Details of Publication 695 for Project A315:

McLaughlin D, Hockey R & Mishra G. Heart disease in women in remote Australia: urban-rural differences after adjusting for lifestyle behaviours and socio-demographic factors. Australian and New Zealand Journal of Public Health, 2013; 37(1): 90

Background: Rural-urban differences in the prevalence of a number of chronic conditions have been identified, with rural residents more likely to have higher morbidity than their urban counterparts. However, differences are not always consistent and variations may exist in particular diseases. The aim of this study was to compare differences in selected chronic conditions in urban, inner regional, outer regional and remote dwelling mid-aged Australian women, and to consider the impact of known socio-demographic and lifestyle factors. Methods: Longitudinal analysis of data from a prospective cohort study. Participants were a community-based random sample of women (n=13,715) aged 45 to 50 years when recruited in 1996. Measures used were: area of residence in Australian States and Territories, chronic conditions, BMI, smoking, physical activity, alcohol consumption and socio-demographic characteristics.Results: Women living in inner regional (OR 1.24, 95%CI 1.05-1.47) and remote/very remote (OR 1.74, 95%CI 1.24-2.44) areas were more likely to report heart disease than women in urban areas after adjusting for survey and age. These differences remained for women in remote/very remote areas after further adjusting for demographic factors alone (OR 1.73, 95%CI 1.23-2.44), demographics and BMI (OR 1.66, 95%CI 1.17-2.34) and demographics, BMI, smoking, alcohol and exercise (OR 1.63, 95%CI 1.16-2.31).Conclusions: Our results indicate that differences in heart disease between urban and remote women are not driven by socio-demographic factors nor are they generally related to poor lifestyle behaviours. These findings suggest that any subsequent discrepancy in mortality between women living in urban and remote areas is most likely the result of differences in access to health services and available treatments.