{"id":{"repo_id":"auckland-ms","oai_identifier":"oai:researchspace.auckland.ac.nz:2292/2365"},"canonical_url":"https://search.dev.ndltd.org/etd/auckland-ms/oai:researchspace.auckland.ac.nz:2292/2365","repository":{"repo_id":"auckland-ms","name":"University of Auckland","base_url":"https://researchspace.auckland.ac.nz/server/oai/request"},"display":{"title":"Trends and ethnic disparities in the incidence and outcome of stroke in Auckland, New Zealand over 20 years","abstract":"Aims: The aims of this thesis were to investigate trends and ethnic disparities in the incidence and outcome of stroke in Auckland, New Zealand between 1981 and 2003. Methods: Trends were assessed using information from the three Auckland Regional Community Stroke (ARCOS) studies, conducted in people (aged ≥15 years) in Auckland, during 12-month calendar periods in 1981-1982, 1991-1992, and 2001-2002. These studies used comparable definitions and case finding methods and have been shown to meet the stringent criteria for a population-based “ideal” stroke incidence study. Rates were calculated using Poisson distribution and are presented with 95% confidence intervals. Trends in survival were assessed using Cox Proportional hazards regression modelling. Results: Overall trends in the incidence and event rates of stroke declined across the study period. These declines were significant in males and for the ages 65 to 74 years only. However, growing disparities in the rates of stroke between the major ethnic groups in New Zealand were found, with significant declines in New Zealand Europeans and increases in Māori and Pacific populations. Dramatic improvements in survival over the study period were also found, with the greatest improvement in the acute period, within the first 28-days after stroke. Adjustments for patient or disease severity factors strengthened the survival model. However, adjustments for care/service factors nullified the survival model, thus explaining most of the improving trend. Conclusions: The small declines in the incidence of stroke, improvements in survival and the ageing of the New Zealand population will lead to data dramatic increases in the number of people living with the effects of stroke. To maintain stable numbers of strokes occurring, more intensive prevention strategies need to target high-risk populations and population-wide health education strategies are needed to improve the health of the general population, hence reducing the risk of stroke.","abstract_html":"Aims: The aims of this thesis were to investigate trends and ethnic disparities in the incidence and outcome of stroke in Auckland, New Zealand between 1981 and 2003. Methods: Trends were assessed using information from the three Auckland Regional Community Stroke (ARCOS) studies, conducted in people (aged ≥15 years) in Auckland, during 12-month calendar periods in 1981-1982, 1991-1992, and 2001-2002. These studies used comparable definitions and case finding methods and have been shown to meet the stringent criteria for a population-based “ideal” stroke incidence study. Rates were calculated using Poisson distribution and are presented with 95% confidence intervals. Trends in survival were assessed using Cox Proportional hazards regression modelling. Results: Overall trends in the incidence and event rates of stroke declined across the study period. These declines were significant in males and for the ages 65 to 74 years only. However, growing disparities in the rates of stroke between the major ethnic groups in New Zealand were found, with significant declines in New Zealand Europeans and increases in Māori and Pacific populations. Dramatic improvements in survival over the study period were also found, with the greatest improvement in the acute period, within the first 28-days after stroke. Adjustments for patient or disease severity factors strengthened the survival model. However, adjustments for care/service factors nullified the survival model, thus explaining most of the improving trend. Conclusions: The small declines in the incidence of stroke, improvements in survival and the ageing of the New Zealand population will lead to data dramatic increases in the number of people living with the effects of stroke. To maintain stable numbers of strokes occurring, more intensive prevention strategies need to target high-risk populations and population-wide health education strategies are needed to improve the health of the general population, hence reducing the risk of stroke.","abstract_has_math":false,"creators":["Carter, Kristie Norah"],"institution":"ResearchSpace@Auckland","degree_name":"PhD","degree_level":"Doctoral","degree_discipline":"Clinical Trials Research Unit.","degree_department":null,"school":null,"contributors":[],"advisors":["Prof. Craig Anderson"],"committee_chairs":[],"committee_members":[],"year":2007,"date_issued":"2007","date_published":"2007","updated_at":"2026-07-24T01:04:34Z","subjects":["Stroke","Epidemiology","Ethnic disparities","Incidence","Survival"],"languages":["en"],"rights":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."],"rights_urls":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/2292/2365","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Prof. Craig Anderson"]},{"key":"dc:creator","label":"Author","values":["Carter, Kristie Norah"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2008-02-19T01:44:45Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2008-02-19T01:44:45Z"]},{"key":"dc:date.issued","label":"Date","values":["2007"]},{"key":"dc:publisher","label":"Institution","values":["ResearchSpace@Auckland"]},{"key":"dc:relation.isreferencedby","label":"Dc Relation Isreferencedby","values":["UoA1775167"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Clinical Trials Research Unit."]