Tobias Martin, Yeh Li-Chia
Public Health Intelligence, Ministry of Health, Wellington, New Zealand.
Aust N Z J Public Health. 2007 Jun;31(3):207-10. doi: 10.1111/j.1753-6405.2007.00049.x.
To quantify the contribution of health care to ethnic and socio-economic inequalities in health in New Zealand in 2000-02, using the concept of 'amenable' mortality (deaths at ages 0-74 years from causes responsive to health care).
Mortality data for 2000-02 were provided by the New Zealand Health Information Service and 2001 Census population data were provided by Statistics New Zealand. The classification of ICD-10 codes as amenable or non-amenable used in the Australian and New Zealand Atlas of Avoidable Mortality (2006) was adopted. Ethnicity was categorised as Maori, Pacific or European/Other. Socio-economic position was measured using a Census-based small area deprivation index, the NZDep2001. Mortality rates were standardised for age by the direct method for the ethnic group comparisons, and for both age and ethnicity for the deprivation group comparisons. The contribution of health care to health inequality was then quantified as the ratio of the difference in standardised amenable mortality rates to the difference in standardised total mortality rates (in the age group 0-74 years) between relevant groups.
Amenable causes of death were estimated to account for 27%, 34%, 33% and 44% of the total mortality disparity (0-74 years) for Maori males, Maori females, Pacific males and Pacific females respectively, relative to their European/ Other counterparts (adjusting for age). The corresponding proportions for the 'deprived' population relative to the 'non-deprived' population were 26% (males) and 30% (females), adjusting for age and ethnicity.
Amenable causes of death made a substantial contribution to differences in mortality in the 0-74 year age range between ethnic and socio-economic groups in New Zealand in 2000-02, ranging from 26-44% depending on the group.
运用“可避免”死亡率（0至74岁因对医疗保健有反应的病因导致的死亡）这一概念，量化2000 - 2002年医疗保健对新西兰健康方面的种族和社会经济不平等的影响。
2000 - 2002年的死亡率数据由新西兰卫生信息服务局提供，2001年人口普查数据由新西兰统计局提供。采用了《澳大利亚和新西兰可避免死亡率地图集》（2006年）中对国际疾病分类第十版（ICD - 10）编码的可避免或不可避免分类方法。种族分为毛利人、太平洋岛民或欧洲人/其他种族。社会经济地位通过基于人口普查的小区域贫困指数NZDep2001来衡量。种族组比较时，死亡率按年龄直接标准化；贫困组比较时，死亡率按年龄和种族标准化。然后将医疗保健对健康不平等的影响量化为相关组之间标准化可避免死亡率差异与标准化总死亡率差异（0至74岁年龄组）的比率。
估计可避免死因分别占毛利男性、毛利女性、太平洋岛民男性和太平洋岛民女性与欧洲人/其他种族对应人群（年龄调整后）总死亡率差距（0至74岁）的27%、34%、33%和44%。相对于“非贫困”人群，“贫困”人群（年龄和种族调整后）的相应比例为男性26%，女性30%。
2000 - 2002年，可避免死因对新西兰0至74岁年龄范围内种族和社会经济群体之间的死亡率差异有重大影响，根据群体不同，影响范围在26%至44%之间。
