National | Health Equity

Damning ICU report reveals systemic inequities for Māori health

Calls for upheaval in the health system are being amplified by a new study that reveals Māori are far more likely to be admitted to Intensive care after trauma or with sepsis, than non-Māori; and once admitted Māori have an increased likelihood of dying.

Analysing data of more than 50,000 patients admitted to hospital over 10 years the research from the Medical Research Institute of New Zealand (MRINZ) reveals Māori patients were more likely than European patients to die within 180 days of ICU admission and that Māori are 13 years younger on average when admitted to ICU than European patients.

“Māori are much more likely than European patients to be admitted to the ICU with life-threatening infections, after major trauma, and following a cardiac arrest," says Dr James Moore, a co-author and MRINZ clinical research fellow and intensive care specialist.

Professor Paul Young, also an intensive care specialist and MRINZ deputy director says there's more to the stats than meets the eye, when removing the higher likelihood of Māori suffering chronic underlying conditions such as kidney disease or diabetes, Māori have the same mortality rate as Pākehā in ICU, meaning it appears lower standards of care for Māori before ICU admission is where the problem arises.

“When we accounted for underlying conditions and how unwell patients were on hospital arrival, there was no difference in survival rates between Māori and European patients. This implies that differences in health outcomes are unlikely to be related to the care being delivered after patients get to the ICU.”

Auckland Hospital emergency room entrance / NZME

Young says healthcare accessibility and inequity in prevention of chronic health conditions could also mean Māori are likely to be sicker than Europeans when admitted.

“Health inequalities are a continuing major public health concern and a strong focus for the Medical Research Institute of New Zealand," Young says.

“Māori are likely to be ill far more frequently, suffer disproportionately high levels of disease, and die younger than non-Māori of the same socioeconomic status. There are also differences in broader societal issues that significantly affect health, including housing, education, employment and socioeconomic deprivation.”

The report authors argue the research should be used by officials when identifying priorities for investment and changes within the health system.

"These study findings are hugely important in identifying priorities for future research that has the potential to lead to change in clinical practice, and support equitable Māori health outcomes,” Moore says.