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

Martin I Tobias,Jit Cheung

doi:10.1186/1478-7954-1-2

Abstract

BackgroundSocioeconomic 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.MethodsThree 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.ResultsThere 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.ConclusionSmall 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.

Highlights

In New Zealand, as in other countries, socioeconomic inequalities in health are of great concern [1]
Previous analyses have been restricted to occupation-based social classes, as occupation is the only socio-economic variable recorded on New Zealand death certificates
These studies show that mortality varies linearly across the six social classes, the ratio between extreme classes being about two-fold [2,3]

Summary

Introduction

In New Zealand, as in other countries, socioeconomic inequalities in health are of great concern [1]. We have only limited information about socioeconomic mortality gradients in New Zealand, and whether the distribution of survival chances across the population is becoming more or less equal over time. Previous analyses have been restricted to occupation-based social classes, as occupation is the only socio-economic variable recorded on New Zealand death certificates. These studies show that mortality varies linearly across the six social classes, the ratio between extreme classes being about two-fold [2,3]. 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

Objectives

Methods

Results

Discussion

Conclusion