Carter Kristie N, Blakely Tony, Soeberg Matthew
Health Inequalities Research Program, School of Medicine and Health Sciences, University of Otago, Wellington, PO Box 7343, Wellington South, Wellington 6242, New Zealand.
N Z Med J. 2010 Aug 13;123(1320):13-24.
Survival and life expectancy are commonly used metrics to describe population health. There are two objectives to this paper: (1) to provide an explanation of methods and data used to develop New Zealand life-tables by ethnic, income and smoking groups; and (2) to compare cumulative survival and life expectancy trends in these subpopulations.
We generated sex-specific life-tables for seven subpopulations: ethnicity (Maori and non-Maori); income tertiles; smoking (never and current); and two-way combinations (ethnicity by income; ethnicity by smoking; and smoking by income). This was repeated for five census-mortality cohorts (1981-84, 1986-89, 1991-94, 1996-99, and 2001-04). The method used to create the life-tables brings together three pieces of information: (1) the official Statistics New Zealand (SNZ) life-tables by year and sex; (2) the proportionate distribution of the total population by subpopulation (e.g. smoking prevalence); and (3) estimates of the differences in subpopulation mortality rates (from the New Zealand Census-Mortality Study [NZCMS]).
Survival and life expectancy improved in all subpopulations across the five census cohorts. However, improvements were greater in non-Maori compared to Maori and high income compared to low income subpopulations. This led to widening of the gap in life expectancy between 1981 and 2001 between Maori and non-Maori (males), which increased from 5.4 years in 1981 to 9.0 in 2001 and between low income and high income which increased from 4.4 in 1981 to 6.5 in 2001 for males. The gap in life expectancy between current and never smokers in 1996 was 7.6 in males and 6.7 in females. However, the size of this gap varied by ethnicity: 7.3 and 6.2 for non-Maori males and females, and 4.3 and 3.9 for Maori male and females. Correspondingly, the gap in life expectancy between Maori and non-Maori is greater among never smokers (9.7 and 8.4 for males and females) than among current smokers (4.3 and 6.6 for males and females).
Life-tables have been successfully developed for subpopulations in New Zealand, and provide an alternative understanding of health and life in New Zealand over the past 20 years. Ethnic and income gaps in life expectancy have widened, and perhaps surprising results were found for smoking by ethnicity. These life-tables provide an important basis for subpopulation modelling and projections, and are freely available to researchers.
生存率和预期寿命是描述人口健康状况常用的指标。本文有两个目标：（1）解释用于按种族、收入和吸烟群体编制新西兰生命表的方法和数据；（2）比较这些亚人群的累积生存率和预期寿命趋势。
我们为七个亚人群编制了按性别划分的生命表：种族（毛利人和非毛利人）；收入三分位数；吸烟情况（从不吸烟和当前吸烟）；以及双向组合（种族与收入；种族与吸烟；吸烟与收入）。对五个普查 - 死亡率队列（1981 - 1984年、1986 - 1989年、1991 - 1994年、1996 - 1999年和2001 - 2004年）重复此过程。用于创建生命表的方法整合了三条信息：（1）新西兰统计局（SNZ）按年份和性别的官方生命表；（2）亚人群在总人口中的比例分布（例如吸烟率）；（3）亚人群死亡率差异的估计值（来自新西兰普查 - 死亡率研究 [NZCMS]）。
在五个普查队列中，所有亚人群的生存率和预期寿命均有所提高。然而，非毛利人比毛利人、高收入亚人群比低收入亚人群的改善更大。这导致1981年至2001年间毛利人和非毛利人（男性）之间的预期寿命差距扩大，从1981年的5.4岁增至2001年的9.0岁，低收入和高收入男性之间的差距从1981年的4.4岁增至2001年的6.5岁。1996年，当前吸烟者和从不吸烟者之间的预期寿命差距男性为7.6岁，女性为6.7岁。然而，这一差距的大小因种族而异：非毛利男性和女性分别为7.3岁和6.2岁，毛利男性和女性分别为4.3岁和3.9岁。相应地，从不吸烟者中毛利人和非毛利人之间的预期寿命差距（男性为9.7岁，女性为8.4岁）大于当前吸烟者（男性为4.3岁，女性为6.6岁）。
已成功为新西兰的亚人群编制生命表，并为过去20年新西兰的健康和生活提供了另一种理解。预期寿命的种族和收入差距已经扩大，而且按种族划分的吸烟情况可能得出了令人惊讶的结果。这些生命表为亚人群建模和预测提供了重要依据，可供研究人员免费使用。
