The contribution of causes of death to socioeconomic inequalities in child mortality: New Zealand 1981-1999.
BACKGROUND
Socioeconomic inequalities in all-cause child mortality exist in New Zealand; however the inequalities in cause-specific mortality have not been examined. This study examines child mortality inequality by household income between 1981 and 1999, by cause of death.


METHODS
Data was used from a record linkage study of census and mortality records of all New Zealand children aged 0-14 years on census night 1981, 1986, 1991, 1996 followed up for 3 years for specific causes of mortality between ages 1-14 years. All cohorts were combined to calculate mortality rates, rate ratios, and rates differences for each cause of death.


RESULTS
Socioeconomic differences in child mortality (low income compared to high income) were observed for injury (non road traffic) (RR 1.87, 1.35 to 2.58), road traffic injury (RR 1.36, 1.01 to 1.82), and 'other' causes of death (RR 1.81, 1.32 to 2.47). 'Other' and non-road traffic injury deaths together contributed 70% of the total gap in child mortality between the rich and the poor.


CONCLUSIONS
Socioeconomic differences existed across most broad causes of child death. The major contributors to mortality inequality are diverse, suggesting that the similar distal causes of inequality (e.g. poverty) play out through a myriad of proximal causes. Fortunately there appears to be some scope for policymakers to modify some of the proximal and distal causes of these inequalities.
Shaw
Caroline
C
Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, Wellington.
Blakely
Tony
T
Crampton
Peter
P
Atkinson
June
J
D000063:Accidents, Traffic / Q000401:mortality; D000293:Adolescent; D017677:Age Distribution; D002423:Cause of Death; D002648:Child; D046688:Child Mortality; D002675:Child, Preschool; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000401:mortality; D005260:Female; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000401:mortality; D009520:New Zealand / Q000453:epidemiology; D012959:Socioeconomic Factors; D013405:Suicide / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000401:mortality