Self-reported physical health, mental health and participation in health-promoting behaviours of rural and urban South Australian adults with a history of cardiovascular disease (CVD)

Introduction: Rural people with Cardiovascular Disease
(CVD) are at risk of poorer outcomes. However, little isknown
about their wellbeing post-discharge from specialist cardiac
care.
Objectives: To determine whether self-reported health,
mental health and health-promoting behaviour differs
between rural and urban adults with a history of CVD.
Methods: Weighted, representative data were collected
from adults between 1 January 2010 and 1 June 2015 via
the South Australian Monitoring and Surveillance System
(SAMSS).
Results: Within the survey population (n=36,437), 4,677
participants (12.8%) reported having a CVD condition; metro
10.2% vs. rural 2.6%; 43.1% ≥ 65 years old; mean BMI (metro
27.9 vs. rural 29.2, p≤0.001). After controlling for survey year,
gender, age, education, income and SEIFA (Socio-Economic
Indexes for Areas), rural CVD participants were significantly
more likely to experience poor health and comorbidities (diabetes,
cancer, COPD, arthritis) relative to their urban CVD
participants. Urban CVD participants were more likely to
report suicidal ideation, distress and dissatisfaction with life.
Rural CVD participants had significantly greater risk of harm
from alcohol and smoking and were significantly less likely
to engage in sufficient levels of physical activity. They were
more also likely to travel over 100km to access specialist
cardiac services [Rural 11.50 (8.35, 15.84)] vs. (Urban 2.12
[1.38, 328]) p≤ 0.001) but had greater trust in their communities.
There was no significant difference between groups
for intake of fruit and vegetables (both groups were below
recommendations).
Conclusions: Rural people with CVD have greater burden
of poor health, comorbidities, alcohol harm and smoking
than their urban counterparts and are less likely to engage in
sufficient levels of physical activity.