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The contribution of avoidable mortality to the life expectancy gap in Māori and Pacific populations in New Zealand – a decomposition analysis

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Authors:
Summary:

Using New Zealand death registration and population data from 2013 through 2015, these researchers assessed life expectancy differentials associated with potentially avoidable causes of death within Māori and Pacific populations when compared to the non-Māori/non-Pacific population. As the study researchers explain, avoidable mortality can be used as a measure of how effectively healthcare, health and social policy are contributing to population health and health equity, by how many premature deaths occur from certain conditions and in the presence of timely, effective and equitable healthcare or other appropriate interventions. In each of the three target study populations, much higher proportions of all deaths were attributed to potentially avoidable causes of death among Māori (53.0%) and Pacific peoples (47.3%) than among non-Māori/non- Pacific populations (23.2%). Conditions considered to be both preventable and amenable made the greatest contribution to the life expectancy differentials within both Māori and Pacific groups, compared with non-Māori/ non-Pacific. Within Māori males and females, trachea, bronchus and lung cancers accounted for 0.8 and 0.9 years of the life expectancy differential, respectively. Avoidable injuries including suicide contributed as much as 1.0 year to the differential in Māori males. Coronary disease, diabetes and cerebrovascular disease were large contributors to the differential in both Pacific males and females.

Comment:
The first report of its kind, this paper received a lot of attention in both the editorial of the N Z Med J (see https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2019/vol-132- no-1492-29-march-2019/7840) and in the media (e.g. https://www.nzherald.co.nz/nz/news/article. cfm?c_id=1&objectid=12217309). A fantastic reference for us and, as the editorial suggests, perhaps we should keep these “figures as screensavers”.
Reference: N Z Med J. 2019;132(1492):46-60
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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