Indicator 26: Mortality rates

How deaths are categorised

The causes of death can be organised into three groups. Deaths can be from:

• external causes (this indicator);
• non-communicable diseases (see Madrid indicator 25); and
• communicable diseases (see Madrid indicator 31, which is about the prevalence of HIV/AIDS, not death rates).^[1]

Some deaths from external causes can be prevented by universal or targeted interventions that governments can introduce. Good-quality data is needed to help set priorities for public spending to reduce deaths from external causes, or to decide whether resources would be better used to decrease deaths from communicable or non-communicable diseases. Data is also needed to know whether the interventions are effective.

The types of deaths discussed here

The category of external causes and poisoning includes deaths from events such as falls, motor vehicle crashes, suicide, and drowning. We show mortality rates for all of these, except drowning, in Figure 1. (The number of deaths by drowning is small.) The data shows that the mortality rate from external causes and poisoning per 100,000 population for people aged 60+ increased since 2000.

Accidental falls

There has been a national focus on reducing the incidence and impact of falls since 2001.^[2] The Accident Compensation Corporation (ACC) is the lead government agency for the national falls prevention strategy.^[3] The strategy aims to reduce the incidence and severity of injury from falls. It guides the activities of Government, health agencies, service providers, non-government, and community organisations to provide services in a co-ordinated and collaborative way. The implementation plan for the strategy expired in 2010. ACC told us (on 30 January 2013) that it was updating the implementation plan and expected to finalise it in mid-2013.

Health Quality and Safety Commission New Zealand is the lead agency for establishing a programme to reduce the harm from falls in health-care settings. Data published in a series of reports of serious and sentinel events occurring within the health sector have identified harm from falls as a major cause of injury to patients in hospital.^{[4], [5]} Action will be taken at the individual, system, and population levels.^[6]

At the individual level, the focus will be on preventing falls and reducing the harm from falls for Maori/Pacifica people aged 55+ and non-Maori/Pacifica people aged 75+:

• in care settings (hospital in-patients, people in aged residential care, and those at home receiving care);
• with polypharmacy;^[7] and
• with a previous fragility fracture.^[8]

Motor vehicle crashes

Older road users are more physically vulnerable to injury and the number of deaths and serious injuries are expected to increase as the population ages. This is one reason the National Road Safety Committee, which is responsible for implementing Safer Journeys 2010-2020, identifies the road safety of older people as a continuing and emerging focus.^[9] The aim is to decrease the mortality rate for people aged 65+ from 15 per 100,000 population to 11 per 100,000 population by 2020. Indications are that this might be achieved before then (see Figure 4).

Deaths from suicide

The Ministry of Health is lead agency for the New Zealand Suicide Prevention Strategy 2006-2016. The strategy noted that, although suicide rates in the elderly had been declining over time, they remained relatively high and (until recently) the risk was often overlooked in that population.^[10] Since 2006, some initiatives have been broadly based and include older people.^[11]