Socioeconomic correlates of mortality and hospital morbidity differentials by Local Government Area in Sydney 1985-1988 (original) (raw)
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Socio-economic mortality differentials in Sydney over a quarter of a century, 1970-94
Australian and New Zealand Journal of Public Health, 2002
Objective: To examine trends in socioeconomic differentials in all-cause mortality in Sydney over a 25-year period (1970-94). Methods: Five measures of single indicators (two for occupation, two for education and one for income) and a composite measure of socioeconomic disadvantage based on Census data (the Australian Bureau of Statistics' Index of Relative SocioEconomic Disadvantage) were used as indicators of socioeconomic status by local government area. The relationship between mortality and socioeconomic status was examined using quintiles based on these six measures of socioeconomic status. Results: Socioeconomic differentials in mortality were evident for males and females for all periods, and over the 25-year period the relative socioeconomic differentials did not decline. For males, the socioeconomic status differential in mortality widened, irrespective of socioeconomic status indicator used, whereas for females it widened only when certain socioeconomic indicators were used: occupation (unemployment measure) and income, but was not significant for the other single indicators or for the composite indicator. Conclusions: Sydney trends of widening inequalities are generally similar to those reported for Britain and for other industrialised countries, suggesting that this is a common phenomenon and that policies to reduce health inequalities over the past quarter of a century have not been effective.
Socioeconomic Status and Mortality: A Brisbane Area Analysis
Community Health Studies, 1987
For the purposes of an area analysis of social class and mortality (from 1976 to 1979) Brisbane City was partitioned into five strata with roughly equal populations ranked on the basis of a socioeconomic s u b u r b score derived f r o m aggregate census data. Deaths by sutiurb, age, sex a n d cause were available f r o m a n n u a l computerised mortality files and population age and sex distributions were computed from census statistics and inter-censal estimates. Mortality rates were found to be higher in lower-ranking strata overall, and for circulatory, exti:rnal (such as accidental) and respiratory causes but not for neoplasms o t h e r t h a n l u n g cdncer. T h e implications of these results are discLssed.
Socioeconomic status and mortality revisited: an extension of the Brisbane area analysis
Australian journal of public health, 1992
Using the methodology of an earlier study of socioeconomic mortality gradients, we partitioned Brisbane City into five strata of equal size on the basis of suburb scores derived from aggregate socioeconomic census data. Numbers of deaths by stratum, age, sex and cause were obtained from mortality files. For almost all causes, mortality gradients had not changed between 1976-1979 and 1980-1987. A new category, medically-preventable death under age 65, had lower rates in higher-ranking suburbs. Potential years of life lost (PYLL) per unit of population, age-standardised, were also computed by stratum and cause. External causes of death were the main contributors to PYLL among men, with a strong socioeconomic gradient, while neoplasms were most important among women, with little evidence of a social class effect. It is estimated that, in urban Australia, the annual number of additional deaths under age 65 due to socioeconomic circumstances is over 2000 for males and over 1000 for femal...
Health inequity in the Northern Territory, Australia
International Journal for Equity in Health, 2013
Introduction: Understanding health inequity is necessary for addressing the disparities in health outcomes in many populations, including the health gap between Indigenous and non-Indigenous Australians. This report investigates the links between Indigenous health outcomes and socioeconomic disadvantage in the Northern Territory of Australia (NT). Methods: Data sources include deaths, public hospital admissions between 2005 and 2007, and SocioEconomic Indexes for Areas from the 2006 Census. Age-sex standardisation, standardised rate ratio, concentration index and Poisson regression model are used for statistical analysis. Results: There was a strong inverse association between socioeconomic status (SES) and both mortality and morbidity rates. Mortality and morbidity rates in the low SES group were approximately twice those in the medium SES group, which were, in turn, 50% higher than those in the high SES group. The gradient was present for most disease categories for both deaths and hospital admissions. Residents in remote and very remote areas experienced higher mortality and hospital morbidity than non-remote areas. Approximately 25-30% of the NT Indigenous health disparity may be explained by socioeconomic disadvantage. Conclusions: Socioeconomic disadvantage is a shared common denominator for the main causes of deaths and principal diagnoses of hospitalisations for the NT population. Closing the gap in health outcomes between Indigenous and non-Indigenous populations will require improving the socioeconomic conditions of Indigenous Australians.
Socioeconomic Position and Premature Mortality in the AusDiab Cohort of Australian Adults
American journal of public health, 2016
To determine the association of socioeconomic position indicators with mortality, without and with adjustment for modifiable risk factors. We examined the relationships of 2 area-based indices and educational level with mortality among 9338 people (including 8094 younger than 70 years at baseline) of the Australian Diabetes Obesity and Lifestyle (AusDiab) from 1999-2000 until November 30, 2012. Age- and gender-adjusted premature mortality (death before age 70 years) was more likely among those living in the most disadvantaged areas versus least disadvantaged (hazard ratio [HR] = 1.48; 95% confidence interval [CI] = 1.08, 2.01), living in inner regional versus major urban areas (HR = 1.36; 95% CI = 1.07, 1.73), or having the lowest educational level versus the highest (HR = 1.64; 95% CI = 1.17, 2.30). The contribution of modifiable risk factors (smoking status, diet quality, physical activity, stress, cardiovascular risk factors) in the relationship between 1 area-based index or educ...
BMC Public Health, 2011
Background: The estimated life expectancy at birth for Indigenous Australians is 10-11 years less than the general Australian population. The mean family income for Indigenous people is also significantly lower than for non-Indigenous people. In this paper we examine poverty or socioeconomic disadvantage as an explanation for the Indigenous health gap in hospital morbidity in Australia. Methods: We utilised a cross-sectional and ecological design using the Northern Territory public hospitalisation data from 1 July 2004 to 30 June 2008 and socioeconomic indexes for areas (SEIFA) from the 2006 census. Multilevel logistic regression models were used to estimate odds ratios and confidence intervals. Both total and potentially avoidable hospitalisations were investigated. Results: This study indicated that lifting SEIFA scores for family income and education/occupation by two quintile categories for low socioeconomic Indigenous groups was sufficient to overcome the excess hospital utilisation among the Indigenous population compared with the non-Indigenous population. The results support a reframing of the Indigenous health gap as being a consequence of poverty and not simplistically of ethnicity. Conclusions: Socioeconomic disadvantage is a likely explanation for a substantial proportion of the hospital morbidity gap between Indigenous and non-Indigenous populations. Efforts to improve Indigenous health outcomes should recognise poverty as an underlying determinant of the health gap.
Explaining health inequalities in Australia: the contribution of income, wealth and employment
Australian Journal of Primary Health
Background Studies show widespread widening of socioeconomic and health inequalities. Comprehensive primary health care has a focus on equity and to enact this requires more data on drivers of the increase in inequities. Hence, we examined trends in the distribution of income, wealth, employment and health in Australia. Methods We analysed data from the Public Health Information Development Unit and Australian Bureau of Statistics. Inequalities were assessed using rate ratios and the slope index of inequality. Results We found that the social gradient in health, income, wealth and labour force participation has steepened in Australia, and inequalities widened between the quintile living in the most disadvantaged areas and the quintile living in the least disadvantaged areas. Conclusion Widening income, wealth and employment inequalities have been accompanied by increasing health inequalities, and have reinforced and amplified adverse health effects, leading to increased mortality in...