The place of population change in explaining geographical inequalities in health in New Zealand

Abstract

We appreciate Harper's comments on the role of population change in explaining rising geographical inequalities in health in New Zealand.¹ As we note in our original paper, we agree that selective migration patterns may well be an important explanation as to why regional health status in New Zealand has become more geographically polarized during the 1980s and 1990s.² Selective patterns of migration between the regions of New Zealand and the high levels of immigration into the country, and emigration from it, are likely to lead to a high level of population sorting between areas and to have strengthened the widening life expectancy gap during the 1980s and 1990s. Given that New Zealand experiences almost the highest rate of combined immigration and emigration (population turnover) in the world,^a if selective migration were to have an explanatory role anywhere it would be in helping to understand changing health patterns within this country.