High death rates point to poverty

Heart disease is still the biggest killer in Wanganui, accounting for 40 per cent of deaths in the region.
And researchers say the region's mortality rates continue at higher levels than national trends, underlining continuing deprivation levels among Wanganui's population.
Those findings have been outlined in research for the Whanganui and MidCentral District Health Boards. The data was gathered by Dr Richard Fong, funding division clinical adviser at MidCentral, who looked at demographics, socio-economic disadvantage, general health status and the major causes of mortality in the first joint assessment covering both boards.
He said while mortality rates had shown signs of improving, the rates for Wanganui residents were consistently higher than those for MidCentral's population, while both regions' figures remained above national figures (see panel). Both DHBs had higher proportions of Maori, lower proportions of Pacific people, and higher numbers of people over 65 years compared with the rest of the country.
Dr Fong said mortality rates had fallen for both regions and New Zealand, which implied better health, but Wanganui and MidCentral death rates were higher than national rates.
He said research showed that socio-economic disadvantage was linked to poorer health and while MidCentral had a greater proportion of people with higher levels of deprivation compared with the rest of New Zealand, Wanganui had an even greater proportion than MidCentral.
Dr Fong said over both DHBs, the groups experiencing poorer health were Maori and Pacific Islanders; those who were socio-economically disadvantaged; those living in the Horowhenua district and those in the Wanganui, and Ruapehu District Council areas. The data was being used by MidCentral to boost community health services, with particular focus on chronic conditions.
MidCentral DHB had invested about $8millon a year since 2004 in additional services, most of them aimed at chronic conditions like diabetes, cardiovascular disease and respiratory disease.
Judith MacDonald, head of the Whanganui Regional Primary Health Organisation and also a member of the WDHB, said the figures were not a surprise. "We know the health of our population is not as good as it is in other parts of the country," she said.
Improving access to primary care was vital if improvements were to be made "and that's why we built the Gonville health centre and took over the running of the Taihape health services".
But primary care was not the cure-all. "This is about education, economy and housing. All of those and more impact on people's health and well-being."
She said Director-General of Health Kevin Woods had said New Zealand had to get used to having a health service delivered with a smaller budget. "The only way that will happen is if there's a stronger primary care service," Mrs MacDonald said. "A stronger primary care service won't fix everything but working to keep people healthy to begin with would be a good place to start."
Tracey Schiebli, service and business planning manager for the WDHB, said the findings were as expected.
The region was still in the "bottom four" nationally for socio-economic disadvantage that was linked to poorer health. "The challenges faced by rural communities, such as Waimarino, in accessing health services are well understood, and for this reason they were chosen as the first recipient of transport assistance in partnership with St John," she said. By working with the two local primary health organisations, the board had been able to increase the focus on better management of chronic conditions such as diabetes and cardiovascular disease and on identifying and addressing risk factors such as obesity and smoking.
"The strategies are not 'quick fix', however, they will bear fruit over the long term," Ms Schiebli said.
Dr Fong's report will be on the agenda of the WDHB community and public health advisory committee when it meets on August 12.
MORTALITY RATES
Major causes of mortality are the same in Wanganui and MidCentral regions and are attributed to:

- 40 per cent - circulatory disease (heart/blood vessels).
- 25 per cent - cancers.
- 8-9 per cent - respiratory disease.
- 5-6 per cent - external causes (accidents, and injuries).
- 6 per cent - endocrine, metabolic, immunity systems, especially diabetes.