Access and society as determinants of ischaemic heart disease in indigenous populations.
BACKGROUND
Ischaemic Heart Disease (IHD) is a leading cause of death in New Zealand and the burden falls disproportionately on Māori, the indigenous population of Aotearoa New Zealand.


METHODS
Data for Māori:non-Māori 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 Māori and non-Māori are reported and compared.


RESULTS
Significant inequalities between Māori and non-Māori in IHD risk factors, hospitalisations, mortality and the receipt of related procedures exist. IHD hospitalisation rates for Māori are 1.4 times that of non-Māori, however mortality rates are more than twice that of non-Māori. In recent years Māori revascularisation rates have increased (as have non-Māori rates) but are still considerably less than might be expected given the much higher mortality rates.


CONCLUSIONS
Despite high need, Māori 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 Māori and non-Māori.
Curtis
Elana
E
Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, Aotearoa, New Zealand. e.curtis@auckland.ac.nz
Harwood
Matire
M
Riddell
Tania
T
Robson
Bridget
B
Harris
Ricci
R
Mills
Clair
C
Reid
Papaarangi
P
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002423:Cause of Death; D016208:Databases, Factual; D005260:Female; D006303:Health Services, Indigenous / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006306:Health Surveys; D054625:Healthcare Disparities; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy; D009520:New Zealand; D044382:Population Groups; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012923:Social Class; D012959:Socioeconomic Factors; D016019:Survival Analysis