Death rates fall but rich live longer

Death rates for all New Zealanders fell during the 1980s and 1990s, but the relative gap in death rates between the rich and poor widened, a new study shows.

The research, released by Otago University and the Ministry of Health, found that if low and middle income groups had experienced the same death rate as the high income group in the late 1990s there would have been about 3600 fewer deaths among 25-to-77-year-olds.

Cardiovascular disease, and increasingly cancer, were linked to socio-economic status and the growing differences between rich and poor.

"Money can buy you better health by the ability to afford a healthier diet, live in a nicer neighbourhood, relieve stress by going on holidays and so on," said lead author Associate Professor Tony Blakely.

"Therefore, it seems that some of the increasing inequalities in health during the 1980s and 1990s were a result of increasing income gaps between the rich and poor."

The report, "Decades of Disparity II: Socio-economic mortality trends in New Zealand, 1981-99", found the death rate for the poorest New Zealand men was 43 per cent higher than the richest group in the early 1980s. By the late 1990s it was 72 per cent higher.

For the poorest women, the death rate grew from 27 per cent to 50 per cent higher.

Professor Blakely said cardiovascular disease was the major contributor to the widening gap in death rates, but cancer was increasingly playing a part.

"Much of it is due to lung cancer but also other cancers, both breast and colon cancers, are becoming increasingly patterned by socio-economic status."

Professor Blakely said those in higher income groups tended to know about lifestyle changes needed to reduce their risk factors, they were more likely to access screening programmes and to receive better treatment.

The ministry's director of public health, Dr Mark Jacobs, said the report highlighted the importance of initiatives to address health inequalities such as the primary health care strategy, which was aimed at making it easier for people to get affordable health care.

Dr Jacobs said the impact of cancer on death rates could overtake heart disease in the near future.

The Cancer Control Strategy and action plan - $40 million was attached to the first stage of the plan - would be instrumental in fighting the disease.

The report found suicide rates among young adults increased the most among those in the low-income group.

The third Decades of Disparity report, which will analyse the interaction between socio-economic position and ethnicity in determining a person's chances of survival, is due for release in 2005-2006.