},{"key":"thesis:degree_level","label":"Degree Level","values":["Doctoral"]},{"key":"thesis:degree_name","label":"Degree Name","values":["PhD"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["The University of Auckland"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Stroke","Epidemiology","Ethnic disparities","Incidence","Survival"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."]},{"key":"dc:rights.uri","label":"Rights URI","values":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/2292/2365"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Aims: The aims of this thesis were to investigate trends and ethnic disparities in the incidence and outcome of stroke in Auckland, New Zealand between 1981 and 2003. Methods: Trends were assessed using information from the three Auckland Regional Community Stroke (ARCOS) studies, conducted in people (aged ≥15 years) in Auckland, during 12-month calendar periods in 1981-1982, 1991-1992, and 2001-2002. These studies used comparable definitions and case finding methods and have been shown to meet the stringent criteria for a population-based “ideal” stroke incidence study. Rates were calculated using Poisson distribution and are presented with 95% confidence intervals. Trends in survival were assessed using Cox Proportional hazards regression modelling. Results: Overall trends in the incidence and event rates of stroke declined across the study period. These declines were significant in males and for the ages 65 to 74 years only. However, growing disparities in the rates of stroke between the major ethnic groups in New Zealand were found, with significant declines in New Zealand Europeans and increases in Māori and Pacific populations. Dramatic improvements in survival over the study period were also found, with the greatest improvement in the acute period, within the first 28-days after stroke. Adjustments for patient or disease severity factors strengthened the survival model. However, adjustments for care/service factors nullified the survival model, thus explaining most of the improving trend. Conclusions: The small declines in the incidence of stroke, improvements in survival and the ageing of the New Zealand population will lead to data dramatic increases in the number of people living with the effects of stroke. To maintain stable numbers of strokes occurring, more intensive prevention strategies need to target high-risk populations and population-wide health education strategies are needed to improve the health of the general population, hence reducing the risk of stroke."]},{"key":"dc:title","label":"Title","values":["Trends and ethnic disparities in the incidence and outcome of stroke in Auckland, New Zealand over 20 years"]}]}],"canonical_facts":{"dc:contributor.advisor":["Prof. Craig Anderson"],"dc:creator":["Carter, Kristie Norah"],"dc:date.accessioned":["2008-02-19T01:44:45Z"],"dc:date.available":["2008-02-19T01:44:45Z"],"dc:date.issued":["2007"],"dc:description.abstract":["Aims: The aims of this thesis were to investigate trends and ethnic disparities in the incidence and outcome of stroke in Auckland, New Zealand between 1981 and 2003. Methods: Trends were assessed using information from the three Auckland Regional Community Stroke (ARCOS) studies, conducted in people (aged ≥15 years) in Auckland, during 12-month calendar periods in 1981-1982, 1991-1992, and 2001-2002. These studies used comparable definitions and case finding methods and have been shown to meet the stringent criteria for a population-based “ideal” stroke incidence study. Rates were calculated using Poisson distribution and are presented with 95% confidence intervals. Trends in survival were assessed using Cox Proportional hazards regression modelling. Results: Overall trends in the incidence and event rates of stroke declined across the study period. These declines were significant in males and for the ages 65 to 74 years only. However, growing disparities in the rates of stroke between the major ethnic groups in New Zealand were found, with significant declines in New Zealand Europeans and increases in Māori and Pacific populations. Dramatic improvements in survival over the study period were also found, with the greatest improvement in the acute period, within the first 28-days after stroke. Adjustments for patient or disease severity factors strengthened the survival model. However, adjustments for care/service factors nullified the survival model, thus explaining most of the improving trend. Conclusions: The small declines in the incidence of stroke, improvements in survival and the ageing of the New Zealand population will lead to data dramatic increases in the number of people living with the effects of stroke. To maintain stable numbers of strokes occurring, more intensive prevention strategies need to target high-risk populations and population-wide health education strategies are needed to improve the health of the general population, hence reducing the risk of stroke."],"dc:identifier.uri":["https://hdl.handle.net/2292/2365"],"dc:language.iso":["en"],"dc:publisher":["ResearchSpace@Auckland"],"dc:relation.isreferencedby":["UoA1775167"],"dc:rights":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."],"dc:rights.uri":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"],"dc:subject":["Stroke","Epidemiology","Ethnic disparities","Incidence","Survival"],"dc:title":["Trends and ethnic disparities in the incidence and outcome of stroke in Auckland, New Zealand over 20 years"],"dc:type":["Thesis"],"thesis:degree_discipline":["Clinical Trials Research Unit."],"thesis:degree_level":["Doctoral"],"thesis:degree_name":["PhD"],"thesis:institution_name":["The University of Auckland"]},"updated_at":"2026-07-24T01:04:34Z"}