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    • Inequalities in cardiovascular disease
      • Inequalities in statin use 2007/08 vs. IHD mortality 2001-2005, by DHB
      • IHD mortality 2001-2005 by DHB, with Maori: nMnP inequalities
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Inequalities in cardiovascular disease

IHD mortality 2001-2005 by DHB, with Māori: nMnP inequalities

As can be seen in the graph, in all DHBs, Māori have higher age-standardised rates of coronary heart disease than non-Māori. The dotted horizontal line indicates the overall NZ relative risk for Māori:nonMāori IHD deaths, while the vertical dotted line indicates the overall NZ standardised mortality for IHD. Disparities for Māori between statin uptake and background IHD death rates are greatest in Tairawhiti, Capital & Coast and Northland DHBs (where overall IHD is highest in Tairawhiti and Whanganui, etc.)

Inequalities in statin use 2007/08 vs. IHD mortality 2001-2005, by DHB

The graph above shows statin use and inequalities (ie: difference in uptake rates for Māori and non-Māori) against mortality rates for coronary heart disease by DHB region.
In the graph:

1. The diagonal line (A) shows the national average rate of statin use (and variance in uptake by population groups) against IHD mortality (ie: potential unmet need).
2. All the DHB regions on the left/above line A show higher inequalities in terms of access to services compared to meet health need.
3. All DHBs above the horizontal dotted line (B) show higher use of statins in Māori compared to non-Māori (below show lower statin use).
4. All DHBs to the right of the vertical dotted line (C) show higher rates of IHD deaths (to the left show lower death rates).
5. The further away from the diagonal line (A) the worse off (if on the right below side) or better off (if on left above side) the DHB’s situation is.
6. All DHBs that are above line (B) show higher relative statin use in Māori and if to the left of line (C) less inequalities in IHD deaths.

For instance, Tairawhiti, Northland, and Hawkes Bay DHBs have high rates of statin use for Māori compared to non-Māori, but their health needs in terms of IHD inequalities are still high. Capital & Coast, Waikato and Bay of Plenty have similarly high IHD inequalities, but in addition they also have high statin inequalities.

To match the historic disparities in IHD deaths between Māori and nMnP, if all things else were (unrealistically) being equal (e.g. assuming other risk factors such as tobacco use, raised blood pressure were distributed equally by ethnicity and DHB), then statin usage in Māori relative to nMnP should be 2.3 (ratio of IHD deaths). In effect there would be a horizontal line further up at a ratio of 2.3 on the y-axis (not able to be graphed here sensibly).

This graph therefore indicates the extent that DHBs need to improve their rates of Māori statin prescribing relative to nMnP in order to redress IHD death inequalities (assuming if all things else were equal).

On that basis, these data suggest that, by DHB, particular gains in Māori IHD from their excess improved statin use may be gained in the Māori component of OHML programmes in Capital & Coast, Waikato and Bay of Plenty DHBs.

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