Health promoting and demoting consumption: What accounts for budget share differentials by ethnicity in New Zealand. (September 2022)

• Record Type: Journal Article
• Authors: Nghiem, Nhung; Leung, William; Doan, Tinh
• Is Part Of: SSM - population health. Volume 19(2022)
• Publication Date: 2022-09
• Subjects: Household expenditure -- Consumption health-risk factors -- Ethnic inequities -- Household economic survey -- New Zealand; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; 362.105
• DOI: 10.1016/j.ssmph.2022.101204
• Languages: English
• ISSNs: 2352-8273

Abstract

Abstract: Background: Health demoting consumption of alcohol and tobacco are some of the most important risk factors for health loss worldwide, however there is limited information on these consumption risk factors in New Zealand (NZ) and whether inequities in the risk factors are ethnically patterned. Methods: We used three nationally representative Household Economic Survey waves (2006/07, 2009/10, 2012/13) (n = 9030) in NZ to examine household expenditure for key health risk-related components of consumption by ethnicity, and its contributors to the differences using non-parametric, parametric and decomposition methods. Results: Māori households (NZ indigenous population) were significantly poorer (25% less) than non-Māori households in terms of household per capita expenditure. However, our various econometric estimations suggested that, in relative terms, Māori spent more on tobacco and alcohol, and less on healthcare. The gaps become larger at upper quantiles of the budget share distributions; the composition effect (the gap due to differences in individual and household characteristics between Māori and non-Māori) explains most of the tobacco and alcohol budget share gap between the two groups, and less for healthcare. The structure effect (the gap due to returns to/or effect of individual and household characteristics) contributes very little to the budget share gap for tobacco and drink, but increasingly and predominantly when moving along the distribution of healthcare budget share. The differences between Māori and non-Māori in household ownership, education, and income negatively affect budget share on these health demoting consumption (tobacco and alcohol). The household head's age, education, and employment contributed most to the structure effect. Conclusions: Our study suggested ethnic inequities in the health risk consumption behaviour are evidenced in NZ. Interventions targeting education and employment that significantly affect household budget shares on risk factors (i.e., harmful consumption) for health loss may help narrow the gaps. Highlights: Alcohol and tobacco are important risk factors for health loss worldwide. National Household Economic Survey data were analysed by ethnicity for New Zealand. Māori households spent more on tobacco and alcoholic drinks, and less on healthcare. The gap due to differences in household characteristics explains most of the budget share gap. Interventions targeting education and employment may help narrow the gaps.