Steyn Nicholas, Binny Rachelle N, Hannah Kate, Hendy Shaun C, James Alex, Kukutai Tahu, Lustig Audrey, McLeod Melissa, Plank Michael J, Ridings Kannan, Sporle Andrew
School of Mathematics and Statistics University of Canterbury; Department of Physics, University of Auckland; Te Pūnaha Matatini: the Centre for Complex Systems and Networks.
Manaaki Whenua; Te Pūnaha Matatini: the Centre for Complex Systems and Networks.
N Z Med J. 2020 Sep 4;133(1521):28-39.
There is limited evidence as to how clinical outcomes of COVID-19 including fatality rates may vary by ethnicity. We aim to estimate inequities in infection fatality rates (IFR) in New Zealand by ethnicity.
We combine existing demographic and health data for ethnic groups in New Zealand with international data on COVID-19 IFR for different age groups. We adjust age-specific IFRs for differences in unmet healthcare need, and comorbidities by ethnicity. We also adjust for life expectancy reflecting evidence that COVID-19 amplifies the existing mortality risk of different groups.
The IFR for Māori is estimated to be 50% higher than that of non-Māori, and could be even higher depending on the relative contributions of age and underlying health conditions to mortality risk.
There are likely to be significant inequities in the health burden from COVID-19 in New Zealand by ethnicity. These will be exacerbated by racism within the healthcare system and other inequities not reflected in official data. Highest risk communities include those with elderly populations, and Māori and Pacific communities. These factors should be included in future disease incidence and impact modelling.
关于新冠病毒病（COVID-19）的临床结局（包括死亡率）如何因种族而异，证据有限。我们旨在估算新西兰不同种族的感染死亡率（IFR）差异。
我们将新西兰各民族现有的人口统计和健康数据与不同年龄组的COVID-19国际IFR数据相结合。我们针对未满足的医疗需求差异以及按种族划分的合并症，对特定年龄的IFR进行调整。我们还根据预期寿命进行调整，以反映COVID-19会加剧不同群体现有死亡风险的证据。
估计毛利人的IFR比非毛利人高50%，根据年龄和潜在健康状况对死亡风险的相对影响，该比例可能更高。
新西兰因种族不同，COVID-19造成的健康负担可能存在显著差异。医疗系统中的种族主义以及官方数据未反映的其他不平等现象会加剧这些差异。最高风险群体包括老年人群体、毛利人和太平洋岛民群体。未来疾病发病率和影响模型应纳入这些因素。
