Blakely Tony, Tobias Martin, Robson Bridget, Ajwani Shilpi, Bonné Martin, Woodward Alistair
Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, P.O. Box 7343, Wellington, New Zealand.
Soc Sci Med. 2005 Nov;61(10):2233-51. doi: 10.1016/j.socscimed.2005.02.011.
The aim of this paper is to determine the extent of undercounting of Mäori and Pacific deaths in New Zealand during the 1980s and 1990s, and to calculate corrected ethnic mortality and life expectancy trends. We calculated adjustment ratios for undercounting of Mäori and Pacific deaths (and over-counting of non-Mäori non-Pacific (nMnP) deaths) using the linked census-mortality data. These ratios were then used to calculate corrected mortality rates and life expectancies. Mäori deaths were underestimated by a quarter, and Pacific deaths by a third, during the 1980s and early 1990s. Undercounting was minor in the late 1990s following alignment of ethnicity collection on mortality data to approximate the census. Corrected mortality rates demonstrated 30% (males) and 26% (females) decreases among nMnP from 1980-84 to 1996-99, smaller decreases among Mäori (8% and 7%) and no clear change among Pacific people (9% decrease for males, 4% increase for females). The gap in life expectancy increased from an average of 7.7 years in 1980-84 to 10.8 years in 1996-99 for Mäori, and from 3.3 to 7.7 years for Pacific people, in comparison to nMnP people. Deaths among 45-64 and 65 plus year olds, and cardiovascular disease and cancer deaths, were the main contributors to these disparities. The economic reforms in New Zealand during the 1980s and early 1990s impacted harder upon Mäori and Pacific people in terms of unemployment and income, and are a likely explanation for the diverging mortality trends in this period. Both behavioural factors and health services probably also play a role, but in the absence of trend data by ethnicity, their contribution to diverging mortality trends is unknown. Internationally, our study demonstrates marked undercounting of Mäori and Pacific deaths. We strongly encourage researchers and custodians of vital statistics in other countries to investigate the possibility of undercounting of deaths by ethnicity.
本文旨在确定20世纪80年代和90年代新西兰毛利人和太平洋岛民死亡人数少计的程度，并计算经校正的种族死亡率和预期寿命趋势。我们使用关联的人口普查-死亡率数据计算了毛利人和太平洋岛民死亡人数少计（以及非毛利非太平洋岛民（nMnP）死亡人数多计）的调整比率。然后，这些比率被用于计算经校正的死亡率和预期寿命。在20世纪80年代和90年代初，毛利人死亡人数被低估了四分之一，太平洋岛民死亡人数被低估了三分之一。在20世纪90年代后期，随着死亡率数据中种族收集的调整以接近人口普查，少计情况有所减少。经校正的死亡率显示，从1980 - 1984年到1996 - 1999年，nMnP人群中男性死亡率下降了30%，女性下降了26%；毛利人下降幅度较小（分别为8%和7%）；太平洋岛民没有明显变化（男性下降9%，女性上升4%）。与nMnP人群相比，毛利人的预期寿命差距从1980 - 1984年的平均7.7岁增加到1996 - 1999年的10.8岁，太平洋岛民的预期寿命差距从3.3岁增加到7.7岁。45 - 64岁及65岁以上人群的死亡，以及心血管疾病和癌症死亡，是这些差异的主要原因。20世纪80年代和90年代初新西兰的经济改革在失业和收入方面对毛利人和太平洋岛民的影响更大，这可能是这一时期死亡率趋势分化的一个解释。行为因素和医疗服务可能也起到了作用，但由于缺乏按种族划分的趋势数据，它们对死亡率趋势分化的贡献尚不清楚。在国际上，我们的研究表明毛利人和太平洋岛民死亡人数存在明显少计的情况。我们强烈鼓励其他国家的研究人员和生命统计数据保管人调查按种族少计死亡人数的可能性。
