Burden of Stroke in Indigenous Western Australians: A Study Using Data Linkage

Background and Purpose: Despite the disproportionate burden of cardiovascular disease among indigenous Australians, information on stroke is sparse. This article documents the incidence and burden of stroke (in disability-adjusted life years) in indigenous and non-indigenous people in Western Austra...

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Main Authors: Katzenellenbogen, Judith, Vos, T., Somerford, Peter, Begg, S., Semmens, James, Codde, James
Format: Journal Article
Published: Lippincott, Williams and Wilkins 2011
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/14073
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author Katzenellenbogen, Judith
Vos, T.
Somerford, Peter
Begg, S.
Semmens, James
Codde, James
author_facet Katzenellenbogen, Judith
Vos, T.
Somerford, Peter
Begg, S.
Semmens, James
Codde, James
author_sort Katzenellenbogen, Judith
building Curtin Institutional Repository
collection Online Access
description Background and Purpose: Despite the disproportionate burden of cardiovascular disease among indigenous Australians, information on stroke is sparse. This article documents the incidence and burden of stroke (in disability-adjusted life years) in indigenous and non-indigenous people in Western Australia (1997–2002), a state resident to 15% of indigenous Australians comprising 3.4% of the population of Western Australia. Methods: Indigenous and non-indigenous stroke incidence and excess mortality rates were estimated from linked hospital and mortality data, with adjustment for nonadmitted events. Nonfatal burden was calculated from nonfatal incidence, duration (modeled from incidence, excess mortality, and remission), and disability weights. Stroke death counts formed the basis of fatal burden. Nonfatal and fatal burden were summed to obtain disability-adjusted life years, by indigenous status.Results: The total burden was 55 099 and 2134 disability-adjusted life years in non-indigenous and indigenous Western Australians, respectively. The indigenous to non-indigenous age-standardized stroke incidence rate ratio (≥15 years) was 2.6 in males (95% CI, 2.3–3.0) and 3.0 (95% CI, 2.6–3.5) in females, with similar rate ratios of disability-adjusted life years. The burden profile differed substantially between populations, with rate ratios being highest at younger ages. Conclusions: The differential between indigenous and non-indigenous stroke burden is considerable, highlighting the need for comprehensive intersectoral interventions to reduce indigenous stroke incidence and improve outcomes. Programs to reduce risk factors and increase access to culturally appropriate stroke services are required. The results here provide the quantitative basis for policy development and monitoring of stroke outcomes.
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spelling curtin-20.500.11937-140732017-09-13T16:00:44Z Burden of Stroke in Indigenous Western Australians: A Study Using Data Linkage Katzenellenbogen, Judith Vos, T. Somerford, Peter Begg, S. Semmens, James Codde, James epidemiology indigenous health policy cerebrovascular accident Background and Purpose: Despite the disproportionate burden of cardiovascular disease among indigenous Australians, information on stroke is sparse. This article documents the incidence and burden of stroke (in disability-adjusted life years) in indigenous and non-indigenous people in Western Australia (1997–2002), a state resident to 15% of indigenous Australians comprising 3.4% of the population of Western Australia. Methods: Indigenous and non-indigenous stroke incidence and excess mortality rates were estimated from linked hospital and mortality data, with adjustment for nonadmitted events. Nonfatal burden was calculated from nonfatal incidence, duration (modeled from incidence, excess mortality, and remission), and disability weights. Stroke death counts formed the basis of fatal burden. Nonfatal and fatal burden were summed to obtain disability-adjusted life years, by indigenous status.Results: The total burden was 55 099 and 2134 disability-adjusted life years in non-indigenous and indigenous Western Australians, respectively. The indigenous to non-indigenous age-standardized stroke incidence rate ratio (≥15 years) was 2.6 in males (95% CI, 2.3–3.0) and 3.0 (95% CI, 2.6–3.5) in females, with similar rate ratios of disability-adjusted life years. The burden profile differed substantially between populations, with rate ratios being highest at younger ages. Conclusions: The differential between indigenous and non-indigenous stroke burden is considerable, highlighting the need for comprehensive intersectoral interventions to reduce indigenous stroke incidence and improve outcomes. Programs to reduce risk factors and increase access to culturally appropriate stroke services are required. The results here provide the quantitative basis for policy development and monitoring of stroke outcomes. 2011 Journal Article http://hdl.handle.net/20.500.11937/14073 10.1161/STROKEAHA.110.601799 Lippincott, Williams and Wilkins unknown
spellingShingle epidemiology
indigenous
health policy
cerebrovascular accident
Katzenellenbogen, Judith
Vos, T.
Somerford, Peter
Begg, S.
Semmens, James
Codde, James
Burden of Stroke in Indigenous Western Australians: A Study Using Data Linkage
title Burden of Stroke in Indigenous Western Australians: A Study Using Data Linkage
title_full Burden of Stroke in Indigenous Western Australians: A Study Using Data Linkage
title_fullStr Burden of Stroke in Indigenous Western Australians: A Study Using Data Linkage
title_full_unstemmed Burden of Stroke in Indigenous Western Australians: A Study Using Data Linkage
title_short Burden of Stroke in Indigenous Western Australians: A Study Using Data Linkage
title_sort burden of stroke in indigenous western australians: a study using data linkage
topic epidemiology
indigenous
health policy
cerebrovascular accident
url http://hdl.handle.net/20.500.11937/14073