Causes of death classified by risk and condition, New Zealand 1997.
OBJECTIVE
To classify causes of death in New Zealand by risk factor (in addition to condition) as a planning tool for health promotion.


METHODS
Deaths occurring in New Zealand in 1997 were classified by 20 prevalent risk factors using a combination of categorical attribution (rule-based) and counterfactual modelling (population-attributable risk-based) approaches.


RESULTS
Approximately 30% of deaths were attributed to the joint effect of dietary factors. Tobacco consumption was responsible for 18% of deaths and insufficient physical activity for almost 10%. Less important behavioural risk factors included alcohol consumption (3%), illicit drug use (0.5%) and unsafe sex (0.5%). Among biological risk factors, higher than optimal total blood cholesterol, systolic blood pressure and body mass index accounted for 17%, 15% and 12% of deaths respectively. Deprivation contributed to 17% of deaths, and adverse in-hospital events to 6%. Among environmental exposures, microbes accounted for 6.5% of deaths, air pollution 3.5% and occupational diseases and injuries 0.5%. Among injury hazards, risk factors related to road traffic were responsible for 2% of deaths, while violence accounted for 2.5% of deaths, mostly through suicide. Cross-classifying deaths by both condition and risk factor, 90% of ischaemic heart disease and 80% of stroke, but only 30% of cancer deaths, could be attributed to specific risk factors.


CONCLUSIONS
This is the first comprehensive ranking of causes of death at the level of risk factors available for New Zealand and should prove useful as a planning tool, especially for disease prevention and health promotion.
Tobias
Martin
M
Ministry of Health, Wellington, New Zealand. martin_tobias@moh.govt.nz
Turley
Maria
M
D001294:Attitude to Health; D001685:Biological Factors; D002423:Cause of Death / Q000639:trends*; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D015438:Health Behavior; D006285:Health Planning / Q000458:organization & administration; D006293:Health Promotion / Q000458:organization & administration*; D006306:Health Surveys; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors
D001685:Biological Factors