Socioeconomic inequalities in coronary heart disease and stroke mortality among Australian men, 1979-1993

Background. During the 1970s in Australia, mortality from coronary heart disease (CHD) and stroke was higher among lower socioeconomic groups and inequalities were widening. This analysis examines subsequent trends in socioeconomic inequalities, with reference to socioeconomic patterns in major cardiovascular risk factors. Methods. Socioeconomic status was defined by occupation. Age-standardized mortality rates were calculated for men aged 25-64, using death registration data and labour force estimates for 1979-1993. Risk factor data were taken from three cross-sectional population surveys conducted in 1980, 1983 and 1989. Results. Men in manual occupations were at least 35% more likely to die from CHD than men in professional occupations, and 60% more likely to die from stroke. Their 5-year population risk of a coronary event was 30% higher, Since 1979, both groups experienced reductions in coronary risk and mortality. Conclusions. Socioeconomic inequalities in CHD mortality continued to widen during the early 1980s, stabilized thereafter and persisted into the 1990s. Decreases in blood pressure and smoking prevalence contributed most to declines in coronary risk and to socioeconomic differentials.