In New Zealand, different factors impact on disease and death rates among different groups of people. New Zealand is a country with an estimated resident population of 4.79 million according to the 2013 census (National Population Estimates, n.d.). 2.36 million were males while 2.43 million comprised of women. This meant that there were ninety-seven males for every hundred females. The population of New Zealand was made up of four ethnic groups. A majority of the people identified as European ethnic group comprising 74% followed by those who identified as Maori ethnic group with 14.9% (598,605 people). 7.4% of the population identified as Pacific ethnic group while the rest (about 5%) identified as New Zealander.
Intriguing facts have emerged about the health of New Zealand people. Although it has been established that major causes of diseases and death are mostly heart diseases (especially Ischaemic heart disease), lung cancer, suicide, diabetes and motor vehicle accidents (Major causes of death, n.d.), these factors have varying impact on different people according to ethnicity and gender. For example, when the people are simply categorized as Maori or non-Maori, it is revealed that Ischaemic heart disease (IHD) becomes the leading cause of death for Maori females and the second cause of death for males. For non-Maori people, IHD was among the top five causes of death (Major causes of death, n.d.). Understanding the main cause of diseases and death among the people as well as the epidemiology of the common diseases is the cornerstone of public health and shapes policy towards eliminating or controlling the main cause of morbidity and mortality (Cotter et al., 2013). As such, this essay critically evaluates the underlying factors that impact on disease and death rates in New Zealand, identifies what is being done and suggests what could be done to address disparities in disease epidemiology in New Zealand.
Epidemiology is the scientific, systemic and data-driven study of the disease distribution (pattern and frequency) and the causes/ risk factors of health-related states and events in a specific population (Cotter et al., 2013). Epidemiological information is useful in both planning and evaluation of strategies to prevent morbidity. It also guides management of patients who have already developed diseases resulting from risk factors.
Causes of Morbidity and Mortality in New Zealand
Causes of diseases or risk factors are the attributes, characteristics or exposures that increase the likeliness of an individual developing injury or disease (Bouchard et al., 2017). Disease risk factors include environmental exposures such as heavy metals or air pollutants, infectious diseases such as pneumonia, injuries, non-infectious diseases such as birth defects, natural disasters, and terrorism.
In New Zealand, five major causes of morbidity and mortality have been identified by the ministry of health. They include ischaemic heart disease, lung cancer, suicide, diabetes, cerebrovascular disease, chronic obstructive pulmonary disease, colorectal cancer and motor vehicle accidents (Major causes of death, n.d.).
These causes of morbidity and mortality have been ranked in two different ways; by age-standardized mortality rates and by years of life lost. The population of New Zealand has been divided into Maori ethnic group and non-Maori.
By age-standardized mortality rates among Maori males, ischaemic heart disease came top on the list as the main cause of deaths followed by lung cancer, suicide, diabetes and motor vehicle accidents. On the other hand, lung cancer tops in the list of main causes of mortality among Maori females followed by ischaemic heart disease, chronic obstructive pulmonary disease, cerebrovascular disease and diabetes (Major causes of death, n.d.). For non-Maori males, ischaemic heart disease is the leading cause of death followed by suicide, lung cancer, cerebrovascular disease and motor vehicle accidents. On the other hand, ischaemic heart disease is the major cause of mortality among non-Maori females followed by breast cancer, cerebrovascular disease, lung cancer and colorectal cancer.
It can be seen that for Maori and non-Maori males as well as non-Maori females, ischaemic heart disease is the leading major cause of death. However, for Maori females, lung cancer is the leading major cause of death. For both Maori and non-Maori females, different forms of cancer, breast, lung and colorectal cancer, appears as major causes of deaths as compared to males who are affected by only one type of cancer, lung cancer. Regardless of gender and or ethnicity, major causes of death (apart from motor vehicle accidents) are all chronic diseases (Major causes of death, n.d.).
When the causes of death are considered and ranked by the years of life lost, chronic diseases are still the leading causes of death. Among the Maori males, ischaemic heart disease is still the leading cause of mortality, followed by suicide, lung cancer, motor vehicle accidents and diabetes, while for females, lung cancer is the leading cause followed by ischaemic disease, breast cancer, chronic obstructive pulmonary disease and cerebrovascular disease. For non-Maori males, ischaemic heart disease is the main cause of death followed by lung cancer, cerebrovascular disease, and colorectal cancer, while for females ischaemic heart disease tops in the list followed by cerebrovascular disease, breast cancer, lung cancer and colorectal cancer (Major causes of death, n.d.).
Still, when considering the cause of death by years of life lost, chronic diseases remain major causes of deaths for Maori and non-Maori, irrespective of gender. Ischaemic heart disease remained the leading cause of premature death for Maori males and non-Maori males and females while lung cancer ranked the leading cause of mortality for Maori females. This shows that non-Maori women are likely to be affected by lung cancer than their counterparts who are non-Maori. Also worth noting is that when causes of death are listed in the order of years of life lost, the list comprised of chronic illnesses only except for Maori males where motor vehicles still rank third cause of premature deaths (Major causes of death, n.d.).
