Lecture 5: Demography and Maori Health Status Flashcards
why is ethnicity data important for the health and disability sector?
- used to design and deliver better policies, services and programmes
- individually focused care planning
- identifying and monitoring inequities
- highlight quality information systems are an important element of improving system integration and health outcomes
- to provide information that enables wider state sector analysis of particular ethnic groups
what is ethnicity?
- ethnicity is the ethnic group or groups a person identifies with or has a sense of belonging to
- it is a measure of cultural affiliation in contrast to race, ancestry, nationality or citizenship
- ethnicity is self-perceived and a person can belong to more than one ethnic group
- an ethnic group is made up of people who have some or all of the following characteristics:
a common proper name, one or more elements of common culture, a unique community, a shared sense of common origins or ancestry, a common geographic origin
what changes in ethnicity have been seen in the 2018 census?
there has been an increase in population for Maori, Pacific, Asian, MELAA but european had a slight decrease from 2006 to 2018.
total population reporting = where people reported more than one ethnic group they are counted in each group
what is the demography of Maori and non-Maori?
Maori population is younger than non-Maori population. Most of the Maori population is 0-25 and there are less Maori in the older age groups
- need to use age-standardised data to overcome this difference
how many rural-urban Maori and non-Maori are there?
this is rural and urban population data
there are many young maori and less old maori
Maori have a higher proportion of population living in rural areas until aged 15. Maori aged 15-50 live in urban areas
Non-maori until 0-45 live in urban areas, then 45-70 live more rurally
then in the older age groups people living rurally move into more urban areas for rest home or health care access
what was the median age of the 2018 census usually resident population by ethnicity?
median age of total population was 37.4 years
median age of Maori population was 25.4 years
median means 50% of population so At 25 years 50% of the population is younger than 25 and 50% is older
what is the demography of Maori and non-Maori living in the north and south island?
- 86% in North Island
- Most Maori live in auckland region, 14% in waikato, 11.5% in bay of plenty and 9.7% in wellington region
how has life expectancy changed for Maori and non-Maori?
Over time life expectancy has increased for Maori and non-Maori males and females
Maori and non-maori life expectancy is lower for males than females
Life expectancy is lower for maori males and females
Adjusted dotted line for maori males and females are adjusted for numerator denominator bias.
Accuracy of ethnicity data was different in the numerator and denominator. The census was linked with mortality data and they worked out the difference and made correction factors to adjust the data.
Dotted line = adjusted/corrected data
Solid = data with the bias which over estimated life expectancy as some Maori were classified as non-Maori.
how does life expectancy at birth change for Maori and non-Maori?
Maori males have a lower life expectancy than maori females and non-maori non-pacifc males and females
Maori females have a lower life expectancy than non-maori non-pacific males and females, but higher than maori males
non-maori non-pacific males and females have a higher life expectancy than maori males and females but non-maori non-pacific females have the highest life expectancy
- Life expectancy gap has come down slightly overtime. More work needs to be done though as there shouldn’t be a life expectancy gap. Lung cancer contributes more than 2 years of female life expectancy gap and nearly 2 years of male life expectancy gap. Sort out lung cancer will result in a huge impact of life expectancy gap.
what are the major causes of death for maori males and non-maori males?
Maori males:
- ischaemic heart disease
- lung cancer
- suicide
- diabetes
- motor vehicle accidents
Non-Maori Males:
- ischaemic heart disease
- sucide
- lung cancer
- stroke
- motor vehicle accidents
what are the major causes of death for maori females and non-maori females?
maori females:
- lung cancer
- ischaemic heart disease
- chronic obstructive pulmonary disease
- stroke
- diabetes
non-maori females:
- ischaemic heart disease
- breast cancer
- stroke
- lung cancer
- colorectal cancer
what are the leading causes of the life expectancy gap for maori men and maori women?
Maori men:
- coronary disease
- lung cancer
- diabetes
- suicide
Maori women:
- lung cancer
- coronary disease
- diabetes
- COPD
what are the leading causes of the life expectancy gap for pacifc men and pacific women?
Pacific men:
- coronary disease
- diabetes
- lung cancer
- stroke
Pacific women:
- diabetes
- coronary disease
- stroke
- uterine cancer
how have mortality rates changed by sex?
- Overtime mortality rates have reduced for both Maori and non-Maori males and females
- Non-maori mortality rates are lower than maori mortality rates
- The absolute difference has reduced over time for women (the space between the 2 rates by subtracting)
- It seems like the decline in mortality for maori men has stopped. Its not declining. See a slight increase in the abolsute difference in mortality for Maori men in the recent years
how are public hospitalisation rates different for Maori and non-Maori?
overall Maori have higher public hospitalisation rates compared to non-Maori
what are the age-standardised cancer data for Maori and non-Maori?
- Age and sex standardization accounts for the different age structure and makes the populations comparable.
- Breast cancer most common for maori and non-maori
- Lung cancer is just as important for maori but not for non-maori
- Prostate more common for non-maori
- Bowel more common for non-maori but it going up for maori overtime
- Melanoma more common for non-maori but when maori do get it they are way more likey to die.
what is lung cancer data for Maori males and females?
- Maori are 3x more likely to be diagnosed with lung cancer
- Maori and non-maori male lung cancer has been trending down overtime
- Maori females is not going down, it looks like it might still be trending up
what is cervical cancer data for Maori females and non-Maori females?
Cervical cancer rates are going down because it is a preventable cancer though screening and pap-smears. Identify pre-cancer and it can be treated and won’t come back. the decline is due to organised screening programmes but inequities are still significant.
- Maori females still have higher rates than non-Maori females despite the downward trend
explain the difference between inequality, equality and equity using this example
equality is treating everyone the same, but the unfairness is still not likely to be sorted (giving everyone 1 box)
equity is resolving the problem and making it fair (giving more boxes to the short person)
but justice would involve getting rid of the fence so that everyone has equal opportunity
