Avoidable deaths by ethnicity strongest factor in new research

Warning: This story discusses death.

New research has found differences in the rates of 'amenable deaths' in New Zealand - across 20 district health boards from 2008-2018 and 50,000 deaths.

However, after accounting for factors such as deprivation, demographics, rural locations, injury, 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.

University of Auckland research fellow in medical and health sciences, Dr Pushkar Silwal, says while the findings were expected, the extent of the differences between ethnicity and deprivation was "quite alarming".

Silwal told Pacific Mornings' William Terite that this study looked at the health system's performance across the country.

"But what we found is ethnicity - wherever they live and the deprivation areas within the districts, the south coast or in Auckland - the most deprived areas is a larger predictor of avoidable deaths. So, that was alarming," Silwal said.

Watch Dr Pushkar Silwal's full interview below.

"We tried to look at - does that make sense? Can we use higher performance-level outcome measures to monitor the districts? Performance level outcomes depend on so many factors and the health system is only one of them.

"There are different discussions in the sector, but this paper that we published is about amenable mortality, one of those performance level outcomes."

According to Health officials, a death is amenable if, in the light of medical knowledge and technology at the time of death, all or most deaths from that cause could be avoided through optimal quality health care.

"The technical term used is amenable mortality or amenable death, but the simple term is avoidable death or potentially avoidable death," Silwal said.

"There are some technical criteria, and different countries would have a different list of those conditions. In New Zealand, a long clinical trial or scientific studies decide which are the conditions that our health system can prevent if we have good quality service and timely access for the people to use the services."

In 2021, Te Whatu Ora Health NZ reported 35,007 deaths were registered in Aotearoa, with Māori - 1.7 times - having higher mortality rates than non-Māori.

The leading causes of death in 2021 were cancer, ischaemic heart diseases, and cerebrovascular diseases.

"Males had a consistently higher mortality rate than females, although the difference between the two decreased over time."

The scope of Silwal's latest study is huge - 10 years of figures from 2008 to 2018 across 20 DHBs and more than 50,000 deaths.

Silwal says there are slightly more than 300 related conditions including infections, some cancers, injury, and maternal and infant-like conditions related to pregnancy and newborn babies.

He says there are also cardiovascular diseases like heart conditions and diabetes, some respiratory diseases, and most of the vaccine-preventable conditions.

"These are the type of conditions we consider. Our health system is in a good position to prevent those related deaths."

Research shows rural populations are dying at higher rates than those living in urban centres.

A study, published in July last year, by Ōtākou Whakaihu Waka, Otago University, found that Aotearoa's rural populations were dying at higher rates than those living in urban centres.

The findings contradict existing data on death rates across geopolitical settings.

Researchers called it the strongest evidence yet that Kiwis who live in rural areas had poorer health outcomes.

The study was also the first to show a consistent pattern of higher mortality rates for rural populations.

Researchers used geographical classification designed for health policy and research, where all of New Zealand's land area was divided into five categories and ranked from most urban to most rural.

The study analysed the age, sex, ethnicity, and cause of more than 160,000 deaths registered between 2014 and 2018 by Te Whatu Ora and StatisticsNZ.

The types of deaths were placed in five categories - all-cause, amenable possibly avoidable, cardiovascular, cancer, and injury.