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 Maori, the indigenous population of Aotearoa New Zealand. Methods: Data for Maori:non-Maori 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-Maori are reported and compared. Results: Significant inequalities between Maori and non-Maori 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-Maori, however mortality rates are more than twice that of non-Maori. In recent years Maori 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. (Heart, Lung and Circulation 2010;19:316-324) (C) 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.