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Objectives: To outline the development and uses of the census-based New Zealand small-area index of relative socio-economic deprivation, NZDep. Methods: NZDep has been created from four 5-yearly censuses using theory developed from international deprivation research, a standard statistical procedure (principal component analysis) and both construct and criterion validation. Results: The latest index was based on nine socio-economic deprivation variables available for just over 4 million people. It was calculated from a basis of 24,000 small areas containing a median of approximately 90 people. The deprivation index has a value from 1 (low) to 10 (high). It is mapped to standard administrative areas and is available free of charge. The index is easy to visualize, and deprivation maps are widely used. The index is used in many applications in research and social epidemiology, and routinely by the country's Ministry of Health, both to explore health variations across the country and to allocate central government funds to local health care providers. Geographers in local government were quick to recognize the index as a good tool for visualizing the diversity and neediness of local communities, and hence as a tool for town and service planning. Conclusion: The national NZDep index of small-area deprivation has been used widely in research on mortality, morbidity and determinants of ill health, and in needs assessment, resource allocation and advocacy. Key words: Socio-economic status; New Zealand; resource allocation; inequalities, The New Zealand small-area index of relative socio-economic deprivation (NZDep) is a national index derived from census data. To date, it has been created from four censuses: 1991, 1996, 2001 [...]

Objectives: To outline the development and uses of the census-based New Zealand small-area index of relative socio- economic deprivation, NZDep. Methods: NZDep has been created from four 5-yearly censuses using theory developed from international deprivation research, a standard statistical procedure (principal component analysis) and both construct and criterion validation. Results: The latest index was based on nine socio-economic deprivation variables available for just over 4 million people. It was calculated from a basis of 24,000 small areas containing a median of approximately 90 people. The deprivation index has a value from 1 (low) to 10 (high). It is mapped to standard administrative areas and is available free of charge. The index is easy to visualize, and deprivation maps are widely used. The index is used in many applications in research and social epidemiology, and routinely by the country's Ministry of Health, both to explore health variations across the country and to allocate central government funds to local health care providers. Geographers in local government were quick to recognize the index as a good tool for visualizing the diversity and neediness of local communities, and hence as a tool for town and service planning. Conclusion: The national NZDep index of small-area deprivation has been used widely in research on mortality, morbidity and determinants of ill health, and in needs assessment, resource allocation and advocacy. Key words: Socio-economic status; New Zealand; resource allocation; inequalities Objectifs: Decrire l'elaboration et les utilisations du NZDep, l'indice de defavorisation socioeconomique relative par petite region fonde sur le recensement de la Nouvelle-Zelande. Methode: Le NZDep a ete cree a partir de quatre recensements quinquennaux a l'aide de theories formulees dans la recherche internationale sur la defavorisation et d'une methode statistique type (l'analyse en composantes principales); sa validite conceptuelle et sa validite de critere ont ete verifiees. Resultats: Le dernier indice est base sur neuf variables de defavorisation socioeconomique disponibles pour un peu plus de 4 millions d'habitants. Il est calcule pour 24 000 petites regions contenant un nombre median d'environ 90 personnes. L'indice de defavorisation a une valeur de 1 (faible) a 10 (elevee). Il est mis en correspondance avec les zones administratives standard, et il est disponible gratuitement. L'indice est facile a visualiser, et les cartes de defavorisation sont largement utilisees. L'indice a de nombreuses applications pour la recherche et l'epidemiologie sociale, et le ministere neo-zelandais de la Sante s'en sert couramment, tant pour analyser les ecarts de sante au pays que pour affecter les fonds du gouvernement central aux personnels soignants locaux. Les geographes des administrations locales en ont rapidement reconnu l'utilite pour visualiser la diversite et les besoins des collectivites locales, et de la comme outil d'urbanisme et de planification des services. Conclusion: L'indice neo-zelandais de defavorisation par petite region (NZDep) est largement utilise dans la recherche sur la mortalite, la morbidite et les determinants des problemes de sante, ainsi que pour l'appreciation des besoins, l'allocation des ressources, et la promotion et la defense des droits. Mots cles: statut socioeconomique; Nouvelle-Zelande; allocation de ressources; inegalites, The New Zealand small-area index of relative socio-economic deprivation (NZDep) is a national index derived from census data. To date, it has been created from four censuses: 1991, 1996, 2001 [...]

In this article, we examined the effect of gender concordance on physicians' perception of their patients and of their medical condition, analyzing a data set of 8,258 visit questionnaires from the New Zealand National Primary Care Medical Care Survey conducted in 2001-2002. Multivariate analysis indicated that the concordant female patient/female physician dyad had a positive independent association with physicians' reporting high rapport and a negative independent association with reporting uncertainty about the diagnosis. The discordant female patient/male physician dyad had a positive independent association with physicians' perceptions of uncertainty of diagnosis and hidden agenda, and a negative independent association with rating the patient's condition of high severity. The findings suggest a need to raise male physicians' awareness to possible biases when treating female patients. The findings also suggest the need to empower female patients to take an active partnership role to improve their communication with male physicians. KEYWORDS. Gender concordance, primary care, physicians, perceptions, survey, New Zealand

