Dataset Information

Inequalities in mortality during and after restructuring of the New Zealand economy: repeated cohort studies.

ABSTRACT:

Objectives

To determine whether disparities between income and mortality changed during a period of major structural and macroeconomic reform and to estimate the changing contribution of different diseases to these disparities.

Design

Repeated cohort studies.

Data sources

1981, 1986, 1991, 1996, and 2001 censuses linked to mortality data. Population Total New Zealand population, ages 1-74 years.

Methods

Mortality rates standardised for age and ethnicity were calculated for each census cohort by level of household income. Standardised rate differences and rate ratios, and slope and relative indices of inequality (SII and RII), were calculated to measure disparities on both absolute and relative scales.

Results

All cause mortality rates declined over the 25 year study period in all groups stratified by sex, age, and income, except for 25-44 year olds of both sexes on low incomes among whom there was little change. In all age groups pooled, relative inequalities increased from 1981-4 to 1996-9 (RIIs increased from 1.85 (95% confidence interval 1.67 to 2.04) to 2.54 (2.29 to 2.82) for males and from 1.54 (1.35 to 1.76) to 2.12 (1.88 to 2.39) for females), then stabilised in 2001-4 (RIIs of 2.60 (2.34 to 2.89) and 2.18 (1.93 to 2.45), respectively). Absolute inequalities were stable over time, with a possible fall from 1996-9 to 2001-4. Cardiovascular disease was the major contributor to the observed disparities between income and mortality but decreased in importance from 45% in 1981-4 to 33% in 2001-4 for males and from 50% to 29% for females. The corresponding contribution of cancer increased from 16% to 22% for males and from 12% to 25% for females.

Conclusions

During and after restructuring of the economy disparities in mortality between income groups in New Zealand increased in relative terms (but not in absolute terms), but it is difficult to confidently draw a causal link with structural reforms. The contribution of different causes of death to this inequality changed over time, indicating a need to re-prioritise health policy accordingly.

SUBMITTER: Blakely T

PROVIDER: S-EPMC2244751 | biostudies-literature | 2008 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Inequalities in mortality during and after restructuring of the New Zealand economy: repeated cohort studies.

Blakely Tony T Tobias Martin M Atkinson June J

BMJ (Clinical research ed.) 20080124 7640

<h4>Objectives</h4>To determine whether disparities between income and mortality changed during a period of major structural and macroeconomic reform and to estimate the changing contribution of different diseases to these disparities.<h4>Design</h4>Repeated cohort studies.<h4>Data sources</h4>1981, 1986, 1991, 1996, and 2001 censuses linked to mortality data. Population Total New Zealand population, ages 1-74 years.<h4>Methods</h4>Mortality rates standardised for age and ethnicity were calculat ...[more]

PMID: 18218998

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Dataset Information

Inequalities in mortality during and after restructuring of the New Zealand economy: repeated cohort studies.

Objectives

Design

Data sources

Methods

Results

Conclusions

Publications

Inequalities in mortality during and after restructuring of the New Zealand economy: repeated cohort studies.

Similar Datasets

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