Tuesday, 24 November 2015

Location location location – can where you live affect your health?

SPHPM’s Associate Professor Dianna Magliano, Ms Jessica Harding and Associate Professor Jonathan Shaw have co-authored an article, with researchers from the Baker IDI Heart and Diabetes Institute, on the effects of residential location and diabetes on ischemic heart disease as well as stroke mortality.

Past studies have demonstrated that populations who live in areas outside of major urban cities are likely to have an increased mortality risk. While this link has been established, there is a lack of research investigating the association with those living with diabetes and whether the presence of diabetes has an increased detrimental impact.

The intention of this study in particular builds off this past research, with the authors seeking to identify whether the effects of diabetes on overall mortality, ischemic heart disease and stroke mortality vary dependent on the distance between residential area and a major urban area.

Some current literature that supports the theory that while one’s rural location may pose disadvantage in light of limited access to resources, health care services, and therefore their mortality risk; there is a chance that the effect of a single risk factor could decrease.

The authors included 1,101, 053 individuals living with diabetes who were on the national diabetes register from 2000 and 2010. All vital statistics were gathered through linkage to the death registry. The Accessibility/Remoteness Index of Australia (ARIA+) was utilised to place different residences into categories such as major urban, inner regional, remote areas and outer regional.

In the follow up period (median of 6.7 years), 187,761 deaths were reported. Age-standardised stroke, ischemic heart disease and overall mortality rates were higher in ARIA+ categories in both the diabetes specific and overall population.  In all various outcomes, there were similar established patterns, however it is noted that the rates were higher in the male population.

The authors conclude that the impact of diabetes on overall mortality saw only small variations based on residential location. Furthermore, they suggest that the impact was higher in both major urban and remote areas, with rates being the lowest in both the inner and outer regional locations.

You can read the paper here.

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