Mortality estimates for years up to 2005 are based on Australian Bureau of Statistics death registration data. Data from 2006 onwards were provided by the Australian Coordinating Registry, Cause of Death Unit Record File; the data for the most 2 recent years are preliminary (SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health)
Only NSW residents are included. Deaths were classified using ICD-10. Rates were age-adjusted using the Australian population as at 30 June 2001.
Counts of deaths in 2007 and following years include an estimate of the number of NSW residents who died interstate and counts for the latest year of data include an estimate of the number of deaths occurring in that year but registered in the next year. Data on interstate deaths and late registrations were unavailable at the time of production.
In order to complete a death registration in Australia, the death must be certified by either a doctor using the Medical Certificate of Cause of Death, or by a coroner. Natural causes are predominantly certified by doctors, whereas External and Unknown causes or unaccompanied deaths are usually certified by a Coroner. Approximately 85-90% of deaths each year are certified by a doctor and the remainder is reported to a Coroner. The death is registered in the state in which the death occurred, rather than the state in which the person resides. The Australian Cause of Death Statistics System is outlined by the Australian Bureau of Statistics (ABS) at http://www.abs.gov.au/AUSSTATS/abs@.nsf/allprimarymainfeatures/47E19CA15036B04BCA2577570014668B?opendocument.
The ABS have implemented a revision process for Coroner certified deaths. Data are deemed preliminary when published for the first time, revised when published the following year and final when published two years after initial publication. This revision process, and the impact on specific causes are described at http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3303.0Explanatory%20Notes12015?OpenDocument .
The ABS publishes two publications every year: Deaths, Australia (Catalogue Number 3302.0) and Causes of death, Australia (Catalogue Number 3303.0) at the end of September, nine months after the end of the concerned year.
The Australian Coordinating Registry (ACR) is an agency appointed coordinate access to coded cause of death unit record data on behalf of the Registrars of Births Deaths and Marriages in each state or territory as well as the Australian Bureau of Statistics and National Coronial Information System. The coordinating registry undertakes the coordination and management of the designated activity. The underlying legal responsibility is retained by the collective Registrars.
The ACR provides the NSW Ministry of Health with a national cause of death unit record file to allow a detailed analysis of deaths data (sixteen to seventeen months after the end of the concerned year).
Prior to 2008, the NSW Ministry of Health obtained data on causes of death of all NSW residents from the Australian Bureau of Statistics (ABS). This Unit Record File (URF) is required to enable the Ministry to report on causes of death in NSW by sub-state geographies (eg by Local Health District or Local Government Area) and by other dimensions and sub-populations such as remoteness categories and socioeconomic groups. Causes of death data are also used throughout the NSW public health system for a variety of health system planning, reporting, research and evaluation needs.
In 2013, the Australian Coordinating Registry (ACR) based at the Queensland government Department of Justice and Attorney-General provided the Centre for Epidemiology and Evidence (CEE) at the NSW Ministry of Health with a URF of all deaths registered in NSW between 2006 and 2011 and which included the cause of death (COD). This file will be referred to as the ACR CODURF. The coding of the causes of death is still undertaken by the ABS but the process for obtaining the data is conducted by the ACR.
The CEE carried out linkage of the ACR CODURF with records from the NSW Registry of Births, Deaths and Marriages (RBDM) death registration file for 2006-2013. The linkage relates the cause of death information from the ACR records to the death registration records which contain addresses of those who died in NSW. This allowed death records to be geocoded so that geographic boundaries such as Local Health Districts, Medicare Locals and Local Government Areas could be added to them. Statistical weights were developed using an imputation process to estimate the number of missing records of NSW residents who died interstate, which were not available for 2007 onwards, and deaths which occurred in the latest year but were registered in the following year. Estimates for the numbers of deaths for 2007 onwards include counts of interstate and late death registrations based on these imputations.
Death count by year of registration and by year of occurrence
There is usually an interval between the occurrence and registration of a death which is related to the time of year or whether a death is referred to a Coroner. The registration of deaths which occur in November and December are likely to be delayed until the following year, for example, of all deaths in NSW registered in 2013, 6.9% occurred in 2012 or earlier (ABS 3302.0).
Deaths data reported by the ABS for the latest year are based on the year of registration therefore do not include deaths which occurred in that year but where registration was delayed. Deaths data reported in HealthStats NSW are based on the year of occurrence of the death. Estimates of missing deaths for the latest year due to delayed registration (ie due to time of year or Coronial cases) are imputed for each cause and included in the count for the reports in HealthStats NSW. A small percentage of death registrations may be delayed for more than one year. All deaths figures are updated historically (eg in trends) in this report when new data becomes available.
Different population projection data
For the calculation of rates, the NSW Ministry of Health uses population projection estimates from the NSW Department of Planning and Environment. The estimated residential populations which are not projected are the same as those published by the ABS and are currently based on the 2016 Census. See Methods associated with indicators in topics Demography (or Population) for further discussion of population estimates.
