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Death in the South Pacific.

The pattern of mortality and the influence of blood pressure, serum cholesterol, and body mass on mortality is examined in 1980 adults in four contrasting South Pacific populations. Three of the populations are Polynesian: Pakapuka, an isolated coral atoll, Rarotonga, a less isolated volcanic island, and the New Zealand Maoris, and they are compared with a New Zealand caucasian sample. The baseline examinations were performed in 1963-64 and the cardiovascular risk factors and associated disease were found to be more prevalent in Polynesians with increasing westernisation. The dead or alive status was ascertained in 1974 for 99 percent of the subjects. The age standardised 10-11 year death rates also increased with increasing westernisation from 11.7 percent in Pukapukan men to 26.7 percent in Maori men. The Mantel-Haenszel method of analysis of survivorship data demonstrated a significant inverse relationship between baseline serum cholesterol and mortality in the New Zealand Maoris. Cox's proportional hazards regression model was used to examine the population differences in mortality and it was found that the variables studied do not explain these differences. This study demonstrates the adverse effect of esternisation on the health of Polynesians and suggests that the relationsip between risk factors and mortality differs between populations.