Mortality due to acute rheumatic fever and rheumatic heart disease in the Northern Territory: a preventable cause of death in Aboriginal people

Objective: To determine the death rates and effect on premature mortality i n the Northern Territory of acute rheumatic fever and rheumatic heart disea se. Methods: We ascertained deaths due to acute rheumatic fever and rheumatic h eart disease for the period 1979-96 from death certificates, a database of all patients with these diseases and mortuary records. Crude and age-standa rdised death rates were calculated, as were years of potential life lost be fore age 65, between 15 and 65, and before age 70. Results: Of 182 deaths, 171 (94%) were in Aboriginal people. The mean age a t death of Aboriginal people was 35.7 years, compared to 67.3 years in non- Aboriginal people. The age-standardised death rate in Aboriginal people was 30.2 per 100,000 person-years, compared to 1.1 in non-Aboriginal people. A cute carditis caused 13 deaths at a mean age of 14.2 years. Mortality in Ab original people was highest in the >30 age groups and in females. Premature mortality for Aboriginal people was more than four times that from develop ing countries. Conclusions: Acute rheumatic fever and rheumatic heart disease are not only common in Aboriginal people, they affect and often kill people in their mo st productive years. A co-ordinated control program should help in the shor t term, but will not address underlying causes of these and other preventab le diseases.