Australian Bureau of Statistics. Deaths, Australia, latest year. 3302.0. Canberra: ABS, . Available at http://www.abs.gov.au/ausstats/abs@.nsf/mf/3302.0
Australian Bureau of Statistics. Causes of Deaths, Australia, latest year. 3303.0. Canberra: ABS, . Available at http://www.abs.gov.au/ausstats/abs@.nsf/mf/3303.0
Australian Bureau of Statistics. Multiple Cause of Deaths, Australia, 1997-2001. 3319.0.55.001. Canberra: ABS, . Available at http://www.abs.gov.au/ausstats/abs@.nsf/mf/3319.0.55.001
|Description||ICD-10 & ICD-10-AM||Comments|
|All Circulatory Diseases||I00-I99, Excluding I84||All records are included, NSW residents only, all ages.|
|Coronary heart disease||I20-I25|
|Peripheral vascular disease||I70-I74|
|Haemorrhoids. This type is not included in the Total of circulatory diseases.||
I84 up to 2012/13
K64 from 2013/14
|Transient ischaemic attacks. This type is not included in the Total of circulatory diseases.||G45|
Transient ischaemic attacks (TIA) are a risk factor for strokes. TIA were classified as diseases of circulatory system in ICD-9-CM (with the exception of amaurosis fugax, which has always been classified with nervous system group; ICD-9: 362.34, ICD10: G45.4). In ICD-10-AM, they are classified with the diseases of nervous system (G codes) and, consequently, are not included in the stroke count and in the total of diseases of circulatory system (i.e. cardiovascular diseases, I codes).
Haemorrhoids were classified as diseases of the circulatory system under ICD-10-AM Seventh edition (I84). In ICD-10-AM Eighth edition haemorrhoids are classified with diseases of the digestive system (K64). Consequently, haemorrhoids are not included in the total count of diseases of circulatory system.
Care should be taken when comparing data from different sources as only an intracranial haemorrhage (I60-I62) is considered a stroke in some reports while haemorrhage (I60-I62), cerebral infarction (I63) and stroke not specified as haemorrhage or infarction (I64) are included in this report.
• Circulatory diseases cause more than 15,000 deaths and 150,000 hospitalisations of NSW residents in each year. Coronary heart disease and atrial fibrillation and flutter contribute the most to these diseases' hospitalisation burden, followed by heart failure and strokes.
• Death rates, and numbers of deaths, from circulatory disease are consistently higher in males than in females. Death rates are higher in Inner regional, Outer regional and Remote areas of NSW than in Major cities.
• Death rates from all forms of circulatory disease have more than halved in the last twenty years after adjusting for population ageing. This is due to both:
• decreased incidence, associated with reductions in some risk factors, including smoking, saturated fats in the diet, and levels of blood pressure;
• increased survival, as a result of improvements in medical and surgical treatment and follow-up care.
• Coronary heart disease caused 5,928 deaths in 2017. Coronary heart disease was the principal reason for 47,953 hospitalisations in NSW in 2018-19.
• Stroke caused just over 2,803 deaths in NSW in 2017. Stroke was the principal reason for 13,651 hospitalisations in NSW in 2018-19.
• Heart failure was the underlying cause of 1,116 deaths in NSW in 2017 and was a contributing cause in many more. Heart failure was the principal reason for 18,646 hospitalisations in NSW in 2018-19.
• In the treatment of coronary heart disease, the number of percutaneous transluminal angioplasty (PCTA) procedures (with and without stents) first exceeded the number of the more invasive coronary artery bypass graft (CABG) procedures in 2000-01. More than 16,000 PCTAs were performed in 2018-19, more than four times as many as CABGs at around 3,800 procedures.
Cardiovascular (or circulatory) diseases comprise all diseases of the heart and blood vessels. Among these diseases, the four types responsible for the most deaths in NSW are: coronary heart disease (or ischaemic heart disease), stroke (or cerebrovascular disease), heart failure, and peripheral vascular disease. Other causes of death are cardiac arrhythmias (most notably atrial fibrillation), heart valve disorders, non-ischaemic cardiomyopathies, pulmonary embolism, and hypertensive renal and heart disease. Significant causes of morbidity include hypertension, deep vein thrombosis, haemorrhoids and varicose veins.
Cardiovascular diseases accounted for 14% of the total disease burden in Australia in 2015, second only to cancers. The burden from cardiovascular diseases was predominantly fatal (78.5%) with only 21.5% due to non-fatal burden. Coronary (ischaemic) heart disease ranked highest in total individual disease burden (6.9% of the total burden) and stroke ranked ninth highest (2.7% of the total disease burden).
Presently, cardiovascular diseases account for around 48,000 deaths in Australia (around 33-34% of all deaths), more than any other group of diseases. This proportion has been in decline since 1970, when nationally cardiovascular diseases were responsible for over half of all deaths.
The four major causes of death from cardiovascular disease share a number of behavioural risk factors (tobacco smoking, physical inactivity, poor diet, risky alcohol consumption) leading to physiological risk factors (high blood pressure, elevated blood lipids, diabetes mellitus, and overweight or obesity).
Australian Institute of Health and Welfare 2019. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2015. Australian Burden of Disease Study series no. 19. BOD 22. Canberra: AIHW at: https://www.aihw.gov.au/reports/burden-of-disease/burden-disease-study-illness-death-2015-summary/contents/table-of-contents
Circulatory diseases share many modifiable risk factors with other lifestyle-related chronic diseases such as type 2 diabetes. These include smoking, physical inactivity, poor diet, harmful alcohol consumption and being overweight. This means that strategies related to the prevention, early detection and optimal management of these risk factors will lead to better health outcomes for people with circulatory diseases and other lifestyle-related chronic diseases.
Information on NSW Health programs and policies is available at http://www.health.nsw.gov.au/healthyliving/Pages/default.aspx.