Burden of Cardiovascular Diseases Among Aboriginal and Torres Strait Islander Peoples: Mortality, Hospitalization and Risk Factors

Abstract:

Aboriginal and Torres Strait Islander peoples (referred to as Indigenous Australians) comprise about 2.4% of the Australian population, yet they are overrepresented in all markers of health and social disadvantage. This pattern is reflected in national data that exists describing the burden and outcomes of cardiovascular disease. Available information, obtained from quasi-national statistics because of suboptimal accuracy of ethnic status across several States and Territories, demonstrate that Indigenous Australians are more likely to die from coronary heart disease, stroke and other cardiovascular conditions; are more likely to be hospitalized; and suffer greater adverse outcomes than their non-Indigenous counterparts.

The reasons for these adverse patterns are likely to be multi-factorial, complex and inter-related. When compared to the non-Indigenous population Indigenous Australians more often live in rural and remote regions (isolated from necessary services); have lower educational attainment and lower income; are more likely to be unemployed; more frequently experience adverse life events and illness throughout the life-course, particularly in childhood; are more likely to exhibit all documented risk factors for cardiovascular conditions; and are less likely to receive evidence-based care.

As is the case among non-Indigenous Australians and throughout high income countries across the world, CVDs are the most common causes of death in the Indigenous population. However, the rate experienced by Indigenous Australians far exceeds that of non-Indigenous Australians. Age-standardized rates of death from CVDs are 2.8-fold that of non-Indigenous males and 2.4-fold that of non-Indigenous females, and hospitalizations for CVDs are 1.4-fold greater than for non-Indigenous Australians. Most concerning, these disparities are greatest among younger individuals.

CVDs are common among Indigenous Australians, and occur considerably more often and at a younger age than in non-Indigenous Australians. They are also the main contributor to the profound life-expectancy gap between Indigenous and non-Indigenous populations. Adopting targeted national, state and local strategic action is urgently required to reduce the incidence of vascular diseases in these groups and reduce the documented life expectancy gap.