The distribution and frequency of blood lipid testing by sociodemographic status among adults in Auckland, New Zealand

Abstract

INTRODUCTION: National cardiovascular disease (CVD) guidelines recommend that adults have cholesterol levels monitored regularly. However, little is known about the extent and equity of cholesterol testing in New Zealand. AIM: To investigate the distribution and frequency of blood lipid testing by sociodemographic status in Auckland, New Zealand. METHODS: We anonymously linked five national health datasets (primary care enrolment, laboratory tests, pharmaceuticals, hospitalisations and mortality) to identify adults aged =25 years without CVD or diabetes who had their lipids tested in 2006–2010, by age, gender, ethnicity and area of residence and deprivation. Multivariate logistic regression was used to estimate the likelihood of testing associated with these factors. RESULTS: Of the 627 907 eligible adults, 66.3% had at least one test between 2006 and 2010. Annual testing increased from 24.7% in 2006 to 35.1% in 2010. Testing increased with age similarly for men and women. Indian people were 87% more likely than New Zealand European and Others (NZEO) to be tested, Pacific people 8% more likely, but rates for Maori were similar to NZEO. There was marked variation within the region, with residents of the most deprived areas less likely to be tested than residents in least deprived areas. DISCUSSION: Understanding differences within and between population groups supports the development of targeted strategies for better service utilisation. While lipid testing has increased, sociodemographic variations persist by place of residence, and deprivation. Of the high CVD risk populations, lipid testing for Maori and Pacific is not being conducted according to need. KEYWORDS: Cardiovascular disease; healthcare disparities; lipids; socioeconomic status