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Heart failure hospitalisations and deaths in New Zealand: patterns by deprivation and ethnicity

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From Māori Health Review Issue 8
Authors:
  • Riddell T
Summary:

This study explored the association between socioeconomic deprivation and heart failure outcomes in Mäori and non-Mäori New Zealanders. Heart failure mortality and hospital admission data from 1988–1998 were retrospectively analysed for Mäori and non-Mäori aged ≥45 years assigned to small area deprivation in the New Zealand Indices of Deprivation for 1991 and 1996. For both Mäori and non-Mäori, socioeconomic deprivation was associated with an increased risk of heart failure deaths and hospitalisations. Within any given socioeconomic strata, this risk was higher for Mäori than non-Mäori. The study author comments that Mäori disparities in heart failure outcomes do not simply reflect differences in socioeconomic deprivation; further research is needed to investigate the influence of other determinants such as lifecourse and lifestyle exposures, neighbourhood characteristics, access to medical care, and racism.

Comment:
This paper is significant, for a number of reasons. Firstly, it addresses a major health issue for Mäori. Hospitalisation and mortality rates for heart failure are up to eight times higher for Mäori than non-Mäori in certain age groups. The study also confirmed that Mäori disparities in health outcomes (heart failure) are not fully explained by differences in deprivation. And finally, having identified the ‘gap’, Dr Riddell describes other factors that may contribute to the disparity including the life-course, access to care and racism.
Reference: N Z Med J. 2005;118:U1254
Abstract
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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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