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Background:

Racial/ethnic inequalities in mortality may be reducible by addressing socioeconomic factors and smoking. To our knowledge, this is the first study to estimate trends over multiple decades in (1) mediation of racial/ethnic inequalities in mortality (between Māori and Europeans in New Zealand) by socioeconomic factors,(2) additional mediation through smoking, and (3) inequalities had there never been smoking.

Methods:

We estimated natural (1 and 2 above) and controlled mediation effects (3 above) in census-mortality cohorts for 1981–1984 (1.1 million people), 1996–1999 (1.5 million), and 2006–2011 (1.5 million) for 25-to 74-year-olds in New Zealand, using a weighting of regression predicted outcomes.

Results:

Socioeconomic factors explained 46% of male inequalities in all three cohorts and made an increasing contribution over time among females from 30.4%(95% confidence interval= 18.1%, 42 …