Much still to be done to reduce ethnic and socio-economic health inequities

Although progress has been made in reducing health inequities, an editorial in today's New Zealand Medical Journal proposes the next ten most important actions needed to further reduce significant health "gaps‟ based on ethnicity and socio-economic status in New Zealand.

The hard hitting editorial previews issues regarding health inequities to be discussed at a number of events next week, including a Symposium, at the University of Otago, Wellington. It is hosted by the NZ Medical Association featuring Sir Professor Michael Marmot from the UK.

Sir Marmot is a world renowned public health researcher and epidemiologist, immediate Past President of the British Medical Association, author of the recent review of ‘Health Inequalities in England and Wales’ (2010), and chair of the WHO‟s ‘Commission on Social Determinants of Health’.

“New Zealand is at the cross roads in addressing health inequities,” says researcher and author Professor Tony Blakely from the Health Inequalities Research Programme at UOW. “At the Wellington Symposium next week, we will be debating what has and has not worked, and what we should do next.”

“We've significantly increased understanding of health inequities because of robust public health research, and made progress in closing some gaps, but there‟re still significant and worrying differences between ethnic and socioeconomic groups in health status in New Zealand.”

The editorial proposes the ten next most important actions needed to reduce health inequities. These range from addressing risk factors to health such as healthy eating, ensuring health services are equitable and accessible, to fair fiscal and social welfare policies.

“Governments come and go, but regardless of where each Government sits on the political spectrum it can and should adapt or modify policies to reduce inequities in health,” says Professor Blakely.

“For example, the current Government has prioritized quality in health care – ensuring high quality access and delivery of health care to socially disadvantaged populations will make some contribution to reducing health inequities.”

However Blakely says, the best results are still likely to come through a focus on public health areas such as obesity, and making New Zealand smokefree by 2025 – something the New Zealand Parliament is committed to as a goal.

“For instance, we've estimated that a smokefree nation in 2025 could result in a huge gain of five years in life expectancy for Maori, and three years for non-Maori, an overall two year reduction in the current seven year life-expectancy gap.”

He says investing in reducing inequities in health is investing in our population's future wellbeing – including economic wellbeing.

“At least some of this investment can be achieved by reallocating current Government expenditure,” says Professor Blakely “For example, $8 billion a year, or 60% of the welfare budget, is spent on universal superannuation, yet the age of entitlement is unchanged from 1899!”

The editorial argues that gradual increases in the age of entitlement would liberate funding for other policy issues, such as early childhood programmes that address inequalities.

The Marmot Symposium will take place at the University of Otago, Wellington on Wednesday July 13 from 1-5pm.

Professor Marmot's visit is supported by the NZ Medical Association, University of Otago Wellington, the Heart Foundation, the University of Auckland, the Public Health Association, the NZ College of Public Health Medicine and the Prior Centre.