Critical Evaluation of the Underlying Factors Impacting On Disease and Death Rates in New Zealand
From the epidemiological study in the previous section, it was noted that chronic diseases are the leading causes of death for both Maori and non-Maori people of New Zealand irrespective of their genders. Chronic diseases are defined as diseases that persist for a long time, three months and more, and cannot be prevented through vaccination or treated to the point that they disappear (Harris, 2013). Chronic diseases are major causes of deaths in the entire world, and in New Zealand, chronic diseases account for 92% of the entire deaths according to a 2002 survey conducted by World Health Organization (Wagner et al., 2017). Also, motor vehicle accidents were listed among the top five causes of death for Maori males.
Why do these Factors contribute to the Incidence of Disease?
Ischaemic heart disease. Ischemic heart disease or coronary artery disease is a condition that develops in the blood vessels and affects the supply of blood to the heart. The major cause of blockage is due to deposition of cholesterol on the linings of the blood vessels (Serruys et al., 2015). The blockage reduces the oxygen and nutrient supply to the heart muscles, and as a result, the heart fails to function properly as required. The improper functioning of the part of the heart where nutrients and oxygen supply has been blocked may die resulting in a heart attack (Murpy et al., 2016). Since the heart is the only pump in the body, the death of its parts implies that supply of oxygenated blood to other parts of the body such as the brain, liver, kidney, and others will be impaired leading to the death of tissues in those organs and eventual failure (Singer, 2014). A failure of major organs either causes diseases or death.
Cancer. Cancer is a condition in which the cells divide abnormally in an uncontrolled manner (Heim, 2015). There are various forms of cancer. In New Zealand, lung cancer is the major cause of death among Maori women (Major causes of death, n.d.). Other types of cancer common among the people of New Zealand include breast and colorectal cancer.
Diabetes. It is a health condition that occurs when the blood sugar becomes too high. The condition develops when the pancreas is unable to make enough insulin which is responsible for regulating the amount of blood sugar (American Diabetes Association, 2014). Too much glucose in the blood damages blood vessels causing heart disease and stroke, eventually leading to death. It may also cause other health problems such as kidney failure, nerve damage and depression among others that lead to diseases and death.
Cerebrovascular disease (stroke). These are a group of conditions that affect the blood supply to the brain leading to stroke (Caplan, 2016). Insufficient supply of blood and oxygen to the brain lead to damage of the brain cells and eventually leading to a stroke.
Cultural (Whanau Factors) Impacting on Disease and Death among People of New Zealand
The health of the people of New Zealand and epidemiology of major killers are attributed to cultural factors.
Ischaemic heart disease and other heart-related diseases. In New Zealand, the Cardiovascular disease accounts for 40% of the annual deaths with the most deaths affecting the Maori people per 100,000 (Finegold, Asaria & Francis, 2013). Ischaemic heart disease accounts for 40.2% of the cardiovascular deaths occurring to the Maori aged below 65 years as compared to only 10.5% of the same cohort deaths in non-Maori people. Ethnic identity is a key determinant of health and epidemiology in New Zealand because the cultural, socio-economic and environmental factors are embedded in ethnic identity (Finegold et al., 2013). Maori people, being the indigenous group, have been marginalized by non-Maori people and are characterized by low levels of education, low occupations, low-income status and high poverty levels. They have been discriminated because of their race and live in deprived neighborhoods.
Poor socio-cultural factors have been blamed for resulting behavioral practices among the Maori. For example, 50% of Maori women 40% of males continue to smoke between the age of 15-64 years whereas only 20-21% of non-Maori people between the same age bracket smoke (Finegold, Asaria, & Francis, 2013). Similarly, 26% of Maori adults are obese compared to 18% of non-Maori (Hawley & McGarvey, 2015). Smoking and obesity have been described as the major risk factors for cardiovascular diseases (Miner-Williams, 2017). This explains why ischaemic heart disease is a major cause of deaths among Maori people as compared to non-Maori. A study Doolan-Noble (2015), screened rural and urban Maori and non-Maori people and established that rural Maori people are highly exposed to cardiovascular diseases risk factors such as hypertension, obesity, dyslipidemia, type 2 diabetes, hyperuricemia, and smoking. The study consequently concluded that these risk factors accounted for high mortality rates due to cardiovascular diseases among the Maori people who mostly reside in rural areas.
Cancer. As earlier identified, lung, breast and colorectal cancer are common causes of death among women in New Zealand. Lung cancer is the leading cause of death among the Maori females. Tobacco smoking is the single biggest cause of cancer, especially lung cancer (Vineis & Wild, 2014). Thus, the fact that lung cancer is the leading cause of death among the Maori females is due to high tobacco smoking. Other risk factors for cancer include poor nutr...
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