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How much does health care contribute to health inequality in New Zealand?

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Authors:
Summary:

The aim of this study was to assess the impact of health care on ethnic and socioeconomic disparities in health amongst New Zealanders. The authors used the concept of “amenable” mortality to refer to deaths occurring between the ages of 0 and 74 years from causes that are responsive to health care. In comparison to New Zealanders of European ethnicity, excess mortality which was accounted for by amenable causes of death was 27% for Mäori males, 34% for Mäori females, 33% for Pacific males and 44% for Pacific females. For deprived vs non-deprived populations, amenable causes of death accounted for 26% of excess mortality in males and 30% in females. In conclusion the authors find that “amenable causes of death made a substantial contribution to differences in mortality in the 0-74 year age range between ethnic and socio-economic groups”.

Comment:
This study looked at the end of health care pathways and compared outcomes for Mäori, Pacifica people and European/Other to see how much health care (or inadequate health care) contributes to ethnic disparities in health outcomes. Deaths from causes considered to be responsive to health care were approximately 30% of total deaths for Mäori compared with the European/Other people. In other words, a third of Mäori deaths appear to be a result of inadequate health care. DHB’s must be informed of these findings in order for them to make appropriate changes to policy and practice.
Reference: Australian and New Zealand Journal of Public Health 2007; 31(3):207–210
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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