Widening ethnic mortality disparities in New Zealand 1981-99. 2005

Tony Blakely, and Martin Tobias, and Bridget Robson, and Shilpi Ajwani, and Martin Bonné, and Alistair Woodward
Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, P.O. Box 7343, Wellington, New Zealand. tblakely@wnmeds.ac.nz

The aim of this paper is to determine the extent of undercounting of Mäori and Pacific deaths in New Zealand during the 1980s and 1990s, and to calculate corrected ethnic mortality and life expectancy trends. We calculated adjustment ratios for undercounting of Mäori and Pacific deaths (and over-counting of non-Mäori non-Pacific (nMnP) deaths) using the linked census-mortality data. These ratios were then used to calculate corrected mortality rates and life expectancies. Mäori deaths were underestimated by a quarter, and Pacific deaths by a third, during the 1980s and early 1990s. Undercounting was minor in the late 1990s following alignment of ethnicity collection on mortality data to approximate the census. Corrected mortality rates demonstrated 30% (males) and 26% (females) decreases among nMnP from 1980-84 to 1996-99, smaller decreases among Mäori (8% and 7%) and no clear change among Pacific people (9% decrease for males, 4% increase for females). The gap in life expectancy increased from an average of 7.7 years in 1980-84 to 10.8 years in 1996-99 for Mäori, and from 3.3 to 7.7 years for Pacific people, in comparison to nMnP people. Deaths among 45-64 and 65 plus year olds, and cardiovascular disease and cancer deaths, were the main contributors to these disparities. The economic reforms in New Zealand during the 1980s and early 1990s impacted harder upon Mäori and Pacific people in terms of unemployment and income, and are a likely explanation for the diverging mortality trends in this period. Both behavioural factors and health services probably also play a role, but in the absence of trend data by ethnicity, their contribution to diverging mortality trends is unknown. Internationally, our study demonstrates marked undercounting of Mäori and Pacific deaths. We strongly encourage researchers and custodians of vital statistics in other countries to investigate the possibility of undercounting of deaths by ethnicity.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008017 Life Expectancy Based on known statistical data, the number of years which any person of a given age may reasonably be expected to live. Life Extension,Years of Potential Life Lost,Expectancies, Life,Expectancy, Life,Life Expectancies
D008019 Life Style Typical way of life or manner of living characteristic of an individual or group. (From APA, Thesaurus of Psychological Index Terms, 8th ed) Lifestyle Factors,Life Style Induced Illness,Lifestyle,Factor, Lifestyle,Life Styles,Lifestyle Factor,Lifestyles
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009026 Mortality All deaths reported in a given population. CFR Case Fatality Rate,Crude Death Rate,Crude Mortality Rate,Death Rate,Age Specific Death Rate,Age-Specific Death Rate,Case Fatality Rate,Decline, Mortality,Determinants, Mortality,Differential Mortality,Excess Mortality,Mortality Decline,Mortality Determinants,Mortality Rate,Mortality, Differential,Mortality, Excess,Age-Specific Death Rates,Case Fatality Rates,Crude Death Rates,Crude Mortality Rates,Death Rate, Age-Specific,Death Rate, Crude,Death Rates,Determinant, Mortality,Differential Mortalities,Excess Mortalities,Mortalities,Mortality Declines,Mortality Determinant,Mortality Rate, Crude,Mortality Rates,Rate, Age-Specific Death,Rate, Case Fatality,Rate, Crude Death,Rate, Crude Mortality,Rate, Death,Rate, Mortality,Rates, Case Fatality
D009520 New Zealand A group of islands in the southwest Pacific. Its capital is Wellington. It was discovered by the Dutch explorer Abel Tasman in 1642 and circumnavigated by Cook in 1769. Colonized in 1840 by the New Zealand Company, it became a British crown colony in 1840 until 1907 when colonial status was terminated. New Zealand is a partly anglicized form of the original Dutch name Nieuw Zeeland, new sea land, possibly with reference to the Dutch province of Zeeland. (From Webster's New Geographical Dictionary, 1988, p842 & Room, Brewer's Dictionary of Names, 1992, p378)
D002423 Cause of Death Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. Causes of Death,Death Cause,Death Causes
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children

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