Heart disease challenges rural and remote Australia

New data on death rates for coronary heart disease and more recent data on smoking and obesity rates at a local level continue to show a picture of vast inequity across Australia.

The updated Heart Maps recently released by the Heart Foundation add to the compelling story: where you live greatly determines your heart health.

Deaths from heart disease are 60 per cent higher for people living in rural and remote areas of Australia than for those living in metropolitan areas.

The Heart Maps shine a picture on how a person’s residential location can have a big impact on their heart health. Even within the states, the differences were staggering.

Outback Queensland has the highest coronary heart disease (CHD) mortality rate of any region, with a rate almost twice that of the Sunshine Coast. Queensland is also home to 12 of the country’s 20 hotspots for heart-related hospital admissions.

Western Australia had the second lowest obesity rate (24.6 per cent), while the Wheat Belt region in WA has double the obesity rate of Inner Perth.

Even where the overall state picture looks better, rural and regional areas are overrepresented in prevalence of heart disease and risk factors.

The increasingly divided New South Wales is over-represented in both the best and worst top 20 regions for all four indicators: heart-related hospital admissions, mortality, obesity and smoking.

And while Victoria ranks second lowest for CHD mortality rates and third lowest for smoking and obesity levels, the regional centres of Shepparton and Bendigo have higher heart-related hospital admission rates, while Ballarat has the highest obesity rates.

But the Heart Maps are not simply a tool for pointing out these differences. Health service providers tell us that they find the Heart Maps very useful in planning and delivering their services to Australians living in those areas. For example, NSW Ambulance Cardiovascular Manager Mick McCullen says the ambulance service has been able to combine its own data with the Heart Maps for a better picture of service needs.

“This allows us to look at our services that we provide in those areas so that we get the best outcomes for patients,” he says.

The Heart Foundation recognises the critical workforce and service issues in rural and remote Australia; as well as the work that is needed to tackle the broader social and economic conditions that underpin people’s health.

The Foundation is working to encourage greater uptake of Absolute Risk Assessment in general practice as part of integrated health checks. The aim is to reduce the barriers for people, particularly those in disadvantaged and/or rural communities, to have regular heart health checks.

The Foundation is also working to support the Aboriginal Health workforce and to ensure culturally-safe health systems for Aboriginal and Torres Strait Islander peoples requiring cardiac care. Eighteen hospitals across Australia are now delivering the Lighthouse Hospital project to communities where Aboriginal cardiac care needs are highest.

Other Heart Foundation initiatives are to: improve active living infrastructure and access to healthy affordable food choices in ‘hotspot’ areas;  increase the awareness of symptoms of a heart attack, and to reduce delay for people having a heart attack;  support a comprehensive tobacco control approach with a special focus on those populations with highest smoking rates; increase availability, access to and participation in cardiac rehabilitation and heart-failure management programs; and prioritise our walking programs for those communities in greatest need.

The Heart Foundation will keep building the heart disease story by adding new local level data, particularly for Aboriginal and Torres Strait Islander people, and we will continue to use the Australian Heart Maps to tailor our efforts and to monitor trends over time.  

The Australian Heart Maps, background information and a full technical report describing the data and analysis are available on the Heart Foundation website.