Renal Related Deaths in Indigenous People in Queensland: 1997-2000
Purpose: To quantify the excess of deaths with a renal causal assignment among Indigenous people in Queensland, their distribution by remoteness, and their association with cardiovascular and diabetes causal assignments.
Methods: Data for all deaths in Queensland from 1997 to 2000 and estimated resident population were obtained from the ABS. Causes of deaths were defined by the ICD, 10th edition, and both underlying and associated causes were examined. Mortality rates were standardized (SMRs) to the concurrent non-Indigenous population. Remoteness of primary residence were based on ARIA assignment (AIHW) and included Major City and Inner Regional (Area 1), Outer Regional and Remote (Area 2), and Very Remote (Area 3).
Results: In Indigenous people age 25+ years, SMRs with a renal assignment as underlying or associated cause of death were 186%, 436% and 787% in Areas 1, 2 and 3, respectively. Of all these deaths, only 18% had a renal assignment as the underlying cause. Of all Indigenous deaths with a renal assignment, 35%, 46% and 53% (Areas 1, 2 and 3 respectively) had a concurrent diabetes assignment and 60%, 60% and 51% respectively had a concurrent cardiovascular assignment.
Conclusion: Although Indigenous identification in deaths in Queensland is still said to be incomplete, compared to non-Indigenous people, the Indigenous population has elevated rates of renal deaths, which increase markedly with increasing remoteness of residence. Reliance on underlying causes of death alone greatly underestimates the association of renal disease with deaths in Indigenous people. Diabetes and cardiovascular disease are frequent concomitant causes.