Melbourne (May 2014) People from ethnic minorities and those from lower socio-economic groups are at significantly higher risk of experiencing cardiovascular disease (CVD) than the rest of the population, according to widespread research to be presented at the World Heart Federation's World Congress of Cardiology (WCC). Several studies undertaken across the Asia-Pacific region show that these populations are more likely to have an overall higher risk of CVD, have poorer treatment outcomes and die earlier from CVD than those of non-indigenous ethnicity or higher socio-economic status.
Research from a host of countries in the Asia-Pacific region shows worrying statistics, including:
- CVD is the biggest cause of death for Aboriginal and Torres Strait Islander people and although absolute CVD mortality has decreased in these groups in the past 25 years, the disparity with non-indigenous Australians has increased.i
- Maori and Pacific ethnicities of New Zealand were younger when presenting for coronary artery bypass grafting, with the greatest degree of socio-economic deprivation (p<0.001) but had higher prevalence of most cardiovascular risk factors and co-morbiditiesii
- These two ethnicities also had the highest 30-day mortality (p=0.008), composite morbidity (p=0.014) and worst survival during follow-up (p=0.004). Even upon adjusting for differences in baseline characteristics, these populations remained independently associated with worse outcomes (p=0.013, 0.037 and 0.053 respectively)ii
However, the news is not all bad; examples of tackling health inequalities at a policy level were also presented at the World Congress of Cardiology. These show promising signs of health sector reform, which have the potential to make inroads in confronting these issues.
Led by Professor Alex Brown of the South Australian Health and Medical Research Institute in Adelaide, the Essential Service Standards for Equitable Cardiovascular CarE (ESSENCE) project for Aboriginal and Torres Strait Islander people recognised the alarming disparity in CVD health between these people and non-indigenous Australians and took into account the critical need to reduce the large mortality gap, which stands at 10.6 years for men and 9.5 years for women.iii
The ESSENCE team sought to identify meaningful ways to reduce these disparities. These include a set of essential service standards to identify treatments or services that should be accessible to everyone with, or at risk of, CVD. By utilising an equity based approach to CVD care, such as enhanced access to transport, prevention, diagnosis and acute time critical therapies, the gap between Indigenous and non-Indigenous Australians could be reduced.
In Australia, Dr Robert Grenfell, National Director of Cardiovascular Health, National Heart Foundation of Australia said: "For many Australians, good health is affected by their social circumstances, cultural background or where they live. If we can empower communities and take away some of the barriers people face, we will begin to address unfair cardiovascular health differences. This requires us to change our thinking about health from a focus on individual behaviours and health services to one that thinks about systems and the conditions that make people sick in the first place."
"We are looking forward to hearing about initiatives from around the world and the opportunity to exchange ideas here at the World Congress of Cardiology," Dr Grenfell continued.
At the global level, the World Heart Federation and its members around the world believe that tackling health inequalities is a priority to reduce CVD premature mortality, with 80% of CVD death occurring in low- and middle-income countriesiv. Professor Ana Olga Mocumbi, Cardiologist and Researcher at National Health Institute in Mozambique said: "Tackling health inequalities is an integral part of creating a fairer and healthier society. Inequalities can arise because of factors such as age or ethnicity and the conditions in which people are born, grow, live and work; no matter what the reasons, they must be addressed. The research presented at WCC shows that urgent action must be taken to ensure equal access to health for indigenous and lower socio-economic groups. Examples of efforts to reduce disparities in Australia can have an impact and are an inspiration to colleagues around the world to demonstrate how we can end inequality for all."
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About the World Congress of Cardiology (WCC)
The World Congress of Cardiology is the official congress of the World Heart Federation and is held every two years. The congress brings together thousands of cardiologists and other healthcare professionals from around the world, and represents an important forum for discussing all aspects of prevention and treatment of cardiovascular disease. WCC 2014 is taking place in Melbourne, Australia from 4-7 May 2014 and is co-hosted by the National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand.
About the World Heart Federation
The World Heart Federation is the only global advocacy and leadership organization bringing together the cardiovascular disease (CVD) community to help people everywhere lead heart-healthy lives. We strive for a world where there are at least 25% fewer premature deaths from CVD by 2025.
That's why we and our 200+ members work courageously to end needless deaths from exposure to tobacco and other risk factors, lack of access to treatment, and neglected conditions like rheumatic heart disease which kills hundreds of thousands of children each year. Across 100 countries, with its members, the World Heart Federation works to build global commitment to addressing cardiovascular health at the policy level, generates and exchanges ideas, shares best practice, advances scientific knowledge and promotes knowledge transfer to tackle CVD- the world's number one killer. World Heart Federation is at the heart of driving the CVD agenda and advocating for better heart health - enabling people to live longer, better and more heart healthy lives whoever and wherever they are.
iBrown A et al. Essential Service Standards for Equitable National Cardiovascular CarE for Aboriginal and Torres Strait Islander People - An Exemplar Approach to Closing the Gap
iiWang TKM et al. Comparing Contemporary Coronary Artery Bypass Grafting Across Six Main Ethnic Groups Of New Zealand: Another Example Of Inequalities In Cardiovascular Disease
iiiAustralian Institute of Health and Welfare. Life expectancy. http://www.
ivWorld Heart Federation. Urbanization and cardiovascular disease. http://www.