The burden of coronary heart disease in Māori: population‐based estimates for 2000‐02

Abstract

To estimate coronary heart disease (CHD) incidence, prevalence, survival, case fatality and mortality for Māori, in order to support service planning and resource allocation. Incidence was defined as first occurrence of a major coronary event, i.e. the sum of first CHD hospital admissions and out-of-hospital CHD deaths in people without a hospital admission for CHD in the preceding five years. Data for the years 2000-02 were sourced from the New Zealand Health Information Service and record linkage was carried out using a unique national identifier, the national health index. Compared to the non-Māori population, Māori had both elevated CHD incidence and higher case fatality. Median age at onset of CHD was younger for Māori, reflecting both higher age specific risks and younger population age structure. The lifetable risk of CHD for Māori was estimated at 37% (males) and 34% (females), only moderately higher than the corresponding estimates for the non-Māori population, despite higher Māori CHD incidence. This reflects the offsetting effect of the higher 'other cause' mortality experienced by Māori. Median duration of survival with CHD was similar to that of the non-Māori population for Māori males but longer for Māori females, which is most likely related to the earlier age of onset. This study has generated consistent estimates of CHD incidence, prevalence, survival, case fatality and mortality for Māori in 2000-02. The inequality identified in CHD incidence calls for a renewed effort in primary prevention. The inequality in CHD case fatality calls for improvement in access for Māori to secondary care services.