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Changing trends in indigenous inequalities in mortality: lessons from New Zealand

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Summary:

These researchers used standard demographic methods to construct abridged period lifetables for Māori and non-Māori in New Zealand from 1951 to 2006. Absolute [standardised rate difference (SRD)] and relative [standardised rate ratio (SRR)] mortality inequalities for Māori compared with European/Other ethnic groups (aged 1–74 years) were measured using the New Zealand Census-Mortality Study (an ongoing data linkage study that links mortality to census records) from 1981–84 to 2001–04. Life expectancy gaps and relative inequalities in mortality rates (aged 1–74 years) widened and then narrowed again, in tandem with changing economic inequalities and changing health inequalities between ethnic groups. 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 cardiovascular disease 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.

Comment:
History tells us that Māori are the first to be affected in tough economic times, so this paper has particular relevance given the current recession. It reinforces the fact that ethnic inequalities in health are not a fixed phenomenon – they are exquisitely sensitive to changing social and economic conditions. So it should be possible to rapidly and significantly reduce health inequities between Māori and non-Māori through health and social policy directed at addressing these determinants of health. In the context of the current economic downturn, it will be important to closely monitor ethnic inequalities and respond appropriately to avoid adverse health and social outcomes for Māori.
Reference: Int J Epidemiol. 2009 Mar 30. [Epub ahead of print]
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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