Ethnic differences in stroke outcomes in Aotearoa New Zealand

Making Education Easy

Authors:

Denison H et al.

March 23, 2023

Summary:

A national cohort study has shown that Māori are more likely to have unfavourable outcomes following stroke than NZ Europeans, after adjusting for traditional risk factors (baseline characteristics, socioeconomic deprivation and stroke characteristics). The study included 5394 NZ Europeans, 762 Māori, 369 Pasifika peoples and 354 Asians who were admitted to hospital with a first stroke between November 2017 and October 2018. The odds of an unfavourable outcome (death, change in residence, or unemployment if working pre-stroke) and of death was increased in Māori vs NZ Europeans at all time points, as was the odds of unemployment at 12 months. There was also evidence of ethnic differences in post-stroke secondary prevention medication. The study authors noted that their findings raise concerns of unconscious bias and institutional racism in stroke services.

Comment:

Just to remind us that, although there are inequities in the wider determinants and exposure to them by ethnicity, quality of care within the health system plays an important role, as demonstrated here for people with stroke in Aotearoa.

Reference: Int J Stroke. 2023:17474930231164024.

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.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.