Income and Ethnicity Both Critical In Health Funding

3 March 2004

Health policies cannot be based solely on economic need, says Wellington School of Medicine and Health Sciences researcher Dr Tony Blakely. That’s because the latest findings of the New Zealand Census-Mortality Study show clearly that Maori still have a higher death rate ­ regardless of how much they earn.

In response to the current political debate over health funding, Dr Blakely, of the University of Otago, decided to pre-release findings of an unpublished study that looked at death rates in terms of both ethnicity and income levels. Death rates are commonly used as an indicator of health need. The results, he says, were "too critical" to leave until they were formally published.

"Income is a major determinant of health, no matter what ethnic group you belong to," says Dr Blakely. "But it is absolutely critical to note that very large differences in mortality still remain between ethnic groups even after allowing for income. High-income Maori still have a 40 per cent higher death rate than low-income Europeans."

Assigning all 25-to-77 year-old New Zealanders into low, medium and high income groups during the 1990s, and treating high-income Europeans as the comparison or baseline group, death rates among:

- low-income Europeans were 1.6 times higher
- high-income Maori were 2.25 times higher
- low-income Maori were 3.5 times higher.

"In light of the current debate over funding and health policies based on economic need, our results clearly demonstrate that both ethnicity and income are important when allocating health resources," he says. "If we only target Maori and Pacific people, we would miss the health needs of low-income Europeans. On the other hand, if we only target low-income people, we would miss the health needs of Maori and Pacific."

The New Zealand Census-Mortality Study (NZCMS) combines census and mortality data for the 1980s and 1990s. It is conducted in close collaboration with Statistics New Zealand, and has received funding from the Health Research Council of New Zealand, Ministry of Health, and University of Otago. The findings released today are part of an ongoing research programme on the determinants of mortality in New Zealand.

Further information for the media

Death rates by income and ethnicity during the 1990s (Please see below for values used in above figure).

Death rates for people aged 25-77 years (per 100,000 people per year) as shown in above graph so that media can create their own graphics. Also, death rate ratios compared to high-income Europeans.

Sex Ethnicity Income Average death rate in 1990s Ratio compared to high-income Europeans

Female Maori Low-income 1247 3.46
Female Maori Med-income 1087 3.02
Female Maori High-income 908 2.52

Female European [*] Low-income 527 1.46
Female European Med-income 441 1.22
Female European High-income 361 1

Male Maori Low-income 1843 3.41
Male Maori Med-income 1481 2.74
Male Maori High-income 1118 2.07

Male European Low-income 904 1.67
Male European Med-income 711 1.32
Male European High-income 540 1

Combined Maori Low-income 1545 3.43
Combined Maori Med-income 1284 2.85
Combined Maori High-income 1013 2.25

Combined European Low-income 716 1.59
Combined European Med-income 576 1.28
Combined European High-income 450 1

[*] European rates were strictly speaking those for non-Maori non-Pacific people ­ therefore Asian and other peoples are included. Rates for Pacific people by income were too imprecise to present. The death rates are calculated by averaging the age-standardised mortality rates for the 1991-94 and 1996-99 cohorts of the NZCMS.

University of Otago Media Release