A JUST-RELEASED report has reinforced the need to consider the poorer health status of people from lower socio-economic backgrounds when formulating health policy.

The Ministry of Health commissioned report, Social Inequalities in Health: New Zealand 1999, has highlighted the varying health-related quality of life people from different socio-economic groups experience.

The report confirms that in all age, gender and ethnic groups, people living in deprived neighbourhoods have shorter life expectancies and higher hospitalisation rates than those from more affluent areas.

Director General of Health Dr Karen Poutasi said the Ministry was aware of the problem.

"We have known the grim health facts for people from lower socio economic backgrounds for some time. We have been working to improve the health status of people from poorer backgrounds in recent years but the issue is complex and requires input from other areas including employment, social welfare and housing," Dr Poutasi said.

Officials from various Government departments are already working together on programmes like Family Start, Social Workers in Schools, co-ordinating services for families at risk, and the Crime Prevention Taskforce.

"This report provides the Ministry, the Government, other Government departments and community organisations with the data necessary to aid effective decision making and the development of solutions. It also provides a baseline from which to monitor changes in health disparities.

"This report is particularly timely in view of the priority the Government has accorded to reducing disparities for Maori and Pacific peoples. Current initiatives include the Goverment's inter-sectoral Closing the Gaps project, while reducing the difference in health status between groups is a key aim of the New Zealand Health Strategy.

"This report will also be useful for district health boards who will focus on the needs of their local populations and will work with other sectors in their communities to address the issues this report raises," Dr Poutasi said.

ENDS

The report is available both in hard copy and on the Ministry's website http://www.moh.govt.nz

For further information contact; Sue McCabe, Media Advisor, 04 496 2067 or 025 495 989

Other people to contact for comment on this report; Professor Peter Davis, Christchurch School of Medicine Public Health 03 364 0530

Dr Philippa Howden-Chapman, Senior Lecturer, Wellington School of Medicine, Department of Public Health 04 385 5541

Background Information Social Inequalities in Health: New Zealand 1999 provides a baseline for future monitoring of trends in the health status of different socio-economic groups. The report looks at key aspects of the community's social structure like deprivation, income, education, occupational class, labourforce participation, employment and housing. The report considers two dimensions of health - quantity and quality of life.

It is a companion to the Ministry's Our Health, Our Future: The health of New Zealanders 1999 publication which analysed the health of the nation in terms of mortality and morbidity, the burden of disease and the scope for health gain. The report, Our Health, Our Future and the accompanying media release was issued last year and is on the Ministry's website, www.moh.govt.nz.

These publications are part of the reporting cycle on public health, providing Government with reliable and valid data on which to base policy decisions. Also part of this cycle are annual reports on progress towards specific health outcome targets.

The Ministry commissioned Wellington School of Medicine researchers to undertake Social Inequalities in Health: New Zealand 1999, a successful partnership between a ministry and academia. Authors include Dr Philippa Howden-Chapman, Dr Peter Crampton, Mr Des O'Dea, Mrs Clare Salmond, Dr Nick Wilson, Dr Tony Blakely.

Key Findings Please note the following information is a summary only of some findings and is not intended to be representative or include all noteworthy points from the report

lower household income is associated with poorer health status (Chapter Three; Income and Income Inequality and Health - pg 65-86)

lower educational status is consistently linked to higher prevalence of diabetes, asthma, hypertension and lower physical health. This is consistent with international findings. (Chapter Four; Education and Health - pg 87-102)

the link between occupational class and non-fatal health outcomes was weak, but an underestimation of the relationship in this area is likely (Chapter Five; Occupational Class and Health - pg 103-118)

unemployment is associated with a higher prevalence of disability, and worse mental and physical health. Also, other New Zealand research (eg Rose 1999) showed unemployment is linked with suicide and intentional self-harm. (Chapter Six; Labour Force Status and Health - pg 119-132)

the relationship between overcrowded houses and self-reported health was marked. Residents in overcrowded homes were more likely to self rate their health as poor. Also, a case control study has found crowding is a major risk factor for meningococcal disease. (Chapter Seven; Housing and Health - pg 133-146)

people in more socioeconomically deprived areas have higher hospitalisation rates than those in less deprived areas obesity is more prevalent among those from lower socio-economic backgrounds and more prevalent among those with no or low educational qualifications people living in more deprived areas in New Zealand have higher rates of smoking than those in less deprived areas. Those with lower educational attainment, lower incomes and lower status occupations were more likely to smoke. This relationship applied to both genders and all ethnic groups. Maori have higher mortality rates than European New Zealanders and there is generally a widening gap between the ethnic groups as deprivation increases Pacific peoples experience worse health status than Europeans, and like Maori are concentrated in the lower end of the socio economic scale the report summary says socio-economic factors do not explain all of the health disparity for Maori and Pacific peoples. Part of the explanation may lie instead in perceived or actual discrimination experienced by these groups Chapter Eight; Summary and Conclusions - pg 147-168)

Sue McCabe Media Advisor Communications DDI: 496 2067 Fax: 496 2010 mailto:sue_mccabe@moh.govt.nz Ministry of Health

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