Volume 18, Number 1—January 2012
Differential Mortality Rates by Ethnicity in 3 Influenza Pandemics Over a Century, New Zealand
|Pandemic and data source||Mortality rate
||Comments (see Methods for details)|
|Individual mortality data in BDM database (10)||Unknown (deaths not registered)||9.1% increase in deaths for 1890–94 compared with 1885–89||–||Based on comparison of no. deaths for top 10 surnames (see method used for 1957 pandemic). Official data also suggest increased influenza deaths for the 1890s beginning in 1890 (17).|
|National mortality data, second wave (6), n = 8,573 deaths||4,230/100,000 population||580/100,000 population) (European)||7.3||See limitations with data quality described in the main text. Comparison was not age-standardized.|
|Mortality in New Zealand military personnel, second and third waves,‡ n = 1,113||2,501/100,000 population||1,103/100,000 population (European/ other)||2.3 (1.6–3.1)§||New Zealand military personnel of Pacific peoples ethnicity also had a raised mortality rate, but absolute number of deaths was small (n = 12) and difference was not significant.|
|National mortality data for Asian influenza pandemic, official report (11), n = 179 deaths||39.6/100,000 population||6.4 per 100,000 population (European)||6.2||Of note, at this time surveillance systems were crude, and attention to quality ethnicity coding was not robust. There was no widespread use of vaccination in response to this pandemic in New Zealand.|
|Individual mortality data in BDM database for selected surnames (10), n = 38 deaths in Aug/Sep 1957||49.0% increase for Aug/Sep 1957 compared with same period in 1956 and 1958||Whole New Zealand population: 20.3% increase||2.4 (Māori vs. total population)||See Discussion for limitations with this method.|
|All cases with pandemic (H1N1) 2009 as primary cause of death,# n = 49||2.0 (0.8–3.1)§||0.8 (0.5–1.1)§||2.6 (1.3–5.3)§||For Pacific peoples in New Zealand, rate = 4.6 (2.0–7.2)§|
*BDM, Births, Deaths & Marriages.
†Māori:non-Māori except as indicated.
‡Age standardization was not possible with available data; 1 study reported that Māori and European soldiers had similar median ages of 24 and 26 years, respectively (8).
§Values in parentheses are 95% confidence intervals.
¶Jun–Sep 2009. Cumulative age-standardized mortality rates per 100,000 population, age-standardized to Māori population. Ratio is Māori versus other New Zealanders (non-Māori and non-Pacific, mainly European).
#Identified by Mortality Review Group.
- Mamelund S-E. Geography may explain adult mortality from the 1918–20 influenza pandemic. Epidemics. 2011;3:46–60.
- La Ruche G, Tarantola A, Barboza P, Vaillant L, Gueguen J, Gastellu-Etchegorry M. The 2009 pandemic H1N1 influenza and indigenous populations of the Americas and the Pacific. Euro Surveill. 2009;14:pii:19366.
- Flint SM, Davis JS, Su JY, Oliver-Landry EP, Rogers BA, Goldstein A, Disproportionate impact of pandemic (H1N1) 2009 influenza on Indigenous people in the Top End of Australia’s Northern Territory. Med J Aust. 2010;192:617–22.
- Centers for Disease Control and Prevention. Deaths related to 2009 pandemic influenza A (H1N1) among American Indian/Alaska Natives—12 states, 2009. MMWR Morb Mortal Wkly Rep. 2009;58:1341–4.
- Zarychanski R, Stuart TL, Kumar A, Doucette S, Elliott L, Kettner J, Correlates of severe disease in patients with 2009 pandemic influenza (H1N1) virus infection. CMAJ. 2010;182:257–64.
- Rice G. Black November: the 1918 influenza pandemic in New Zealand. Christchurch (New Zealand): Canterbury University Press; 2005.
- Auckland War Memorial Museum. Cenotaph database. Auckland, New Zealand. Auckland War Memorial Museum, 2008 [cited 2010 Dec 1]. http://www.aucklandmuseum.com/130/cenotaph-database
- Inwood K, Oxley L, Roberts E. Physical stature in nineteenth-century New Zealand: a preliminary interpretation. Aust Econ Hist Rev. 2010;50:262–83.
- Pacific Research & Development Services & SHORE/Whariki Massey University. Pacific drugs & alcohol consumption survey 2003. Final report: volume I. Auckland (New Zealand): Massey University, 2004.
- Department of Internal Affairs. Birth, Death and Marriage Historical Records. Wellington (New Zealand): New Zealand Government [cited 2010 Dec 1]. http://bdmhistoricalrecords.identityservices.govt.nz/home/
- Davis L. Report on the 1957 pandemic of influenza (to the World Health Organization, Geneva). Wellington (New Zealand): Division of Public Hygiene, Department of Health; 1958. p. 1–4.
- Department of Statistics. New Zealand Official Yearbook 1973. Wellington (New Zealand): Government Printer; 1973.
- Mortality PI; Morbidity Review Group. Report for the Minister of Health from the Pandemic Influenza Mortality and Morbidity Review Group. Wellington (New Zealand): Ministry of Health; 2010.
- Rice G. Maori mortality in the 1918 influenza epidemic. N Z Popul Rev. 1983;9:44–61.
- Pool DI. The effects of the 1918 pandemic of influenza on the Maori population of New Zealand. Bull Hist Med. 1973;47:273–81.
