Vol 133 No 1521: 4 September 2020

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Issue Summary

Article

SUMMARY

Estimated inequities in COVID-19 infection fatality rates by ethnicity for Aotearoa New Zealand | OPEN ACCESS

Nicholas Steyn, Rachelle N Binny, Kate Hannah, Shaun C Hendy, Alex James, Tahu Kukutai, Audrey Lustig, Melissa McLeod, Michael J Plank, Kannan Ridings, Andrew Sporle

We estimate the risk of fatality from COVID-19 for different ethnicities in New Zealand. We find that Māori have at least a 50% higher risk of fatality than non-Māori. Pacific people may also be at a higher risk of fatality. These results show the need for good data collection systems and measures that pro-tect at-risk groups, communities and regions.

Article

SUMMARY

Racism and health in Aotearoa New Zealand: a systematic review of quantitative studies | OPEN ACCESS

Natalie Talamaivao, Ricci Harris, Donna Cormack, Sarah-Jane Paine, Paula King

This paper reviews the body of quantitative research in New Zealand that examines self-reported experiences of racial discrimination and associations with a range of health outcomes (eg, mental health, physical health, self-rated health, wellbeing, individual level health risks and healthcare indicators). The review found 24 studies that report associations between health outcomes and experience of racial discrimination—finding that experience of racism is linked with poorer health outcomes. Indigenous and minoritised ethnic groups are more likely to experience racial discrimination and therefore are disproportionately affected by the impacts of racial discrimination on health outcomes. There is an urgent need to identify and implement policy initiatives and interventions to address the negative impact of racism on health.

Viewpoint

SUMMARY

The most commonly diagnosed and most common causes of cancer death for Māori New Zealanders | OPEN ACCESS

Jason K Gurney, Bridget Robson, Jonathan Koea, Nina Scott, James Stanley, Diana Sarfati

Cancer is an important cause of health burden and death for Māori, with a quarter of all Māori deaths attributable to this disease. There are also unfair differences between Māori and non-Māori New Zealanders in terms of who gets cancer, who dies from cancer and who survives it. In this paper we show the most important cancers for Māori—the top-10 most commonly diagnosed, the top-10 most common causes of cancer death, and how survival differs between Māori and non-Māori for these cancers. We finish by talking about the things that need to happen to reduce the cancer burden for Māori.

Article

SUMMARY

Ethnic differences in cardiovascular risk profiles among 475,241 adults in primary care in Aotearoa, New Zealand | OPEN ACCESS

Vanessa Selak, Katrina Poppe, Corina Grey, Suneela Mehta, Julie Winter-Smith, Rod Jackson, Sue Wells, Daniel Exeter, Andrew Kerr, Tania Riddell, Matire Harwood

The aim of this study was to describe CVD risk profiles by ethnicity using data collected in primary care clinics between 2004 and 2016. 475,241 people (43% women) were included of whom 14% percent identified as Māori, 13% Pacific, 8% Indian, 10% Other Asian and 55% European. Māori and Pacific people experience the most significant inequities in exposure to CVD risk factors compared with other ethnic groups. Indian people have a high prevalence of diabetes and coronary heart disease. We recommend strong political commitment and cross-sectoral action to implement interventions that address these inequities.

Article

SUMMARY

Inequity in one-year mortality after first myocardial infarction in Māori and Pacific patients: how much is associated with differences in modifiable clinical risk factors? (ANZACS-QI 49)

Janine Mazengarb, Corina Grey, Mildred Lee, Katrina Poppe, Suneela Mehta, Matire Harwood, Wil Harrison, Nicki Earle, Rod Jackson, Andrew Kerr

We studied the reasons for differences in survival in people from different ethnic groups experiencing their first heart attack in New Zealand. We found that mortality in the first year was nearly three times higher for Pacific and Māori people than European people of similar age and sex. At least half of these worse outcomes for Māori, and three-quarters for Pacific people, were found to be related to differences in potentially preventable or modifiable clinical factors present at, or prior to, the heart attack. It follows that much of the poorer survival in Māori and Pacific people relative to European people could be reduced by improvements in prevention in the community (eg, diet, exercise, stopping smoking), in primary (General practice) care (eg, blood pressure, cholesterol and diabetes control) and at the community-to-hospital interface.

Article

SUMMARY

Inequalities between Māori and non-Māori men with prostate cancer in Aotearoa New Zealand

Richard Egan, Jacquie Kidd, Ross Lawrenson, Shemana Cassim, Stella Black, Rawiri Blundell, Jerram Bateman, John Broughton

Māori experience poorer health statistics in terms of cancer incidence and mortality compared to non-Māori. For prostate cancer, Māori men are less likely than non-Māori men to be diagnosed with prostate cancer, but those that are diagnosed are much more likely to die of the disease than non-Māori men resulting in an excess mortality rate in Māori men compared with non-Māori. A review of the literature included a review of the epidemiology of prostate cancer; of screening; of access to healthcare and of treatment modalities. Our conclusion was that there are a number of reasons for the disparity in outcomes for Māori including differences in staging and characteristics at diagnosis; differences in screening and treatment offered to Māori men; and general barriers to healthcare that exist for Māori men in New Zealand. We conclude that there is a need for more culturally appropriate care to be available to Māori men.

Editorial