The aim of this research was to identify a small set of indicators of an individual's deprivation that is appropriate for all ethnic groups and can be combined into a single and simple index of individual socioeconomic deprivation in New Zealand. The NZiDep index of socioeconomic deprivation was derived using the same theoretical basis as the national census-based small-area indices of relative socioeconomic deprivation. The index has been created and validated from the analysis of representative sample survey data obtained from approximately 300 Maori, 300 Pacific, and 300 non-Maori, non-Pacific adults. Twenty-eight deprivation-related characteristics, derived from New Zealand and overseas surveys, were analysed by standard statistical techniques (factor analysis, Cronbach's coefficient alpha, item-total correlations, principal component analysis). The index was validated using information on tobacco smoking, which is known to be strongly related to deprivation. The NZiDep index is based on eight simple questions which take 2-3 min to administer. The index is a significant new (non-occupational) tool for measuring socioeconomic position for individuals. We argue that the index has advantages over existing measures, including a specific focus on deficits, applicability to all adults (not just the economically active), and usefulness for all ethnic groups. Its strengths include focus, simplicity, utility, acceptability across ethnic groups, construct validity, statistical validity, criterion validity (measured with reference to tobacco smoking), and relevance to the current New Zealand context. The index is indicative of deprivation in general, and is designed for use as a variable in research, and for elucidating the relationships between socioeconomic position and health/social outcomes. Keywords: New Zealand; Deprivation; Index; Socioeconomic position; Income poverty; Living standards

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2005.08.008 Byline: Clare Salmond (a), Peter Crampton (a), Peter King (b), Charles Waldegrave (b) Keywords: New Zealand; Deprivation; Index; Socioeconomic position; Income poverty; Living standards Abstract: The aim of this research was to identify a small set of indicators of an individual's deprivation that is appropriate for all ethnic groups and can be combined into a single and simple index of individual socioeconomic deprivation in New Zealand. The NZiDep index of socioeconomic deprivation was derived using the same theoretical basis as the national census-based small-area indices of relative socioeconomic deprivation. The index has been created and validated from the analysis of representative sample survey data obtained from approximately 300 Maori, 300 Pacific, and 300 non-Maori, non-Pacific adults. Twenty-eight deprivation-related characteristics, derived from New Zealand and overseas surveys, were analysed by standard statistical techniques (factor analysis, Cronbach's coefficient alpha, item-total correlations, principal component analysis). The index was validated using information on tobacco smoking, which is known to be strongly related to deprivation. The NZiDep index is based on eight simple questions which take 2-3min to administer. The index is a significant new (non-occupational) tool for measuring socioeconomic position for individuals. We argue that the index has advantages over existing measures, including a specific focus on deficits, applicability to all adults (not just the economically active), and usefulness for all ethnic groups. Its strengths include focus, simplicity, utility, acceptability across ethnic groups, construct validity, statistical validity, criterion validity (measured with reference to tobacco smoking), and relevance to the current New Zealand context. The index is indicative of deprivation in general, and is designed for use as a variable in research, and for elucidating the relationships between socioeconomic position and health/social outcomes. Author Affiliation: (a) Department of Public Health, Wellington School of Medicine & Health Sciences, PO Box 7343, Wellington South, New Zealand (b) The Family Centre Social Policy Research Unit, 71, Woburn Road, Lower Hutt, New Zealand

Abstract NZDep96 is an index of deprivation for small areas. Originally designed for use in health research, resource allocation and advocacy, it has now become a widely used social research [...]

Abstract The purpose of this paper is to promote debate on the devolution of primary care services to the third sector. The paper first discusses definitions of the term 'third [...]

New Zealand's deprivation index (NZDep91) measures and evaluates socioeconomic disadvantage at a small community level. The index uses household income and occupancy variables, which are adjusted for composition and size to alleviate bias. Principal components analysis identifies linear variable combinations, which account for data variation and target redundancy.

A new index of poverty, or deprivation, has been devised for New Zealand based on census data. Previous indices lacked appropriate theoretical underpinning and relied on relatively large areas that masked variation within them. The new design is based on the smallest possible geographical areas and ten age and gender variables, and has been found to strongly correlate with mortality, lung cancer registrations, and hospital discharges.

This paper aims to describe and explain the development of third sector primary care organisations in New Zealand. The third sector is the non-government, non-profit sector. International literature suggests that this sector fulfils an important role in democratic societies with market-based economies, providing services otherwise neglected by the government and private for-profit sectors. Third sector organisations provided a range of social services throughout New Zealand's colonial history. However, it was not until the 1980s that third sector organisations providing comprehensive primary medical and related services started having a significant presence in New Zealand. In 1994 a range of union health centres, tribally based Maori health providers, and community-based primary care providers established a formal network -- Health Care Aotearoa. While not representing all third sector primary care providers in New Zealand, Health Care Aotearoa was the best-developed example of a grouping of third sector primary care organisations. Member organisations served populations that were largely non-European and lived in deprived areas, and tended to adopt population approaches to funding and provision of services. The development of Health Care Aotearoa has been consistent with international experience of third sector involvement -- there were perceived 'failures' in government policies for funding primary care and private sector responses to these policies, resulting in lack of universal funding and provision of primary care and continuing patient co-payments. The principal policy implication concerns the role of the third sector in providing primary care services for vulnerable populations as a partial alternative to universal funding and provision of primary care. Such an alternative may be convenient for proponents of reduced state involvement in funding and provision of health care, but may not be desirable from the point of view of equity and social cohesion insofar as the role of the welfare state is diminished. Keywords: Primary health care; Third sector; New Zealand; Vulnerable populations