Monitoring health inequalities: life expectancy and small area deprivation in New Zealand

Martin I. Tobias · Jit Cheung

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Health disparities and outcomes Insurance, Mortality, Demography, Risk Management Public Health and Social Inequalities

Abstract

BACKGROUND: Socioeconomic and ethnic inequalities in health are of great concern, and life expectancy provides a readily understood means of monitoring such inequalities. The objectives of this study are to (1) measure life expectancy by socioeconomic deprivation and ethnicity, and (2) describe trends in the deprivation gradient in life expectancy since the mid-1990s. METHODS: Three years of national mortality data have been combined with mid-point population denominators to produce life tables within nationally determined levels of small area deprivation (NZDep96) for three ethnic group: European, Mäori and Pacific peoples. This process has been repeated for the periods 1995-97, 1996-98, 1997-99 and 1998-2000. RESULTS: There was a strong relationship between increasing small area deprivation and decreasing life expectancy. Through the mid- to late 1990s, males living in the most deprived small areas in New Zealand experienced life expectancies at birth approximately nine years less than their counterparts living in the least deprived areas; for females the corresponding difference was under seven years.Mäori and Pacific life expectancies at birth were lower than those of Europeans at each level of deprivation.Over the study period (1995-2000) the gradient in life expectancy across deprivation deciles remained stable. CONCLUSION: Small area deprivation analyses of life expectancy could be repeated routinely at regular intervals, which would provide a useful approach to monitoring trends in socioeconomic, geographic, ethnic and gender inequalities in mortality.

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References

1987The New Zealand Medical Journal 1887-1987.2000Levels of racism: a theoretic framework and a gardener's tale 1995Deprivation indices: their interpretation and use in relation to health.1993Social deprivation and premature mortality: regional comparison across England.1998NZDep91: A New Zealand index of deprivation 2002Social class mortality differences in Maori and non-Maori men aged 15-64 during the last two decades.

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