Heart health equity What prospects? Norman Sharpe

2 Disproportionate universalism: CVD mortality

An increasing burden for Māori For Māori, an actual increase in the absolute number of deaths is projected for males and a relatively stable number for females IHD Mortality in NZ Trends and Projections Tobias et al NZMedJ April 2006

Cigarette smoking, obesity prevalence and NZ Dep NZ Health Survey NZ Dep Quintile I II III IV V Smoking % Obesity % BMI >40 % Poverty and health risk in New Zealand

Risk Factors for Acute Rheumatic Fever 0-24 years New Zealand NZ Dep ScoreRR Maori (29/100,000) Pacific (62/100,000) European (1.3/100,000) 1.00 Asian/Indian (1.3/100,000) 0.99 Maori 23 times and Pacific ~50 times more affected Poor

Smaller health inequalities Lakes Whanganui Tairawhiti Waitemata Cap/Coast Canty Counties M Wairarapa H Bay W Coast S’land MidC Taranaki Hutt Otago Auckland S Canty BoP Waikato N-M Northland Shorter life expectancy Longer life expectancy Greater health inequalities “Health inequality” = variation in life expectancy within each DHB’s area. Life expectancy and health inequalities in NZ Variation amongst DHB areas

Inequality of Access to Health Services Hospital Discharges in 2009 with an Angiography Procedure

Acute Coronary Syndrome Revascularisation Cohort Study 5,456 Māori and 62,294 non-Māori 1 st acute admissions with ACS