Tobias Martin, Yeh Li-Chia, Wright Craig, Riddell Tania, Chan Wing Cheuk, Jackson Rod, Mann Stewart
Public Health Intelligence, New Zealand Ministry of Health, New Zealand.
Aust N Z J Public Health. 2009 Aug;33(4):384-7. doi: 10.1111/j.1753-6405.2009.00412.x.
To estimate coronary heart disease (CHD) incidence, prevalence, survival, case fatality and mortality for Māori, in order to support service planning and resource allocation.
Incidence was defined as first occurrence of a major coronary event, i.e. the sum of first CHD hospital admissions and out-of-hospital CHD deaths in people without a hospital admission for CHD in the preceding five years. Data for the years 2000-02 were sourced from the New Zealand Health Information Service and record linkage was carried out using a unique national identifier, the national health index.
Compared to the non-Māori population, Māori had both elevated CHD incidence and higher case fatality. Median age at onset of CHD was younger for Māori, reflecting both higher age specific risks and younger population age structure. The lifetable risk of CHD for Māori was estimated at 37% (males) and 34% (females), only moderately higher than the corresponding estimates for the non-Māori population, despite higher Māori CHD incidence. This reflects the offsetting effect of the higher 'other cause' mortality experienced by Māori. Median duration of survival with CHD was similar to that of the non-Māori population for Māori males but longer for Māori females, which is most likely related to the earlier age of onset.
This study has generated consistent estimates of CHD incidence, prevalence, survival, case fatality and mortality for Māori in 2000-02. The inequality identified in CHD incidence calls for a renewed effort in primary prevention. The inequality in CHD case fatality calls for improvement in access for Māori to secondary care services.
估算毛利人的冠心病（CHD）发病率、患病率、生存率、病死率和死亡率，以支持服务规划和资源分配。
发病率定义为首次发生重大冠状动脉事件，即过去五年内未因冠心病住院的人群中首次冠心病住院人数与院外冠心病死亡人数之和。2000 - 2002年的数据来源于新西兰卫生信息服务局，并使用唯一的国家标识符——国家健康指数进行记录链接。
与非毛利人群相比，毛利人的冠心病发病率和病死率均较高。毛利人冠心病发病的中位年龄较轻，这既反映了较高的年龄特异性风险，也反映了较年轻的人口年龄结构。尽管毛利人的冠心病发病率较高，但估计毛利人患冠心病的生命表风险为37%（男性）和34%（女性），仅略高于非毛利人群的相应估计值。这反映了毛利人较高的“其他原因”死亡率的抵消作用。毛利男性冠心病生存的中位持续时间与非毛利人群相似，但毛利女性更长，这很可能与发病年龄较早有关。
本研究得出了2000 - 2002年毛利人冠心病发病率、患病率、生存率、病死率和死亡率的一致估计值。冠心病发病率方面发现的不平等现象要求在一级预防方面重新做出努力。冠心病病死率方面的不平等现象要求改善毛利人获得二级医疗服务的机会。
