Bramley Et Al. Respond
Bibliographic Data
We are grateful for Baker’s letter and the opportunity to reply. In our article we focused on the relative (not absolute) size of health care disparities in New Zealand and the United States between the indigenous populations and the numerically dominant populations. Although Baker is correct in pointing out that infant mortality, male life expectancy, and homicide rates are worse in the United States, the disparities between Maoris and Europeans in New Zealand are larger than those between American Indians/Alaska Natives and US Whites for each of these health indicators. For homicide, we found a mortality risk ratio of 5.4 for Maoris compared with Europeans and a mortality risk ratio of 3.7 for American Indians/Alaska Natives compared with Whites. We agree that there is an urgent need to reduce homicides in the United States, though we would add that there is also a need to reduce disparities in homicide rates between indigenous and majority populations in both countries. We would also like to emphasize that indigenous peoples in both countries experience a number of health disparities. The statement Baker mentions calling attention to the “success of the United States in eliminating disparities” was made specifically with regard to childhood immunization and was intended to show that disparities are not necessarily intractable. We did not include unintentional injuries in our analysis because differences in the grouping and reporting of injury-related International Classification of Diseases codes across countries make direct comparisons impracticable. We agree that there are a number of useful measures that could be used to quantify burden of disease. One possible direction for future research in health disparities might be to examine how such disparities are reflected by different measures of disease burden
Environmental health · Autopsy Techniques and Outcomes · Medicine · Vaccine Coverage and Hesitancy
| Citations per year | 0.06 |
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| Citation span | 2008 - 2008 (1) |
| Highly cited | No |