Ethnic inequalities in mortality among the elderly in New Zealand

Jatrana, Santosh and Blakely, Tony 2008, Ethnic inequalities in mortality among the elderly in New Zealand, Australian and New Zealand journal of public health, vol. 32, no. 5, pp. 437-443, doi: 10.1111/j.1753-6405.2008.00276.x.

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Title Ethnic inequalities in mortality among the elderly in New Zealand
Author(s) Jatrana, Santosh
Blakely, Tony
Journal name Australian and New Zealand journal of public health
Volume number 32
Issue number 5
Start page 437
End page 443
Total pages 7
Publisher Wiley
Place of publication Chichester, Eng.
Publication date 2008-10
ISSN 1326-0200
Keyword(s) Aged
Aged, 80 and over
Asian Continental Ancestry Group
Cause of Death
Censuses
Ethnic Groups
Female
Health Status Disparities
Humans
Male
Medical Record Linkage
Mortality
New Zealand
Oceanic Ancestry Group
Poisson Distribution
Residence Characteristics
Risk Assessment
Risk Factors
Sex Distribution
Socioeconomic Factors
Vulnerable Populations
Summary OBJECTIVES: To explore the contributions of socio-economic and demographic factors to ethnic disparity among older adult (65+) all cause and cause-specific mortality differentials among Māori, Pacific, Asians and non-Māori, non-Pacific non-Asian (nMnPnA) in New Zealand. METHODS: We used univariate and multivariable Poisson regression models on linked New Zealand census and mortality data for older adults (65 years and above) (2001 to 2004, 1.3 million person years) with a comprehensive set of socio-economic indicators (education, income, car access, housing tenure, neighourhood deprivation). RESULTS: After controlling for the differences in age structure, Māori and Pacific males had a higher relative risk of dying than nMnPnA (RR=1.88 (95% Cl: 1.74, 2.04) and RR=1.75 (95% Cl: 1.54, 1.99) respectively) while Asian males had lower risk of dying (RR=0.66, 95% Cl: 0.57, 0.76). For females, the pattern was similar. The mortality gap between ethnic groups was mediated in part by socio-economic factors. The five socio-economic factors appear to account for greater than 40% of the excess mortality for Māori and Pacific men and about 34% for Māori females and 48% for Pacific females compared to nMnPnA men and nMnPnA women respectively. However, for Asian people, adjusting for socio-economic factors actually increases the relative gaps in mortality compared to nMnPnA by 18% for male and 71% for females. CONCLUSION: The results demonstrate that clear ethnic mortality gradients persist into old age and the mortality level of most groups was influenced by varying distribution of socio-economic factors. To reduce ethnic differences in old age mortality, inequalities as a result of socio-economic position should be reduced.
Language eng
DOI 10.1111/j.1753-6405.2008.00276.x
Field of Research 1117 Public Health And Health Services
1402 Applied Economics
1605 Policy And Administration
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2008, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30118303

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