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Decomposing Indigenous life expectancy gap by risk factors: a life table analysis.

Zhao Y, Wright J, Begg S, Guthridge S - Popul Health Metr (2013)

Bottom Line: The standard life table and cause decomposition technique was used to examine the individual and joint effects on health inequality.Improving socioeconomic status, smoking cessation, and overweight reduction are critical to closing the Indigenous LE gap.This paper presents a useful way to explain the impact of risk factors of health inequalities, and suggests that reducing poverty should be placed squarely at the centre of the strategies to close the Indigenous LE gap.

View Article: PubMed Central - HTML - PubMed

Affiliation: Health Gains Planning Branch, Northern Territory Department of Health, Darwin Plaza, 1st Floor, Smith St Mall, Darwin, NT 0801, Australia. yuejen.zhao@nt.gov.au.

ABSTRACT

Background: The estimated gap in life expectancy (LE) between Indigenous and non-Indigenous Australians was 12 years for men and 10 years for women, whereas the Northern Territory Indigenous LE gap was at least 50% greater than the national figures. This study aims to explain the Indigenous LE gap by common modifiable risk factors.

Methods: This study covered the period from 1986 to 2005. Unit record death data from the Northern Territory were used to assess the differences in LE at birth between the Indigenous and non-Indigenous populations by socioeconomic disadvantage, smoking, alcohol abuse, obesity, pollution, and intimate partner violence. The population attributable fractions were applied to estimate the numbers of deaths associated with the selected risks. The standard life table and cause decomposition technique was used to examine the individual and joint effects on health inequality.

Results: The findings from this study indicate that among the selected risk factors, socioeconomic disadvantage was the leading health risk and accounted for one-third to one-half of the Indigenous LE gap. A combination of all six selected risks explained over 60% of the Indigenous LE gap.

Conclusions: Improving socioeconomic status, smoking cessation, and overweight reduction are critical to closing the Indigenous LE gap. This paper presents a useful way to explain the impact of risk factors of health inequalities, and suggests that reducing poverty should be placed squarely at the centre of the strategies to close the Indigenous LE gap.

No MeSH data available.


Related in: MedlinePlus

Survival curves by Indigenous status, (a) male and (b) female, Northern Territory, Australia, 1996–2000 vs 2001–2005.
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Figure 3: Survival curves by Indigenous status, (a) male and (b) female, Northern Territory, Australia, 1996–2000 vs 2001–2005.

Mentions: Figure 3 demonstrates a shift of the survival curves to the upper-right corner (rectangularisation) between 1996 to 2000 and 2001 to 2005 for all groups except Indigenous males. There were encouraging improvements across all age groups for Indigenous females, with a substantial lift in survival in older women. The improvements are visible across most age groups for non-Indigenous males, but only limited improvement was observed for non-Indigenous females and this was restricted to mortality in the elderly. By examining the Indigenous male survival curves in detail (see the thin lines in Figure 3a), there was some slight improvement for elderly males (aged 50 to 69), but the extent was much smaller than for females. For the middle-aged groups (25 to 49), the survival curve actually worsened, highlighting the need for prevention and early intervention in these age groups among Indigenous males.


Decomposing Indigenous life expectancy gap by risk factors: a life table analysis.

Zhao Y, Wright J, Begg S, Guthridge S - Popul Health Metr (2013)

Survival curves by Indigenous status, (a) male and (b) female, Northern Territory, Australia, 1996–2000 vs 2001–2005.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3585166&req=5

Figure 3: Survival curves by Indigenous status, (a) male and (b) female, Northern Territory, Australia, 1996–2000 vs 2001–2005.
Mentions: Figure 3 demonstrates a shift of the survival curves to the upper-right corner (rectangularisation) between 1996 to 2000 and 2001 to 2005 for all groups except Indigenous males. There were encouraging improvements across all age groups for Indigenous females, with a substantial lift in survival in older women. The improvements are visible across most age groups for non-Indigenous males, but only limited improvement was observed for non-Indigenous females and this was restricted to mortality in the elderly. By examining the Indigenous male survival curves in detail (see the thin lines in Figure 3a), there was some slight improvement for elderly males (aged 50 to 69), but the extent was much smaller than for females. For the middle-aged groups (25 to 49), the survival curve actually worsened, highlighting the need for prevention and early intervention in these age groups among Indigenous males.

Bottom Line: The standard life table and cause decomposition technique was used to examine the individual and joint effects on health inequality.Improving socioeconomic status, smoking cessation, and overweight reduction are critical to closing the Indigenous LE gap.This paper presents a useful way to explain the impact of risk factors of health inequalities, and suggests that reducing poverty should be placed squarely at the centre of the strategies to close the Indigenous LE gap.

View Article: PubMed Central - HTML - PubMed

Affiliation: Health Gains Planning Branch, Northern Territory Department of Health, Darwin Plaza, 1st Floor, Smith St Mall, Darwin, NT 0801, Australia. yuejen.zhao@nt.gov.au.

ABSTRACT

Background: The estimated gap in life expectancy (LE) between Indigenous and non-Indigenous Australians was 12 years for men and 10 years for women, whereas the Northern Territory Indigenous LE gap was at least 50% greater than the national figures. This study aims to explain the Indigenous LE gap by common modifiable risk factors.

Methods: This study covered the period from 1986 to 2005. Unit record death data from the Northern Territory were used to assess the differences in LE at birth between the Indigenous and non-Indigenous populations by socioeconomic disadvantage, smoking, alcohol abuse, obesity, pollution, and intimate partner violence. The population attributable fractions were applied to estimate the numbers of deaths associated with the selected risks. The standard life table and cause decomposition technique was used to examine the individual and joint effects on health inequality.

Results: The findings from this study indicate that among the selected risk factors, socioeconomic disadvantage was the leading health risk and accounted for one-third to one-half of the Indigenous LE gap. A combination of all six selected risks explained over 60% of the Indigenous LE gap.

Conclusions: Improving socioeconomic status, smoking cessation, and overweight reduction are critical to closing the Indigenous LE gap. This paper presents a useful way to explain the impact of risk factors of health inequalities, and suggests that reducing poverty should be placed squarely at the centre of the strategies to close the Indigenous LE gap.

No MeSH data available.


Related in: MedlinePlus