A new way to measure inequality in health
The Ministry of Health has published a report proposing a new method of measuring and monitoring inequality in health.
Monitoring Health Inequality Through Neighbourhood Life Expectancy uses the variations in survival across small areas to
measure inequalities in health.
Deputy Director-General of Public Health, Dr Don Matheson says, "Reducing health inequalities is a key priority for the
Ministry of Health and an important component of this is measuring and monitoring inequalities. Health inequalities are
currently measured using average differences between social groups, especially ethnic and economic groups. While this is
vital it shows only part of the picture.
"This new method can be used to examine total health inequality including both between-group and within-group
inequality. It is not intended to replace current practice, but rather to complement existing monitoring of average
group disparities and provide a different perspective."
The report estimates total health inequality at national and health district level for New Zealand for 1999-2003. Total
health inequality was measured by calculating life expectancy at birth across small areas, more or less equivalent to
neighbourhoods. The range of life expectancy at birth was approximately 5 years across District Health Boards but
approximately 28 years across neighbourhoods (from approximately 65 to 93 years). Districts varied widely in their
extent of total health inequality.
Dr Matheson says, "A potential application of total health inequality monitoring might be its use by District Health
Boards to estimate trends in the distribution of the health of their populations over time."
Dr Matheson emphasises that, "This methodology does not measure the performance of District Health Boards, because the
health of populations depends on much more than just the provision of health services. Other factors like demography and
the local economy also need to be taken into account. However it does provide an overall goal for District Health Boards
with regard to the equity dimension of population health.
"The purpose of this paper is to allow planners at district and national level to decide if total health inequality
monitoring would be a useful strategic planning tool for them."
The publication, Monitoring Health Inequality through Neighbourhood Life Expectancy,is available at www.moh.govt.nz