Objectives To systematically review published literature on socioeconomic inequality trends in cardiovascular disease (CVD) mortality among Australian adults. Study design Systematic review. Methods We searched PubMed, Scopus, Web of Science, ProQuest, Google Advanced Search, government and international administrative sources for English-language studies from inception to June 2024. Studies were included if they reported population-representative CVD mortality among adults (≥18 years) across ≥2 time points by socioeconomic position (SEP). Outcomes were changes in absolute and relative inequalities in CVD mortality. Results Fifteen studies were included: seven examined composite area-level measures (1979-2016) and eight used individual-level measures of occupation (1968-2001, men only). All were assessed as high quality. Age-standardised CVD mortality rates declined across all socioeconomic groups from 1968 to 2016. For area-level measures, absolute inequalities narrowed while relative inequalities widened from 1979 to 2000, but during 2000-2016, absolute inequalities showed inconsistent trends and relative inequalities continued to widen. For occupational SEP measures, absolute inequalities between manual and professional workers narrowed, but widened between manual workers and clerical workers, and between manual and non-manual workers. Relative gaps widened across all occupational comparisons from 1968 to 2001. There are limited recent data, and no studies that examine CVD mortality rates by household-level SEP. Conclusions Socioeconomic inequalities in CVD mortality among Australian adults persisted from the 1970s to the 2000s, with absolute inequalities narrowing but relative inequalities widening. Scarce individual-level data and reliance on area-level measures from the 2000s limit understanding of recent trends. Improvements in availability and use of individual-level data are needed to enhance monitoring of inequalities, enable comparison with other high-income countries, and inform equitable policy.
Nguyen et al. (Mon,) studied this question.