- Bryder L. The 1918 influenza epidemic in Auckland [master’s thesis]. Auckland (New Zealand): Auckland University; 1980.
- Donovan JW. A study in New Zealand mortality: 6. epidemic diseases. N Z Med J. 1969;70:406–15.
- Bandaranayake D, Huang QS, Bissielo A, Wood T, Mackereth G, Baker MG, Risk factors and immunity in a nationally representative population following the 2009 influenza A(H1N1) pandemic. PLoS ONE. 2010;5:e13211.
- Baker MG, Wilson N, Huang QS, Paine S, Lopez L, Bandaranayake D, Pandemic influenza A(H1N1)v in New Zealand: the experience from April to August 2009. Euro Surveill. 2009;14:ArticleId=19319.
- Verrall A, Norton K, Rooker S, Dee S, Olsen L, Tan CE, Hospitalizations for pandemic (H1N1) 2009 among Maori and Pacific Islanders, New Zealand. Emerg Infect Dis. 2010;16:100–2.
- ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System. Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study. BMJ. 2010;340:c1279.
- Statistics New Zealand. New Zealand: an urban/rural profile. Wellington (New Zealand): Statistics New Zealand; 2005.
- ANZIC Influenza Investigators; Webb SA, Pettila V, Seppelt I, Bellomo R, Bailey M, Cooper DJ, et al. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med. 2009;361:1925–34.
- Ministry of Health. A portrait of health: key results of the 2006/07 New Zealand Health Survey. Wellington, New Zealand: Ministry of Health, 2008 [cited 2010 Dec 1]. http://www.moh.govt.nz/moh.nsf/indexmh/portrait-of-health
- Robson B, Harris R, eds. Hauora: Māori standards of health IV. A study of the years 2000–2005. Wellington (New Zealand): Te Rōpū Rangahau Hauora a Eru Pōmare, 2007 [cited 2010 Dec 1]. http://www.hauora.maori.nz/hauora
- Baker M, Telfar Barnard L, Zhang J, Lanumata T, Keall M, Verral A, Close-contact infectious diseases in New Zealand: trends and ethnic inequalities in hospitalisations, 1989 to 2008. 2nd ed. Wellington: Housing and Health Research Programme, University of Otago; 2010 [cited 2010 Dec 1]. http://www.healthyhousing.org.nz/wp-content/uploads/2010/06/Close-contact-IDs-2nd-edition1.pdf
- Baker M, Das D, Venugopal K, Howden-Chapman P. Tuberculosis associated with household crowding in a developed country. J Epidemiol Community Health. 2008;62:715–21.
- Baker M, McNicholas A, Garrett N, Jones N, Stewart J, Koberstein V, Household crowding a major risk factor for epidemic meningococcal disease in Auckland children. Pediatr Infect Dis J. 2000;19:983–90.
- Jaine R, Baker M, Venugopal K. Acute rheumatic fever associated with household crowding in a developed country. [Epub ahead of print]. Pediatr Infect Dis J. 2010.
- Epidemiological Task Group for Overseas French Territories of the Pacific; Barboza P, Baudon C, Cherie-Challine L, Gastellu-Etchegorry M, Gueguen J, La Ruche G, et al. Influenza A(H1N1)2009 in the French Pacific territories: assessment of the epidemic wave during the austral winter. Clin Microbiol Infect. 2010;16:304–8.
- Shanks GD, Mackenzie A, McLaughlin R, Waller M, Dennis P, Lee SE, Mortality risk factors during the 1918–1919 influenza pandemic in the Australian army. J Infect Dis. 2010;201:1880–9.
- Mamelund S-E. Spanish Influenza mortality of ethnic minorities in Norway 1918–1919. Eur J Popul. 2003;19:83–102.
- Maclean F. Challenge for health: a history of public health in New Zealand. Wellington (New Zealand): Government Printer; 1964.
- Cowan J. Maoris in the great war: a history of the New Zealand native contingent and pioneer battalion—Gallipoli 1915 France and Flanders 1916–1918. Auckland (New Zealand): Whitcombe & Tombs; 1926.
- Pugsley C. Te Hokowhitu a Tu: the Maori pioneer battalion in the first World War. Auckland (New Zealand): Reed; 1995.
- Blakely T, Thomson G, Wilson N, Edwards R, Gifford H. The Māori Affairs Select Committee Inquiry and the road to a smokefree Aotearoa. N Z Med J. 2010;123:7–18.
- Massey PD, Pearce G, Taylor KA, Orcher L, Saggers S, Durrheim DN. Reducing the risk of pandemic influenza in Aboriginal communities. Rural Remote Health. 2009;9:1290.
- Rudge S, Massey PD. Responding to pandemic (H1N1) 2009 influenza in Aboriginal communities in NSW through collaboration between NSW Health and the Aboriginal community-controlled health sector. N S W Public Health Bull. 2010;21:26–9.
- Groom AV, Jim C, Laroque M, Mason C, McLaughlin J, Neel L, Pandemic influenza preparedness and vulnerable populations in tribal communities. Am J Public Health. 2009;99(Suppl 2):S271–8.
- Hutchins SS, Fiscella K, Levine RS, Ompad DC, McDonald M. Protection of racial/ethnic minority populations during an influenza pandemic. Am J Public Health. 2009;99(Suppl 2):S261–70.