

“The lowest rate we see in the northern suburbs of Sydney tells us what is possible, what we should be striving for across the country.”

Adj Prof Kelly added that the Heart Maps would serve as a valuable tool for health professionals, health services, local governments, researchers and policy makers to be used to set strategy, plan services and target prevention initiatives to areas of greatest need.

“What we need is a greater focus on prevention and management of heart disease in rural and remote Australia and in areas of disadvantage,” he said.

“For those with established heart disease, we want to work with health planners to ensure everyone has good access to co-ordinated cardiac services to reduce hospital readmissions and the development of further chronic disease.”

The Heart Foundation Heart Maps display hospital admission rates for two years of hospital separation data, with a separation defined as a completed episode of patient care in hospital resulting in discharge, death, transfer or change in type of care (ie: acute to rehabilitation).

The Heart Maps display separations for four key heart diagnosis – NSTEMI, STEMI, Unstable Angina and Heart Failure, with data for all heart-related admissions presented.

The data is shown on interactive online maps that drill down into each region looking at the number of hospital admissions as well as identify the risk factors for heart problems by high blood pressure, high cholesterol, obesity, smoking and physical inactivity.

Further Away You’re Closer to a Heart Related Hospital Visit

Living in a very remote area, you’re nearly twice as likely to need to visit a hospital for a heart event.

In figures available as part of the Heart Foundation Australian Heart Maps, the further a person lives from a major city the greater the rate of heart related hospitalisations.

Those living in major cities had an ASR of 47.1, with rates increasing for people living in regional areas (inner regional 53.1; outer regional 57.6; remote 62.2; very remote 92.5).

“If Australians in outer regional and beyond had the same hospital admissions rate as those in major cities, there would be more than 3400 avoidable hospital visits for a serious heart event each year,” Adj Prof John Kelly said.

“That would mean 1700 fewer admissions for a heart attack, which is more than four a day.

“The Heart Foundation urges regional service providers and State and local governments to use this information to ensure all Australians have access to preventative health care and facilities to reduce the risk factors.”

“Along with higher rates of smoking, obesity and physical inactivity, remote Australia experiences higher levels of disadvantage, has poorer access to health services and the conditions needed for health such as an environment that supports physical activity, access to affordable healthy food, access to education and secure employment.”

see report in full Australian Heart Maps Report 2016

About the Maps

The Heart Foundation’s Australian Heart Maps bring together for the first time a national picture of hospital admission rates for heart-related conditions at a national, state, regional and where possible, at a local government level.

The Heart Maps show how rates of heart related admissions compare across Australia. Importantly, the Heart Maps also highlight the association between socioeconomic disadvantage and remoteness with heart health outcomes.

The Heart Maps can act as a valuable tool for health professionals, health services, local governments, researchers and policy makers. The Heart Maps can be used to establish health related strategies, to plan for health services and to develop/implement targeted prevention initiatives. Specifically, the Heart Maps show:

  1. The rate of hospital admissions (per 10,000 people) for “All Heart Admissions” at a Local Government level. Local Governments can be compared against the national average and are ranked from highest to lowest admission rate across Australia.
  2. The rate of admissions (per 10,000 people) for “All Heart Admissions”, Heart Attack (both STEMI and Non-STEMI), Heart Failure, and Unstable angina for states/territories and SA4 regions.
  3. Australian Health Survey data (2011/12) for the prevalence of smoking, obesity, insufficient physical activity, hypertension and total high cholesterol for states/territories and SA4 regions.

The Heart Maps provide a national context for the more detailed state level maps available for Victoria and South Australia.

About the Data

Two years of hospital separation data (2012/13 and 2013/14) is presented in the Heart Maps. The separation (admission) data excludes admissions where a patient has been transferred from another hospital.

The admission data was accessed from State and Territory Health departments via the Australian Institute of Health and Welfare (AIHW). Suppression rules have been applied to the Heart Maps, in accordance with the State and Territory Conditions of Data Release. That is, admission rates are suppressed for any population smaller than 1,000 or where there are fewer than five admissions.

A full technical report describing the data and analysis is now available.

Acknowledgments

The Heart Foundation would like to acknowledge the following organisations:

  • The Australian Institute of Health and Welfare (AIHW): in seeking clearance from the State/Territory Data custodians and for undertaking the preliminary data analysis.
  • State/Territory Health departments: for providing initial feedback and recommendations relating to the project.
  • Statistical Consultant and Epidemiologist, Stephen Vander Hoorn: for undertaking comprehensive statistical analysis and for developing the online mapping tool.

 

   

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