Gender inequality in New Zealand life expectancy: decomposition by age and cause.

AIM To quantify gender inequality in life expectancy at birth (LEB) in New Zealand and the contribution to it made by different age groups and causes of death. To examine the response of the health sector.METHOD Determination of the trend in sex differences in LEB. Multiple decrement decomposition of LEB differences into components ages and causes. Review of the gender equity policies and priorities of New Zealand's main health sector stakeholders.RESULTS A difference between the sexes in LEB of 4.7 years for Māori and 4.0 years for non-Māori, reverses the historically lower gender disparity among the Māori. Over half of the sex difference in LEB is accounted for by heart disease and all types of cancer and almost a quarter by accidents and suicide but male survival disadvantage is evident in many other causes of death. The health sector is beginning to acknowledge the survival disadvantage of men as inequitable, and reducing disparity as a legitimate goal for health policy.CONCLUSION Although gender inequality in LEB is declining among the non-Māori it remains high among the Māori. Smoking habits may explain some of the difference in LEB but policies must also address the causes of sex differences in accidental death and suicide.