Pearce Neil, Davis Peter, Sporle Andrew
Department of Medicine, Wellington School of Medicine, and Centre for Public Health Research, Massey University, New Zealand.
Aust N Z J Public Health. 2002 Feb;26(1):17-22. doi: 10.1111/j.1467-842x.2002.tb00265.x.
Social class mortality differences in New Zealand men aged 15-64 years have previously been examined for the periods 1975-77 and 1985-87 using the Elley-Irving social class scale. The objective was to repeat these analyses for 1995-97 in order to examine time trends, and to assess current social class patterns of mortality.
Age-standardised mortality rates were calculated for each social class and a weighted estimate of the social class mortality gradient was obtained.
Male mortality declined 21% between 1985-87 and 1995-97, but the social class mortality differences have not diminished and may have even increased. The Relative Index of Inequality has increased from 1.8 in 1975-77 to 2.1 in 1985-87 and 2.3 in 1995-97. Unlike previous analyses, the relative social class mortality gradient was just as strong in the older age groups as in the younger age groups, indicating that the possible increase in social class gradient has largely occurred in the older age groups.
These findings indicate that the potential to address the excess preventable mortality caused by socio-economic factors has not been fully realised in New Zealand.
Social class analyses identify groups in the community that have an excess mortality that is potentially preventable. There are still major social class differences in mortality in New Zealand, and these differences may even have increased. It is important that these patterns are taken into account in public health planning and that further research is conducted to identify the mechanisms by which these differences occur.
此前曾使用埃利 - 欧文社会阶层量表,对1975 - 1977年和1985 - 1987年期间新西兰15 - 64岁男性的社会阶层死亡率差异进行过研究。目的是重复对1995 - 1997年的这些分析,以研究时间趋势,并评估当前的社会阶层死亡率模式。
计算每个社会阶层的年龄标准化死亡率,并获得社会阶层死亡率梯度的加权估计值。
1985 - 1987年至1995 - 1997年期间,男性死亡率下降了21%,但社会阶层死亡率差异并未缩小,甚至可能有所增加。不平等相对指数已从1975 - 1977年的1.8增至1985 - 1987年的2.1和1995 - 1997年的2.3。与之前的分析不同,老年组的相对社会阶层死亡率梯度与年轻组一样大,这表明社会阶层梯度可能的增加主要发生在老年组。
这些发现表明,新西兰尚未充分实现解决由社会经济因素导致的可预防的超额死亡率的潜力。
社会阶层分析确定了社区中存在潜在可预防的超额死亡率的群体。新西兰的死亡率在社会阶层方面仍存在重大差异,而且这些差异甚至可能有所增加。在公共卫生规划中考虑这些模式很重要,并且需要进行进一步研究以确定这些差异产生的机制。