Sporle Andrew, Pearce Neil, Davis Peter
Department of Public Health and General Practice, Christchurch School of Medicine.
N Z Med J. 2002 Mar 22;115(1150):127-31.
This investigation uses data from 1996-97 to update previous studies of social class mortality differences in Maori and non-Maori New Zealand men aged 15-64 years.
Numerator data were obtained from the national death registrations and denominator data were from the 1976, 1986 and 1996 censi. For each social class, age standardised death rates in Maori and non-Maori men were calculated for amenable, non-amenable and all causes of mortality.
Maori male mortality was significantly higher than non-Maori mortality in each social class and for the total population for amenable (overall RR = 5.3(CI = 4.0-6.9)), non-amenable (overall RR = 2.4(2.2-2.6)) and all causes of mortality (overall RR = 2.4(2.3-2.6)). The social class mortality differences within Maori (relative index of inequality was 3.3) were markedly greater than non-Maori class differences (RII = 1.5).
The persistently high Maori mortality rates, when controlled for social class, indicate that the poor state of Maori health cannot be explained solely by relative socioeconomic disadvantage. The high Maori rate of potentially preventable deaths indicates that the health sector is still not meeting the serious health needs of many Maori. The social class mortality gradient within Maori underlines the need to address disparities within Maori.
本研究利用1996 - 1997年的数据更新此前对15 - 64岁新西兰毛利族和非毛利族男性社会阶层死亡率差异的研究。
分子数据取自国家死亡登记处,分母数据来自1976年、1986年和1996年的人口普查。针对每个社会阶层,计算毛利族和非毛利族男性在可避免、不可避免及所有死因方面的年龄标准化死亡率。
在每个社会阶层以及总人口中,毛利族男性在可避免死因(总体相对危险度RR = 5.3(可信区间CI = 4.0 - 6.9))、不可避免死因(总体RR = 2.4(2.2 - 2.6))和所有死因(总体RR = 2.4(2.3 - 2.6))方面的死亡率显著高于非毛利族。毛利族内部的社会阶层死亡率差异(不平等相对指数为3.3)明显大于非毛利族的阶层差异(RII = 1.5)。
在控制社会阶层因素后,毛利族持续居高的死亡率表明,毛利族健康状况不佳不能仅用相对社会经济劣势来解释。毛利族潜在可预防死亡的高比率表明,卫生部门仍未满足许多毛利人的严重健康需求。毛利族内部的社会阶层死亡率梯度凸显了解决毛利族内部差异问题的必要性。