Differences and Comparative Declines in Ischaemic Heart Disease Mortality Among Subpopulations in Australia, 1969–1978

Gibberd R W (Faculty of Mathematics, University of Newcastle, NSW, 2308, Australia), Dobson A J, Florey C duVe and Leeder S R. Differences and comparative declines in ischaemic heart disease mortality among subpopulations in Australia, 1969–1978. International Journal of Epidemiology 1984, 13: 25–31. Mortality rates from ischaemic heart disease (IHD) in Australia for the period 1969–78 have been analysed by place of residence, occupation and country of birth. Large variations were found among subpopulations. Throughout the period IHD mortality was lowest among professional and farming occupations and highest among workers in mining, transport and communications. Geographically, mortality from IHD was highest on the east coast and lowest in Western Australia. Mortality among immigrants was lower than among people born in Australia, with death rates for those born in Greece, Italy and Yugoslavia about half the average rates. Mortality from IHD in Australia has declined by about 25% over the last decade. However, the decline has not occurred uniformly. By occupation, the professional, technical and related workers showed the largest decline, while administrative, executive and managerial workers experienced the smallest decline. By place of residence in Australia, the largest declines occurred in the Hunter and Geelong regions, although the Hunter region still has the highest rate. Western Australia, excluding Perth, and rural Victoria did not show any marked decline. The remaining regions particularly the capital cities all experienced similar declines. When analysed by country of birth, Australian born residents showed a greater decline, while men born in Greece and Italy may have had an increase in IHD mortality. There is every indication that the decline will continue. Even those subpopulations with low initial IHD mortality experienced the decline, thus Perth and Adelaide (with low rates) had similar declines to Brisbane and Sydney (with high rates) and the professional occupation group which had the lowest rate also experienced the greatest decline. If it is possible for those subpopulations with high mortality eventually to achieve rates comparable to those subpopulations with low rates, then a further decline of 10–20% in IHD mortality can be expected to occur.