Prof Tony Blakely, Dr Andrea Teng, Prof Nick Wilson
Policy-makers need to know how much of ethnic inequalities in health are due to socioeconomic position and tobacco smoking, but quantifying this is surprisingly difficult. In this Blog, and accompanying video, we summarize new research using NZ’s linked census-mortality data, blended with innovative new ‘counterfactual’ methods to determine causal relationships that can shed light on policy-relevant questions. A half or more of Māori:European/Other inequalities in mortality are due to four socioeconomic factors (education, labour force status, income and deprivation), and this percentage is stable over time for males but increasing for females. Eradicating tobacco will not only improve mortality for all sociodemographic groups, but reduce absolute inequalities in mortality between Māori and European/Other by a quarter. It is hard to think of another intervention that will reduce inequalities by as much.
Richard Edwards, Anaru Waa, Janet Hoek, Louise Thornley, Nick Wilson.
ASPIRE 2025, Department of Public Health, University of Otago, Wellington
World Smokefree Day is an apt day on which to propose some ideas that may greatly increase momentum for the achieving Smokefree Aotearoa 2025. Tobacco and vaping products such as e-cigarettes vary greatly in their likely adverse health effects and overall impact on population health. Reflecting this, the Ministry of Health announced in May that it will investigate ‘risk-proportionate’ regulation for tobacco and vaping products. This blog discusses public health considerations in developing the new regulatory framework, and proposes key features of a risk-proportionate approach. We argue the framework should aim to minimise harm and maximise benefits to population health by accelerating progress towards New Zealand’s Smokefree 2025 goal. As well as clarifying the appropriate regulatory approaches to vaping products, we see an overwhelming need for much stronger regulation of smoked tobacco products, as these are vastly under-regulated in relation to the harm they cause.
Prof Nick Wilson, Prof Tony Blakely, Dr Amanda Jones, Dr Linda Cobiac, Dr Nhung Nghiem, Dr Anja Mizdrak, Dr Cristina Cleghorn
The New Zealand Government has set up a Tax Working Group to consider reforms of the tax system. In this blog we briefly discuss some of the opportunities for tax reform that will potentially improve health and lower health costs, reduce health inequalities and enhance environmental sustainability.
Prof Tony Blakely, Prof Nick Wilson, Dr Anja Mizdrak, Dr Cristina Cleghorn
From 1 April 2018, the UK is putting in place a type of sugary drinks tax – actually a “soft drinks industry levy”. This blog reviews how they are doing it, early signs of its success, and ponders its relevance for NZ. We also take this opportunity to point out some problems with a recent NZIER Report on sugary drink taxes.
Prof Nick Wilson, Dr Matt Boyd, Dr Andrea Teng, Prof Tony Blakely
Everyone knows that socio-economic inequalities in health exist – in recent times. But one thing we do not know is whether they have always been there. We have just published a study that looks at two historical datasets – with one of these suggesting life span differences by occupational class as measured 100 years ago. We find strong differences in life expectancy by occupational class among men enlisted to fight in the First World War (but not actually getting to the frontline). Whilst not definitive evidence (it is hard to get perfect evidence from 100 years ago!), it does suggest that socio-economic inequalities in mortality have existed for at least 100 years in NZ. In this blog we also take the opportunity to discuss what might be done to address the current inequality problem in this country.