Deprivation and tobacco are working together
25 October 2001
Deprivation and tobacco are working together to shorten life expectancy
It's no secret that deprivation and tobacco reduce life expectancy but two new Ministry of Health reports provide detailed evidence of the relationship between the two across different New Zealand communities.
The Ministry's occasional bulletins on Life expectancy and small area deprivation in New Zealand and Inhaling Inequality: Tobacco's contribution to health inequality in New Zealand take an in-depth look at how deprivation affects life expectancy and how tobacco contributes to this inequality, said Deputy Director-General of Public Health Dr Don Matheson.
The report focuses on the life expectancy of residents of meshblocks -- an area with a population of about 90 people that is the smallest block studied in each census -- grouped according to their level of socioeconomic deprivation.
It found a steep gradient in life expectancy across the range of deprivation levels. Men from the most advantaged areas live on average nine years longer than men from the most disadvantaged communities. For women the difference is under seven years.
"The disparities these reports highlight are of grave concern to the Ministry and we remain committed to trying to reduce them.
"We were already aware of many of the issues but this new data helps us quantify the relationships better and track changes over time," Dr Matheson said.
Tobacco is widely recognised as the leading cause of early death in developed countries but its impact hits different sections of the community in different ways.
The report shows smoking is one of the main pathways linking deprivation to premature death. Smoking accounts for about one-third of the deprivation gradient, one-quarter of the Maori-non Maori difference, and one-fifth of the gender difference in life expectancy.
"Tobacco control is a vital part of addressing inequalities. Even though New Zealand's tobacco control programme is among the world's best, and already addresses the needs of deprived communities and certain ethnic groups, there is still some way to go.
The report also identifies the importance of wider factors around deprivation that need to be addressed. Two-thirds of the effect of deprivation on life expectancy is related these wider causes such as housing, education and income.
"We need to tackle the root causes of social inequality as well as treat the 'symptoms', such as smoking," Dr Matheson said.
For more information contact: Anne-Marie Robinson, Media Advisor, ph: 04-496-2067 or 025-802 622 http://www.moh.govt.nz/media.html
or: Murray Laugesen Managing Director and Public Health Physician Health New Zealand ph: 09 585 1228 or 025 884 375 firstname.lastname@example.org
Peter Crampton Senior Lecturer Department of Public Health Wellington School of Medicine ph: (04) 385 5999 x 6045 email@example.com
Questions and Answers about the Reports
Q. What is the overall conclusion about the effect of tobacco on life expectancy?
A. Overall it concludes that the loss of health to tobacco accounts for about one-fifth of the gender difference in life expectancy at birth, one-quarter of the inequality between Mäori and non-Mäori, and one-third of the deprivation gradient
Q. The report says smokers lose about five years in life expectancy -- why is this less the fourteen year figure sometimes mentioned?
A. The fourteen year figure refers only to those smokers who die early because of tobacco, the figure estimated in the report includes all smokers (whether they die from a smoking-related cause or not)
Q. How much would life expectancy in New Zealand improve from reducing tobacco use compared with other public health efforts?
A. The impact of eliminating tobacco consumption on the health of New Zealand's population is estimated to be greater than that of infectious diseases and all maternal and infant conditions combined, or similar to that of preventing all types of intentional and unintentional injuries. These estimates of increases in life expectancy from tobacco elimination are conservative, mostly because the effects of second-hand smoke are not included in the model.
Q. What is the deprivation gradient?
The deprivation gradient in life expectancy refers to the fact people living in more deprived small areas have lower life expectancy than those living in less deprived areas, and this applies right across all degrees of deprivation, not just comparing the most with the least deprived areas.
Anne Marie Robinson Media Advisor Ministry of Health DDI: 04 496 2067 Mobile: Fax: 04-496-2010