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There has recently been public and media discourse comparing
Finland with New Zealand (in both countries). This discussion was triggered by
comments in the New Zealand Parliament, and has not always been well informed by
facts. Nevertheless, country comparisons can provide learning opportunities and
hence we continue the comparison in the domain of infectious diseases. This
domain is a particularly relevant one for New Zealand, given evidence for
increasing rates of serious infectious diseases in this county over
time.1
Methods—We examined
infectious diseases related data detailed on the World Health Organization (WHO)
website for the two countries for the three most recent years available
(2008–2010).2 This data source was
selected as it contains an internationally agreed set of indicators and complete
data from both countries.
Results and Discussion—The results
indicate more favourable indicators for health service activities to control
infectious diseases for Finland (4/6 indicators) vs. one being more favourable
for New Zealand (Table 1). In terms of infectious disease burdens, the
indicators also tended to favour Finland (8/17) compared to New Zealand (1/17)
(Table 1). Furthermore, this comparison using WHO indicators ignores those
infectious diseases for which New Zealand has particularly serious problems:
skin infections,3 rheumatic
fever,4 meningococcal
disease,5 and
campylobacteriosis.6
Many reasons for these differences in infectious diseases
burden between Finland and New Zealand are plausible. There is the fact that
Finland is wealthier, spends more per capita on health, and has more physicians
per capita.2 Other reasons could relate to
better levels of education in Finland (for all
indicators7), lower levels of socioeconomic
inequality (for all versions of the Gini
index8), and probably better housing quality.
Indeed, Finland has “good” housing conditions along with other
long-standing northern EU member states.9
Nevertheless, comparisons with New Zealand on housing are difficult in the
absence of systematic data gathering through a regular, comprehensive national
housing survey.
As shown in Table 1, the lower levels of immunisation
coverage are also likely to be relevant (though this is an area that the New
Zealand Government is actively addressing as one of its six health
priorities10). In addition, to the credit of
Finland, the tabulated data do not convey that measles, mumps and rubella have
all been regarded as eliminated in this country since the mid-1990s (albeit with
occasional imported cases).11 Some other
European countries may have also achieved measles elimination e.g., there were
zero cases of measles in a total of eight such countries in
2010.12 Furthermore, Finland has introduced
routine rotavirus vaccination for children13
(in 2009), while New Zealand has not.
In summary, the control of infectious diseases is clearly a
domain where Finland leads New Zealand and where there is scope for New Zealand
health sector leaders and politicians across the political spectrum to learn
lessons from such countries.
Table 1. Comparison between Finland and New
Zealand in infectious disease related health service activity and outcome
measures (WHO data for 2010 unless otherwise indicated, bolded data shows the
better result from a health perspective, except where this is not statistically
significant)*
* Ignoring tropical infectious diseases e.g., malaria,
Japanese encephalitis, yellow fever.
** Better than NZ when considered as a crude annual
population rate since Finland has a larger population (5.33 million vs 4.27
million for New Zealand in 2009).
Nick Wilson*, Philippa Howden-Chapman, Michael G
Baker
Department of Public Health, University of Otago, Wellington * Email: nick.wilson@otago.ac.nz
Competing interests: The authors
declare no competing interests.
References:
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