Article

Sociodemographic differences in prevalence of diagnosed coronary heart disease in New Zealand estimated from linked national health records.

Section of Epidemiology and Biostatistics, School of Population Health, Tamaki Campus, University of Auckland, Private Bag 92019, Auckland, New Zealand.
The New Zealand medical journal 01/2011; 124(1334):21-34.
Source: PubMed

ABSTRACT To estimate sociodemographic differences in the prevalence of coronary heart disease (CHD) in New Zealand from linked health records.
We combined records of hospital treatment for CHD, dispensing of selected anti-anginal drugs and mortality to estimate the national point prevalence of coronary heart disease in New Zealand in December 2008. Stratified estimates are presented by gender; age; Māori, Pacific, Indian and 'Other' (mainly New Zealand European) ethnic groups; and socioeconomic status.
Among a "health contact" population of adults (greater than and equal to 15 years), about one in twenty (6.5% of men and 4.1% of women) had indicators of a past diagnosis or treatment for CHD or both. Substantial differences in prevalence occurred by gender, ethnic group and socioeconomic status. For example, among New Zealanders aged 35 to 74 years, Indian men had the highest age-adjusted prevalence (7.78%; 95%CI 7.43 to 8.15), almost double the prevalence of 'Other' males. Among women, Māori had the highest adjusted prevalence (4.03%; 95% CI 3.89 to 4.17), just over twice that of 'Others.'
Major sociodemographic disparities in the national burden of CHD persist. Our results are similar to previous studies of ethnic disparities in CHD incidence, but also confirm concerns about the emerging CHD burden among South Asians. Indian males have the highest CHD prevalence of any gender-specific ethnic group. Of equal concern, Māori women have a similar prevalence to European males.

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    ABSTRACT: The aim of this paper was to see whether all-cause and cause-specific mortality rates vary between Asian ethnic subgroups, and whether overseas born Asian subgroup mortality rate ratios varied by nativity and duration of residence. We used hierarchical Bayesian methods to allow for sparse data in the analysis of linked census-mortality data for 25–75 year old New Zealanders. We found directly standardised posterior all-cause and cardiovascular mortality rates were highest for the Indian ethnic group, significantly so when compared with those of Chinese ethnicity. In contrast, cancer mortality rates were lowest for ethnic Indians. Asian overseas born subgroups have about 70% of the mortality rate of their New Zealand born Asian counterparts, a result that showed little variation by Asian subgroup or cause of death. Within the overseas born population, all-cause mortality rates for migrants living 0–9 years in New Zealand were about 60% of the mortality rate of those living more than 25 years in New Zealand regardless of ethnicity. The corresponding figure for cardiovascular mortality rates was 50%. However, while Chinese cancer mortality rates increased with duration of residence, Indian and Other Asian cancer mortality rates did not. Future research on the mechanisms of worsening of health with increased time spent in the host country is required to improve the understanding of the process, and would assist the policy-makers and health planners. Copyright: ß 2014 Jatrana et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: The authors confirm that, for approved reasons, some access restrictions apply to the data underlying the findings. The data used in this study is held by Statistics New Zealand under conditions designed to give effect to the security and confidentiality provisions of the Statistics Act 1975. Researchers interested in obtaining the data can view Statistics New Zealand's microdata access policy at http://www.stats.govt.nz/tools_and_services/microdata-access.aspx or by emailing access2microdata@stats.govt.nz. Funding: This study was funded by a University of Otago Research Grant (ORG 0111-0312) and used data from the New Zealand Census-Mortality Study (NZCMS). The NZCMS was initially funded by the Health Research Council of New Zealand, and receives on-going funding from the New Zealand Ministry of Health. The New Zealand Population Health Charitable Trust provided Saira Dayal with financial assistance as a public health medicine registrar. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.
    PLoS ONE 08/2014; 9(8). · 3.53 Impact Factor

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