Premature deaths were classified by ICD-9 up to 1998 and by ICD-10 from 1999 onwards. Data are reported by year of death. Rates were age-adjusted using the standard Australian population as a 30 June 2001. A Poisson regression model was fitted to assess differences in the slope of the trend lines.
Source:
ABS mortality data, ABS population estimates and ABS Socio Economic Indices for Areas (HOIST). Centre for Epidemiology and Research, NSW Health
There is strong evidence internationally that people with lower socioeconomic status (SES) die at a younger age than those in higher SES groups (WHO 2000). In Australia, death rates for males and females aged up to 64 years increased consistently with decreasing SES in both the 1985-1987 and 1995-1997 periods, however rates decreased overall for all SES groups between these periods (Turrell et al., 2000). Higher mortality and morbidity in lower SES groups is principally accounted for by higher rates of cardiovascular disease (particularly coronary heart disease), cancer (particularly lung cancer), and injuries (particularly from motor vehicle crashes, suicide, and occupational injuries) (Taylor, 2001).
In NSW, between 1980 and 2000, death rates before the age of 75 years,fell across all socioeconomic groups for both males and females. For males, death rates fell by 53% in the highest SES group (least disadvantaged 20%), by 44% in the lowest group (most disadvantaged 20%) and by 41% in the rest (middle 60%) of the population. For females, rates fell by 45% in the highest SES group, by 36% in the lowest SES group and by 35% in the rest of the population.
In absolute terms, the gap between the highest and lowest SES groups in NSW narrowed in males between 1980 and 2000, with the difference in death rates decreasing from 156 to 140 per 100,000, however, it increased slightly from 67 to 68 per 100,000 in females. In relative terms, the gap actually increased. In the period between 1980 and 2000 the relative difference in rates between the lowest and highest SES groups for males increased from 30% higher in the lowest SES group at the beginning of the period, to 52% higher in 2000. This relative increase in the gap between the highest and lowest SES groups over the twenty-year period was highly significant (p< 0.0001). For females, in 1980, the death rates were 24% higher in the lowest compared with highest SES groups and 32% higher in 2000. This relative increase in the gap between lowest and highest SES groups over 20 years for females was moderately significant (p< 0.05).
The gap between the rest of the population and the highest SES group increased in both absolute and relative terms for both males and females between 1980 and 2000. In relative terms, the death rate in the rest of the population increased from 20% higher to 48% higher in males and from 18% higher to 30% higher in females. This relative increase was highly significant (p < 0.0001). In contrast, the absolute difference in mortality rates of the lowest SES group and the rest of the population decreased for both males and females between 1980 to 2000, and the relative gap also decreased significantly for males.
The results overall show that there have been reductions across all SES groups in premature death rates between 1980 and 2000, however the rate of reduction has been higher in the highest SES group compared to both the lowest SES group and the rest of the population. The premature mortality gap between the highest SES group and the lowest and rest (middle 60%)of the population is widening and that between the lowest SES group and the rest of the population is narrowing.
The data for Hunter New England for the period 1994 to 2003 indicate that a similar pattern exists for both males and females with people from the lowest socioeconomic status quintile consistently having worse premature death rates (among the population aged less than 75 years) compared with those from the higher socioeconomic status group.
For more information:
World Health Organization. The World Health Report 2000. Health Systems: Improving Performance. Geneva: WHO, 2000.
Turrell G and Mathers CD. Socioeconomic inequalities in all-cause mortality in Australia: 1985-97 and 1995-97. Int J Epidemiol 2000b; 29: 231-239.
Taylor R. Mediation of the effects of social and economic status on health and mortality: the roles of behaviour and constitution. In The social origins of health and well-being. Eckersley R, Dixon J, Douglas B Editors. Cambridge: Cambridge University Press, 2002.
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Rider:
The information presented in this report result from analyses of a variety of social and health focused datasets. These datasets originate from a variety of sources including Hunter New England Health, the NSW Department of Health, and the Australian Bureau of Statistics. The timing of the release of these data to third parties is controlled by the owner of these data. It is therefore possible for these organisations to publish data that they have not yet made available to Hunter New England Population Health for analysis and release. Users should therefore check the publications of these organisations as it is possible that they may have published even more up to date information on Hunter New England than those available in this report. As this report is an ongoing project, the indicators presented will be updated as soon as possible after the release of all datasets to Hunter New England Population Health.
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in whole or in part, subject to the inclusion of an acknowledgement of the source. Commercial usage or sale is prohibited.
Hunter New England Population Health. Health in Hunter New England. Hunter New England Area Health Service, 2005. Available at:
http://www.hnehealth.nsw.gov.au/HHNE/ses/ses_dthlomidhi.htm. Accessed (insert date of access).
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