Disparities in Death Rates No Longer Widening

Wednesday 22 August 2007

Ethnic and Socio-economic Disparities in Death Rates No Longer Widening

Research from the University of Otago, Wellington shows that death rates in New Zealand related to ethnic and socio-economic disparities are no longer widening, and may have even narrowed in the periods 1996-99 to 2001-04. This is in contrast to growing gaps in death rates in the general population in the 1980’s and 1990s.

“This apparent plateau in health disparities, and possible turnaround, is of major importance if it can be maintained,” says researcher Professor Tony Blakely.

“However, the gaps in death rates – especially the two- to three-fold high death rates for Māori compared to European/Other – remain unacceptably high.”

The Tracking Disparity report will be released jointly today by the University of Otago and the Ministry of Health. It updates previous work by Professor Blakely and others from the New Zealand Census-Mortality Study for the 1980s and 1990s to include 2001-04 mortality data.

Death rates for 1-74 year olds fell from 1981-84 to 2001-04 for all ethnic groups: by 25% and 22% for Māori (males and females respectively), by 14% and 10% for Pacific peoples, and by 42% and 35% for European/Others. Of note, from the late 1990s to the early 2000s the rate of decline in Māori and Pacific mortality increased, compared to a slowing in the European/Other rate of decline.

Falls in cardiovascular disease death rates for males and females from 1981-84 to 2001-04 were profound: 40% and 45% for Māori, 19% and 38% for Pacific peoples, and an astonishing 64% and 65% for European/Other.

Regarding socio-economic disparities, 1-74 year old death rates have also fallen for all income groups. But of concern, amongst 25–44-year-olds with low income, there was little if any decline in mortality rates from 1981-84 to 2001-04.

Understanding why mortality disparities between socio-economic and ethnic groups change over time is challenging. At one level, the profound falls in cardiovascular disease for all social groups provide an explanation. Off-setting this, though, is the emergence of other diseases – particularly cancer – that are making an increasing contribution to disparities.

At another level, it seems highly likely that underlying widening social inequalities during the 1980s and 1990s (e.g. growing income and unemployment gaps between ethnic groups) were at least partly responsible for widening health inequalities.

Major efforts in the last two decades to provide health services more equitably presumably influences ethnic and socio-economic disparities in mortality rates. However, it was not possible to test this directly in this research.

“This research provides hope that gaps in mortality rates have plateaued,” says Tony Blakely. “Ongoing and concerted efforts are required to try and close the large health gaps we still have in New Zealand.”

This research was funded by Ministry of Health, and previously the Health Research Council of New Zealand.

ENDS

See report, Tracking Disparity: Trends in ethnic and socioeconomic inequalities in mortality, 1981–2004, at www.wnmeds.ac.nz/nzcms-info.html.

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