Health, the IDI and evidence-based policy

Joel Hernandez
Insights Newsletter
5 July, 2019

Many New Zealanders are living longer and healthier lives than at any point in history.

In the last quarter century, health outcomes in New Zealand have improved across the board. Life expectancy at birth is 81.4 years, above the OECD average of 80.5 years.

At the same time, health loss, measured in Disability Adjusted Life Years (DALYs), is declining by an estimated 1.2% per year, adjusted for population size and age structure.

However, inequalities in health outcomes persist, particularly for Maori. Life expectancy at birth for Maori is seven years less compared to non-Maori.

Moreover, cardiovascular disease mortality for Maori compared to non-Maori is two and a half times higher, stroke hospitalisation is two times higher, and mortality across all types of cancer is two times higher.

These are just a small sample of the poor health statistics highlighted in the Waitangi Tribunal report released earlier this week.

The report also highlights that since the last major health reforms in 2000, the government has pumped $220 billion into the health system with little measurable improvement for Maori. And that the Crown does not collect sufficient qualitative or quantitative data, or effectively use the collected data.

Promisingly, the empirical research presented at the New Zealand Association of Economists’ (NZAE) annual conference this week illustrates excellent use of existing data, particularly government data located in Statistics New Zealand’s Integrated Data Infrastructure (IDI) – New Zealand’s largest research database.

Motu Fellow Dr Lynn Riggs has used health data in the IDI to study the burden of disease from cold, damp and mouldy housing, of which Maori disproportionately occupy. Riggs estimated the direct cost of poor housing conditions was $145 million and more than 40,000 nights in hospital.

In another study, MBIE Research Analyst Lucas Chen estimated the accuracy of the New Zealand Index of Deprivation (NZDep), a common index used to allocate funding and plan strategic interventions. Chen found the NZDep index mismatched 14% of the 2013 population – or high socioeconomic individuals living in low socioeconomic areas, and vice versa.

By themselves, these findings will not improve the health outcomes of Maori and non-Maori. However, using the findings to inform evidence-based policy will make better use of the billions of dollars the New Zealand government spends on health care.

New Zealand has plenty left to improve in terms of the health outcomes of its citizens, particularly of Maori decent. The excellent research presented at the NZAE conference is a promising start.

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