Tā mātou e tūhura ana
What we are investigating
Take | Issue
Despite proven treatments that can halve rates of heart disease, Māori and Pacific people are less likely to receive treatment and more likely to die from heart disease than other New Zealanders. Barriers to accessing healthcare are important contributors to these disparities.
Whāinga | Aim
This research aimed to systematically identify and understand the key barriers faced by Māori and Pacific people in accessing treatments for heart disease across the healthcare-continuum. Given the availability of effective interventions, identifying access barriers, investigating their causes, and developing solutions, could rapidly improve heart health outcomes in Māori and Pacific people.
Huarahi I Whāia | Approach
Systematic reviews were undertaken to document barriers to equitable care at three points along the healthcare-continuum:
- assessment and management of the risk of heart disease in general practice;
- accessing hospital care for heart attacks;
- post-hospital management of heart failure.
and also in rural areas.
In-depth kōrero (conversations) with patients, whānau and kaimahi (health providers) were conducted across Aotearoa to better understand the barriers to accessing care, to ensure that the research would be mana-enhancing by elevating the voices of patients and whānau in healthcare planning.
Co-funding
This project is co-funded by:
The National Heart Foundation of New Zealand and Healthier Lives National Science Challenge.
NGA PUTANGA ME TE PĀNGA
Outcomes and Impact
Putanga | Outcome
A national network of investigators undertaking research on equitable access to evidence-based heart healthcare was established.
The quantitative arm of the programme used hospitalisation, ambulance and other routinely collected data to identify and quantify access to care across the heart health spectrum, including risk assessment and management, paramedic and hospital care.
The qualitative arm of the programme captured stories of people’s journey through the health system and their ideas for how it could be improved.
Te Ara Kei Mua | Next Steps
A workforce that is representative of the population it serves is needed to deliver and sustain equitable heart healthcare. This entails building the capacity, and addressing the cultural safety, of Māori and Pacific health providers and researchers.
Nga Hua O Te Rangahau | Research Products
A Quality-Improvement-Equity Roadmap, a living plan for the health system to focus attention on the gaps between evidence and practice in heart healthcare, is underway.
Video
Research presentation: Designing heart health services to achieve Māori and Pacific health equity
Healthier Lives Kōrero Tahi 2024: equity and beyond (13-14 February 2024)
View the website for this project
WHAKAWHITI MŌHIOTANGA
Knowledge Exchange
Puka Rangahau | Academic Publications
2024
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Māori and Pacific families’ experiences and perspectives of cardiovascular care; A qualitative study Australian and New Zealand Journal of Public Health (2024), Volume 48(3), 10.1016/j.anzjph.2024.100149
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Drivers of access to cardiovascular healthcare for rural Indigenous peoples: A scoping review. Rural and Remote Health (2024)
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2023
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- Manawataki Fatu Fatu for ACCESS (Māori and Pacific Hearts in Unison for Achieving Cardiovascular Care in Equity StudieS). Protocol for a Mixed Methods Programme of Research International Journal of Qualitative Methods (2023), 22.
- Development and validation of cardiovascular risk prediction equations in 76 000 people with known cardiovascular disease European Journal of Preventative Cardiology (2023)
- Reasons for Ethnic Disparities in the Prehospital Care Pathway Following an Out-of-Hospital Cardiac Event: Protocol of a Systematic Review JMIR research protocols vol. 12 e40557. 12 Jul. 2023.
- Widening ethnic inequities in heart failure incidence in New Zealand Heart (British Cardiac Society), heartjnl-2023-322795. 3 Aug. 2023.
- Ethnic differences of the care pathway following an out-of-hospital cardiac event: A systematic review Resuscitation, Volume 193, 2023, 110017.
- Upholding te mana o te wā: Māori patients and their families’ experiences of accessing care following an out-of-hospital cardiac event American Heart Journal Plus: Cardiology Research and Practice. 2023 Dec 1;36:100341.
- Who are Pacific peoples in terms of ethnicity and country of birth? A cross sectional study of 2,238,039 adults in Aotearoa New Zealand’s Integrated Data Infrastructure Dialogues in Health. 2023 Dec 1;3:100152.
- Performance of cardiovascular disease risk prediction equations in more than 14 000 survivors of cancer in New Zealand primary care: a validation study Lancet 2023; 401: 357–65
- Reasons for Ethnic Disparities in the Prehospital Care Pathway Following an Out-of-Hospital Cardiac Event: Protocol of a Systematic Review JMIR Res Protoc. 2023 Jul 12;12:e40557.
- How pharmacist-led health services are tailored to minoritized populations, their acceptability and effectiveness: A scoping literature review Research in social & administrative pharmacy : RSAP vol. 19,9 (2023): 1256-1266.
2022
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- Cardiovascular disease preventive medication dispensing for almost every New Zealander 65 years and over: a preventive treatment paradox? Age and Ageing (2022);51.
- What are the gaps in cardiovascular risk assessment and management in primary care for Māori and Pacific people in Aotearoa New Zealand? Protocol for a systematic review BMJ Open (2022); 10.1136/bmjopen-2021-060145.
- Understanding the barriers and facilitators that influence access to quality cardiovascular care for rural Indigenous peoples: protocol for a scoping review BMJ Open 2022;12:e065685. 10.1136/bmjopen-2022-065685.
- Identification of clinically relevant cohorts of people with heart failure from electronic health data in Aotearoa: potential, pitfalls and a plan NZ Medical Journal (2022).
- Contrasting trends in heart failure in younger and older New Zealanders, 2006-2018. Heart (2022)
2021
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- Cardiovascular disease and its management among Pacific people: a systematic review by ethnicity and place of birth BMC Cardiovascular Disorders (2021) 21,515.
- Cardiovascular risk prediction in type 2 diabetes before and after widespread screening: a derivation and validation study The Lancet (2021);397:2264–74.
Ētahi Atu Puka | Other Publications
Ngā Rā Nunui | Events
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- Manawataki Fatu Fatu for ACCESS hui July 2021
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Pāpāho | Media
- Pacific Research Fellowship winner excited to spread early heart check message Stuff.co.nz, December 2023
- GST cut the prescription says Māori doc Waatea News, August 2023
- Lack of rural Māori services data raises hackles NZ Doctor, October 2022
Kōnae Whakaata | Video
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- Healthier Lives Kōrero Tahi 2024: equity and beyond (13-14 February 2024)