. At the heart of health promotion: Australian About the Heart Maps Foundation & Health Promotion Policy & Advocacy Rachelle Foreman
I would like to pay my respects to the Traditional Owners of the land on which we are meeting today. I would also like to pay my respects to the Elders past and present.
. Unlocking hidden inequities in cardiovascular disease About the Heart Foundation Mapping heart-related hospitalisations across Australia
The problem? A growing cardiovascular equity gap Disparate heart disease data sources Data not standardised or engaging Little local level data
The Australian Heart Maps https://heartfoundation.org.au/for-professionals/australianheart-maps Hospital separation data - National Hospital Morbidity Database 2012-14 o NSTEMI o STEMI o Unstable Angina o Heart Failure Risk factor data from the Australian Health Survey 2011-13. ABS Geographies (ASGC) ABS Census 2011
The Australian Heart Maps
The Australian Heart Maps
CLINICAL RISK FACTORS KEY FINDINGS
SEPARATIONS INDIGENOUS STATUS STATUS STANDARDISED RATE/10,000 POPULATION Indigenous (all separations) 117.9 Non-Indigenous (all separations) 48.9 Indigenous (STEMI) 32.7 Non-Indigenous (STEMI) 12.5 Indigenous (NSTEMI) 8.9 Non-Indigenous (NSTEMI) 4.2 Indigenous (Heart Failure) 51.0 Non-Indigenous (Heart Failure) 22.3 Indigenous (Unstable Angina) 25.4 Non-Indigenous (Unstable Angina) 9.9
ALL SEPARATIONS COUNTRY OF BIRTH COUNTRY OF BIRTH STANDARDISED RATE/10,000 POPULATION NORTH AFRICA AND THE MIDDLE EAST 75.4 SOUTHERN AND EASTERN EUROPE 54.4 OCEANIA 51.7 SOUTHERN AND CENTRAL ASIA 51.5 NORTH-WEST EUROPE 40.6 AMERICAS 37.7 SUB-SAHARAN AFRICA 36.3 SOUTH-EAST ASIA 27.2 NORTH-EAST ASIA 18.9
ALL SEPARATIONS SEIFA SEIFA STANDARDISED RATE/10,000 POPULATION 1 (lowest) 66.2 2 54.9 3 47.8 4 44.0 5 (highest) 36.1
ALL SEPARATIONS REMOTENESS REMOTENESS STANDARDISED RATE/10,000 POPULATION Major Cities 47.1 Inner Regional 53.1 Outer Regional 57.6 Remote 62.2 Very Remote 92.5
RISK FACTOR CORRELATIONS ALL HEART SEPARATIONS Positive correlation between all heart related admissions and: Obesity, Smoking, Physical inactivity. Relationship strong with unstable angina and NSTEMI admissions. Relationship with hypertension and high total cholesterol indifferent
RISK FACTOR CORRELATIONS ALL HEART SEPARATIONS Positive correlation between all heart related admissions and: Obesity, Smoking, Physical inactivity. Relationship strong with unstable angina and NSTEMI admissions. Relationship with hypertension and high total cholesterol indifferent
ALL SEPARATIONS STATE/TERRITORY RANK STATE STANDARDISED RATE/10,000 POPULATION 1 NT 87.4 2 QLD 61.8 3 SA 49.7 =4 ACT* 47.8 =4 TAS* 47.8 6 VIC 47.5 7 WA 46.9 8 NSW 45.8 *Due to data suppression, rates for ACT and TAs can not be presented separately
ALL SEPARATIONS WORST 20 NATIONALLY REGION ASR ALL HEART SEP % OBESE % SMOKE % INSUFFICIENTLY ACTIVE 702 Northern Territory - Outback 161.0 28.9 28.6 60.5 315 Queensland - Outback 100.9 43.7 25.6 35.7 701 Darwin 79.0 26.8 24.0 63.5 310 Ipswich 77.4 38.9 21.2 68.9 319 Wide Bay 75.6 28.5 18.8 72.5 312 Mackay 73.8 41.0 25.9 65.1 311 Logan - Beaudesert 71.0 35.0 24.2 66.2 113 Riverina 69.9 33.2 14.9 81.2 313 Moreton Bay - North 69.8 33.2 26.3 50.9 508 Western Australia - Outback 66.0 32.4 26.2 72.4 308 Fitzroy 65.8 39.0 24.4 64.2 318 Townsville 65.0 36.3 22.8 61.5 105 Far West and Orana (remote) 64.9 35.7 18.4 64.5 307 Darling Downs - Maranoa 63.2 44.2 22.3 74.5 306 Cairns 63.2 30.5 27.1 75.6 302 Brisbane - North 61.9 28.6 17.3 60.3 116 Sydney - Blacktown 60.3 28.8 18.5 60.1 317 Toowoomba 59.4 35.6 21.3 66.0 216 Shepparton 59.0 36.1 25.7 77.1
Future updates Biannual hospitalisation rates CHD mortality rates Update to 2014-2015 risk factor data LGA risk factor estimates Service level data Community Heart snapshots
Australian heart disease statistics physical activity and cardiovascular disease More adults reported being highly active and fewer reported low levels of activity in the 2011-12 National Health Survey than in the previous health surveys since 1995. A large majority of adults (~71%) did at least some active transport in the week prior to interview. Two-thirds of Australian adults engaged in four or more hours of sedentary behaviour daily. The prevalence of biomarkers for heart disease was lower among people who met physical activity recommendations than those who did not. Peterson K, Herbert J, Allender S, Nichols M. Australian heart disease statistics. Physical activity and cardiovascular disease. Melbourne: National Heart Foundation of Australia, 2016.
What are we asking for? National heart & stroke strategy robust rural, remote focus Fund prevention measures that target high risk groups Uptake of absolute risk assessment, esp in high risk areas A national audit of cardiac rehabilitation services Better data on time-to-treatment for people
. Heart Foundation state budget submission 2017-2018 About the Heart Foundation Five actions to beat heart disease
Action 2: Eliminate RHD
Action 4: Prevention
Action 4: Low cost policy & legislation Smoking reforms Food reforms Planning and transport reforms
Action 5: Active travel
Questions? Rachelle Foreman Health Director Heart Foundation Rachelle.Foreman@heartfoundation.org.au Tel 07 3872 2500