Importance of reducing health inequalities
20 April 2005
Report highlights importance of reducing health inequalities
A new report measuring trends in socioeconomic mortality in New Zealand highlights the importance of reducing health inequalities, the Ministry of Health said today.
Decades of Disparity II: Socioeconomic mortality trends in New Zealand, 1981-1999 shows that life expectancy improved by the same amount for people in high and low income groups.
``It's pleasing that death rates among low-income New Zealanders have reduced to the same extent as among wealthier people. But we would like to see the low-income group improve even faster,'' said Director of Public Health Dr Mark Jacobs.
``The results in this report show how crucial it is to have policies and initiatives that address health inequalities so that there is more support for the high-needs communities that will benefit most.''
Heart disease made the largest contribution to the total socioeconomic inequality in death rates, although this lessened over time among women. However, Dr Jacobs said that the impact of cancer on death rates increased over time and could overtake heart disease in the near future.
``As the chronic disease most amenable to primary intervention and treatment, heart disease death rates among low income groups is a high priority in helping reduce these inequalities in the future. This is where the Primary Health Care Strategy and Primary Health Organisations (PHOs) play a vital role. PHOs are making it easier for people to get affordable primary health care and PHO providers are exploring innovative ways to keep people enrolled with them healthy and out of hospital. To help do this, PHO providers are strengthening prevention, early management and health promotion.''
He noted that the Cancer Control Strategy, along with the recently announced Cancer Control Strategy Action Plan and the additional $40 million that went with the first phase of the plan, would be instrumental in fighting the disease.
The Ministry of Health is also continuing to promote the equity tools - Reducing Inequalities Intervention Framework and the Health Equity Assessment Tool. Workshops have been held with District Health Boards, and DHBs include equity in their annual planning and reporting processes.
Decades of Disparity II: Socioeconomic mortality trends in New Zealand, 1981-1999, a routine monitoring report on health inequalities, was jointly produced by the Ministry of Health and Otago University's Wellington School of Medicine. It is a product of the New Zealand Census - Mortality Study (NZCMS), conducted in close collaboration with Statistics New Zealand.
The first Decades of Disparity report, published in 2003, described the widening mortality inequality between Maori and Pacific peoples compared with non-Maori and non-Pacific people in New Zealand over the 1980s and 1990s.
The third and final report is due for publication in 2006 and will analyse the interaction between socio-economic position and ethnic identity in determining survival chances in New Zealand.
To view Decades of Disparity II: Socioeconomic mortality trends in New Zealand, 1981-1999, go to www.moh.govt.nz
Questions and Answers
What does Decades of Disparity II: Socioeconomic mortality trends in New Zealand, 1981-1999 aim to do? It describes and interprets trends in inequalities in mortality by income for New Zealand from 1981 to 1999.
Who produced the report? It was a collaboration between the Wellington School of Medicine and Health Sciences of the University of Otago and the Public Health Intelligence group of the Ministry of Health.
What has driven this collaboration? The Ministry's mandate to monitor and report on the health of the population, and the need to understand and interpret trends in social inequalities in health to both improve knowledge and assist policy.
Why is it important to monitor inequalities in mortality by socioeconomic position? Because the low mortality rates experienced by the powerful and privileged in New Zealand society provide a benchmark, indicating the level of survival that all income groups could reasonably aspire to.
Why is it important to monitor trends in mortality by socioeconomic position? Information on trends increases our understanding of social inequalities in health, and most importantly, provides a pointer for the future.
Projecting the historical trends in cause-specific mortality by socioeconomic group can identify which causes of death are likely to be the major drivers of the socioeconomic mortality gradient over the next 10-20 years.
What are ``absolute inequalities'' between income groups? It is the difference in mortality rates between low and high-income people.
What are ``relative inequalities'' between income groups? It is the ratio of mortality rates for low compared with high-income people.
What is the overall key finding of the report? The key finding is one of stable absolute inequality, with increasing relative inequality in mortality from most major causes.
Increasing relative inequality is not surprising when mortality rates are falling for all groups.
Widening inequality in New Zealand's income distribution over the observation period has clearly contributed to this trend.