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首页> 外文期刊>Population health metrics >Changing ethnic inequalities in mortality in New Zealand over 30?years: linked cohort studies with 68.9 million person-years of follow-up
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Changing ethnic inequalities in mortality in New Zealand over 30?years: linked cohort studies with 68.9 million person-years of follow-up

机译：30年来不断变化的新西兰种族不平等死亡率：相关队列研究的随访人数为6890万人年

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BackgroundInternationally, ethnic inequalities in mortality within countries are increasingly recognized as a public health concern. But few countries have data to monitor such inequalities. We aimed to provide a detailed description of ethnic inequalities (Māori [indigenous], Pacific, and European/Other) in mortality for a country with high quality ethnicity data, using both standard and novel visualization methods. MethodsCohort studies of the entire New Zealand population were conducted, using probabilistically-linked Census and mortality data from 1981 to 2011 (68.9 million person years). Absolute (standardized rate difference) and relative (standardized rate ratio) inequalities were calculated, in 1–74-year-olds, for Māori and Pacific peoples in comparison to European/Other. ResultsAll-cause mortality rates were highest for Māori, followed by Pacific peoples then European/Other, and declined in all three ethnic groups over time. Pacific peoples experienced the slowest annual percentage fall in mortality rates, then Māori, with European/Other having the highest percentage falls – resulting in widening relative inequalities.Absolute inequalities, however, for both Māori and Pacific males compared to European/Other have been falling since 1996. But for females, only Māori absolute inequalities (compared with European/Other) have been falling.Regarding cause of death, cancer is becoming a more important contributor than cardiovascular disease (CVD) to absolute inequalities, especially for Māori females. ConclusionsWe found declines in all-cause mortality rates, over time, for each ethnic group of interest. Ethnic mortality inequalities are generally stable or even falling in absolute terms, but have increased on a relative scale. The drivers of these inequalities in mortality are transitioning over time, away from CVD to cancer and diabetes; such transitions are likely in other countries, and warrant further research. To address these inequalities, policymakers need to enhance prevention activities and health care delivery, but also support wider improvements in educational achievement and socioeconomic position for highest need populations.
机译：背景技术在国际上，越来越多的国家将死亡率的种族不平等现象视为公共卫生问题。但是很少有国家有数据来监测这种不平等。我们的目标是使用标准和新颖的可视化方法，详细描述具有高质量种族数据的国家的死亡率中的种族不平等（毛利人（土著），太平洋和欧洲/其他地区）。方法使用1981年至2011年（6 890万人年）的概率相关人口普查和死亡率数据，对整个新西兰人口进行了队列研究。与欧洲/其他国家相比，毛利人和太平洋人在1–74岁之间计算了绝对（标准化比率差异）和相对（标准化比率比率）不平等。结果毛利人的全因死亡率最高，其次是太平洋人，其次是欧洲人/其他人，随时间推移，所有三个族裔的死亡率均下降。太平洋人口的死亡率下降速度最慢，然后是毛利人，欧洲/其他人的死亡率下降幅度最大，导致相对不平等现象加剧。但是，毛利人和太平洋地区男性的绝对不平等率与欧洲/其他人相比正在下降自1996年以来。但是对于女性而言，只有毛利人的绝对不平等现象（与欧洲/其他国家相比）正在下降。就死亡原因而言，癌症已成为导致绝对不平等现象的重要因素，比心血管疾病（CVD）更重要，特别是对于毛利人的女性。结论我们发现，每个感兴趣的种族的全因死亡率随时间下降。种族死亡率的不平等现象总体上是稳定的，甚至从绝对意义上来说甚至在下降，但是相对规模却在增加。随着时间的推移，这些死亡率不平等的驱动因素正在逐步发生变化，从CVD转向癌症和糖尿病。这种过渡可能会在其他国家/地区进行，因此有待进一步研究。为了解决这些不平等现象，政策制定者需要加强预防活动和卫生保健的提供，同时还需要为最需要的人群提供更广泛的教育成果和社会经济地位方面的支持。

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