Persistent socioeconomic inequalities in cardiovascular disease mortality amid declining death rates in Australia, 2016-2023
1
National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
2
QIMR Berghofer Medical Research Institute, Brisbane, Australia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Cardiovascular disease (CVD) mortality rates have declined substantially in Australia over the past half century. However, whether these reductions have been experienced equitably across subpopulations within the country remains unclear. This study quantifies changes in CVD mortality inequalities by area-level socioeconomic deprivation from 2016 to 2023 among Australians aged ≥25 years.
METHODS:
We used individual-level death records and estimated resident population data to calculate annual age-standardised mortality rates 2016-2023 by population-based quintiles of the Index of Relative Socioeconomic Disadvantage. We analysed deaths from all CVD (ICD-10 codes: I00-I99), including coronary heart disease (I20-I25), and cerebrovascular disease (I60-I69, G45) subtypes. Absolute and relative inequalities were quantified using rate differences, rate ratios, slope index of inequality (SII), and relative index of inequality (RII), stratified by age group (25-54, 55-74, 75+) and sex.
RESULTS:
Between 2016 and 2023, there were 333,508 CVD deaths. Socioeconomic inequalities persisted across all age-sex categories, with consistently higher mortality rates among more disadvantaged populations, although some anomalies were noted during COVID pandemic period (2021-2022). Absolute inequalities were generally higher among men than women. Among men, inequalities remained stable across all age groups; for example, among those aged 55-74 years, SII ranged from 53 (95%CI: 47-59) to 48 (41-54) per 100,000 population, and RII ranged from 2.6 (2.3-2.8) to 2.5 (2.3-2.9) between 2016 and 2023. Among women aged 25-74 years, there was little evidence of changes over time. In contrast, SII among women aged 75+ increased from 15 (6-24) to 29 (21-37) between 2016 and 2023. Similar patterns were observed across CVD subtypes.
CONCLUSIONS:
Reductions in CVD mortality rates were observed in all socioeconomic groups, with inequalities in mortality rates persisting, not reducing, over time. Targeted public health efforts to achieve greater mortality reductions among disadvantaged populations are needed to narrow socioeconomic gaps in CVD mortality.
Cardiovascular disease (CVD) mortality rates have declined substantially in Australia over the past half century. However, whether these reductions have been experienced equitably across subpopulations within the country remains unclear. This study quantifies changes in CVD mortality inequalities by area-level socioeconomic deprivation from 2016 to 2023 among Australians aged ≥25 years.
METHODS:
We used individual-level death records and estimated resident population data to calculate annual age-standardised mortality rates 2016-2023 by population-based quintiles of the Index of Relative Socioeconomic Disadvantage. We analysed deaths from all CVD (ICD-10 codes: I00-I99), including coronary heart disease (I20-I25), and cerebrovascular disease (I60-I69, G45) subtypes. Absolute and relative inequalities were quantified using rate differences, rate ratios, slope index of inequality (SII), and relative index of inequality (RII), stratified by age group (25-54, 55-74, 75+) and sex.
RESULTS:
Between 2016 and 2023, there were 333,508 CVD deaths. Socioeconomic inequalities persisted across all age-sex categories, with consistently higher mortality rates among more disadvantaged populations, although some anomalies were noted during COVID pandemic period (2021-2022). Absolute inequalities were generally higher among men than women. Among men, inequalities remained stable across all age groups; for example, among those aged 55-74 years, SII ranged from 53 (95%CI: 47-59) to 48 (41-54) per 100,000 population, and RII ranged from 2.6 (2.3-2.8) to 2.5 (2.3-2.9) between 2016 and 2023. Among women aged 25-74 years, there was little evidence of changes over time. In contrast, SII among women aged 75+ increased from 15 (6-24) to 29 (21-37) between 2016 and 2023. Similar patterns were observed across CVD subtypes.
CONCLUSIONS:
Reductions in CVD mortality rates were observed in all socioeconomic groups, with inequalities in mortality rates persisting, not reducing, over time. Targeted public health efforts to achieve greater mortality reductions among disadvantaged populations are needed to narrow socioeconomic gaps in CVD mortality.
| eISSN: | 2654-1459 |
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