Photo by Marcelo Leal on Unsplash
Photo by Marcelo Leal on Unsplash

Avoidable deaths in NZ linked more with ethnicity and deprivation than with local health system performance

Embargoed until: Publicly released:
Peer-reviewed: This work was reviewed and scrutinised by relevant independent experts.

Observational study: A study in which the subject is observed to see if there is a relationship between two or more things (eg: the consumption of diet drinks and obesity). Observational studies cannot prove that one thing causes another, only that they are linked.

People: This is a study based on research using people.

Geographical differences in deaths that could have been avoided with good quality, timely healthcare, aren't linked to differences in local health systems as much as they are to ethnicity and deprivation. New research has found differences in the rates of 'amenable deaths' across 20 DHBs from 2008-2018, with the highest rate in Whanganui almost double the rate in Waitemata. However, after accounting for factors beyond the control of local DHBs - such as deprivation, demographic factors, rural locations, and funding - there was only a small difference that could potentially be linked to the local system performance. Ethnicity was the strongest factor in avoidable deaths, with Māori being three times as likely, and Pacific Peoples almost twice as likely to die as people who were neither Māori nor Pacific. People from the most deprived areas were 35% more likely to die than than those from the least deprived areas.

Journal/conference: Public Health in Practice

Research: Paper

Organisation/s: University of Auckland

Funder: We acknowledge the National Collections team at the Ministry of Health NZ and TAS NZ, who provided the dataset required for this analysis. The data processing and analysis work were possible only because of the computing facilities provided by the New Zealand eScience Infrastructure (NeSI).

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Expert Reaction

These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.

Dr Pushkar Silwal, Research Fellow in the Faculty of Medical and Health Sciences, University of Auckland

"This research explores whether differences between local health systems could explain the district-level variations in the risk of people dying from potentially avoidable causes. These include deaths among people aged 75 years and below from conditions such as stomach cancer, complications of pregnancy, diabetes, heart failure, and asthma that effective interventions and access to good-quality healthcare services could avert.

"The study looked at data from 2008 to 2018 across 20 District Health Boards (DHBs) in New Zealand, which includes 51,469 registered deaths. 

"The findings showed significant differences in the risk of people dying from potentially avoidable causes across the different DHBs. Some areas had much higher rates of preventable deaths than others. The study found that factors like ethnicity and socioeconomic status are likely to influence these variations more. For example, the risk is three times higher for a person identifying as Māori than for people who are not non-Māori non-or Pacific. Additionally, people living in more deprived areas were more likely to die from preventable causes.

"The study concluded that while local health system factors play a role in these variations, they only explain a small part of the differences. Other factors that are considered beyond the control of a local health system unit, such as the socioeconomic conditions of the population, also have a significant impact.

"Overall, the study highlights the need for targeted health policies to address disparities in health outcomes. By focusing on these areas, New Zealand can work towards reducing the number of preventable deaths and improving overall health equity."

Last updated: 03 Sep 2024 9:13am
Declared conflicts of interest:
Dr Silwal is the lead author of this study

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