SMALL AREA RATE VARIATION IN CARDIOVASCULAR DISEASE PREVALENCE IN NOVA SCOTIA, CANADA

Abstract

This study assessed small area rate variation (SARV) in cardiovascular disease (CVD) prevalence in Nova Scotia, Canada. It described how estimates varied according to population demographics and estimated the contribution of area socioeconomic status (SES) to between-area variation. Applying multilevel logistic regression to healthcare utilization databases, pronounced spatial variation was observed across forward sortation areas (FSAs) in the prevalence of ischemic heart disease, congestive heart failure, and hypertension. Pockets of FSAs were identified with above-average and below-average prevalence estimates. Age-sex standardization resulted in noticeably different estimates in many areas. Stratified comparisons between relatively older and younger age groups revealed SARV that generally followed variation in the overall population, although younger age groups typically had greater variation in prevalence. Statistical associations were observed between area-level variables and variation in prevalence. This study contributes to the knowledge base on CVD and has policy implications for a disease that significantly impacts Nova Scotia.