Background – Hospital admissions of Aboriginal Australians for coronary disease (CHD) are double those of non- indigenous Australians in men and fourfold in women (1), with greater average cost and length of stay (LOS). Objectives – To examine predictors of hospital admission and LOS for CHD in Aboriginal Australians.
Design: In 1988-89, randomly selected Australian Aborigines (256 men, 258 women), aged 15-88 years, completed interviewer-administered questionnaires about diet, exercise, smoking and alcohol drinking. Blood pressure, weight, height and blood lipids were measured. The WA Data Linkage Unit linked participants to hospital records to the end of 2002. Cox regression and negative binomial models were used to model Hospital admissions and LOS for CHD. Outcomes – Among 51 men and 55 women admitted with CHD, greater LOS was predicted by hypertension (hazard ratio (HR) 1.32; 95% CI 1.03, 1.68); diabetes (HR 1.62, 95% CI 1.03, 1.53); smoking (HR 1.90, 95% CI 1.02, 3.53); eating processed meat > 4 times/month (HR 1.81, 95% CI 1.01, 3.24); sweet foods > 6 times/month (HR 1.69, 95% CI 0.94, 2.88); and > 6 eggs/week (HR 1.72, 95% CI 1.03, 2.94). Relative to abstainers, lower alcohol intake (HR 0.54, 95% CI 0.35, 0.83) predicted shorter LOS. Intake of eggs (HR 1.05, 955 CI 1.01, 1.09) predicted shorter intervals between admission; exercise ≥ 1/week (HR 0.61, 95% CI 0.36, 1.05); eating bush meats ≥ 7 times/month (HR 0.46, 95% CI 0.23, 0.92), and red meat >7 times/week (HR 0.56, 95% CI 0.31, 1.03) predicted longer intervals. Risk of admission was higher in hypertensives (HR 4.07, 95% CI 1.32, 15.52); ex-drinkers (HR 6.60, 95% CI 2.30, 19.00); and those adding salt to prepared food (HR 3.16, 95% CI 1.12, 8.92), and lower with eating bush meats ≥ 7 times/month (HR 0.26, 95% CI 0.10, 0.67); and red meat > 7 times/week (HR 0.98, 95% CI 0.97, 0.99).
Conclusion – Hospital admissions for CHD in Aboriginal Australians are predicted by hypertension and diabetes and by several aspects of diet (intake of processed meat, red meat, “bush” food, eggs and sweet foods) and lifestyle. Such findings can inform planning of preventive health programs and health services for indigenous Australians. Reference