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In New Zealand, as elsewhere, inequalities in health exist between socioeconomic and ethnic groups, people living in different geographic areas, people belonging to different generations, and between males and females. These inequalities are not random: in all countries, socially disadvantaged and marginalised groups have poorer health, greater exposure to health risks, and lesser access to high-quality health services than their more advantaged counterparts.
Decades of Disparity II: Socioeconomic mortality trends in New Zealand, 1981.1999 represents an important contribution to the health inequalities debate in this country. For the first time a report presents reliable estimates of trends in mortality by income, education and occupational class, based on linking individual-level mortality and census records. These trends can be broken down by age, gender and calendar year, and are presented for all causes of death and by cause, including causes responsive to health care intervention. The period covered in this report, the 1980s and 1990s, represents a period of major social change in New Zealand, which makes it especially relevant.
The report presents the results for four measures of inequality side by side: absolute and relative measures, and measures of effect and impact. Each measure tells a different story, and presenting them together enables different interpretations of the observed trends in inequality of survival chances to be considered. Overall, however, the key finding is one of increasing relative inequality in mortality from most major causes, with stable absolute inequality.
Widening inequality in New Zealand’s income distribution over the observation period has clearly contributed to this trend.
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