Access and Society as Determinants of Ischaemic Heart Disease in Indigenous Populations

Abstract

Background: Ischaemic Heart Disease (IHD) is a leading cause of death in New Zealand and the burden falls disproportionately on Maori, the indigenous population of Aotearoa New Zealand. ¯ Methods: Data for Maori:non-M ¯ aori disparities in risk factors, hospitalisation, procedure receipt and mortality for ¯ IHD are analysed. Age-adjusted rates of IHD mortality (2000–2004) and publicly funded hospitalisations and procedures (2003–2005) for Maori and non-M ¯ aori are reported and compared. ¯ Results: Significant inequalities between Maori and non-M ¯ aori in IHD risk factors, hospitalisations, mortality and ¯ the receipt of related procedures exist. IHD hospitalisation rates for Maori are 1.4 times that of non-M ¯ aori, however ¯ mortality rates are more than twice that of non-Maori. In recent years M ¯ aori revascularisation rates have increased (as ¯ have non-Maori rates) but are still considerably less than might be expected given the much higher mortality rates. ¯ Conclusion: Despite high need, Maori receive relatively low access to appropriate care for IHD. The role of society, ¯ policy, and the clinician are three key factors to be considered in reducing inequalities for IHD between Maori and ¯ non-Maori.