Maternal health inequity is strongly associated with a range of socioeconomic and health determinants, according to an analysis of 97% of all births (approximately 970,000) in New Zealand between 2003 and 2018. The Statistics New Zealand Integrated Data Infrastructure suite was used to link adverse maternal and perinatal outcomes with socioeconomic and health variables. Compared with New Zealand European/European women, Māori (adjusted odds ratio 1.21; 95% CI 1.18-1.23) and Asian women (adjusted odds ratio 1.39; 95% CI 1.36-1.43) had poorer maternal or perinatal outcomes. Poor outcomes were associated with high use of emergency department (adjusted odds ratio 2.68; 95% CI 2.53-2.84), disability (adjusted odds ratio 1.98; 95% CI 1.83-2.14) and lack of engagement with maternity care (adjusted odds ratio 1.89; 95% CI 1.84-1.95).
The authors raise an important point when they say that much of the research measuring inequities is failing to advance progress on reducing it. However, as with health inequities themselves, the reasons for ‘failing’ to intervene can be complex too. As we’ve seen with the COVID-19 pandemic experience, Māori efforts have received either inadequate support or outright criticism.
Independent commentary by Dr. Matire Hardwood
Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.
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