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

Jane Jacobs, Karen Louise Peterson, Steven Allender, Laura Veronica Alston, Melanie Nichols

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Objective: To assess the extent to which socioeconomic status (SES) contributes to geographic disparity in cardiovascular disease (CVD) mortality. Methods: An ecological study assessed the association between remoteness and CVD mortality rates, and the mediating effect of SES on this relationship, using Australia-wide data from 2009 to 2012. Results: Socioeconomic status explained approximately one-quarter of the increased CVD mortality rates for females in inner and outer regional areas, and more than half of the increased CVD mortality rates in inner regional and remote/very remote areas for males, compared to major cities. After allowing for the mediating effect of SES, females living in inner regional areas and males living in remote/very remote areas had the greatest CVD mortality rates (Mortality Rate Ratio: 1.12, 95%CI 1.07–1.17; MRR: 1.15, 95%CI 1.05–1.25, respectively) compared to those in major cities. Conclusion: 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.

Original languageEnglish
Pages (from-to)467-473
Number of pages7
JournalAustralian and New Zealand Journal of Public Health
Issue number5
Publication statusPublished or Issued - Oct 2018
Externally publishedYes


  • cardiovascular disease
  • epidemiology
  • health inequalities
  • rural health
  • socioeconomic status

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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