Changing trends in indigenous inequalities in mortality: lessons from New Zealand
Author(s)/Editor(s): Tobias M, Blakely T, Matheson D
Publisher/Organizer: International Journal of Epidemiology
Publication date: Volume 38, Number 6, December 2009
Number of pages: 10
Language: English
Overview
"Life expectancy gaps and relative inequalities in mortality rates (aged 1-74 years) widened and then narrowed again, in tandem with the trends in social inequalities (allowing for a short lag). Among females, the contribution of cardiovascular disease to absolute mortality inequalities steadily decreased, but was partly offset by an increasing contribution from cancer. Among males, the contribution of CVD increased from the early 1980s to the 1990s, then decreased again. The extent of socio-economic mediation of the ethnic mortality inequality peaked in 1991-94, again more notably among males.
Our results are consistent with a causal association between changing economic inequalities and changing health inequalities between ethnic groups. However, causality cannot be established from a historical analysis alone. Three lessons nevertheless emerge from the New Zealand experience:
- the lag between changes in ethnic social inequality and ethnic health inequality may be short (<5 years); both changes in the distribution of the social determinants of health and
- an appropriate health system response may be required to address ethnic health inequalities; and
- timely monitoring of ethnic health inequalities, based on high-quality ethnicity data, may help to sustain political commitment to pro-equity health and social policies.”