Vulnerable Maori face twice death risk

Ma¯ori are more than twice as likely to die from Covid-19 than Pa¯keha¯, according to new modelling. The rate is even higher for older Ma¯ori and Pasifika.

Public health researchers behind the report say it provides further evidence a “one size fits all” approach to the epidemic will fail vulnerable communities and earlier interventions are needed for Ma¯ori and Pasifika.

Researchers at Te Pu¯naha Matatini, New Zealand’s Centre of Research Excellence in Complex Systems and Data Analytics, estimated simply factoring in age, infection fatality rates (IFR) for Ma¯ori would be around 50 per cent higher than nonMa¯ori. But if more importance was placed on underlying health conditions, the IFR for Ma¯ori rose to more than 2.5 times Pa¯keha¯, and almost double for Pasifika.

These rates were likely to increase even further because of racism within the healthcare system, and other inequities not reflected in official data, the report said.

The findings were not surprising, University of Auckland Ma¯ori health researcher and statistician Andrew Sporle said. In the 1918 flu epidemic, Ma¯ori died at seven times the rate of non-Ma¯ori, and in the 2009 H1N1 influenza pandemic the rate was 2.6.

“This information allows us to take actions to massively reduce avoidable deaths.”

International data suggests older people are at greater risk of dying from the virus, along with those with health conditions such as diabetes.

The researchers combined international fatality rates of Covid-19 with New Zealand population data, taking into account age, life expectancy, access to healthcare, and rates of heart disease, diabetes, asthma, cancer and smoking.

The estimated death rate for people aged 60-79 was 7.9 per cent for Ma¯ori and 5.5 per cent for Pasifika, compared with an overall rate of

2.8 per cent. For those 80 and older, it was 13.9 per cent for Ma¯ori and

11.8 per cent for Pasifika, compared with 6.8 per cent overall.

But when factoring in unequal access to health these became even more “stark”.

“You might have an overall infection fatality rate for the over-80s that is around 8 per cent, but for Ma¯ori it’s

28 per cent,” Sporle said.

“For the 60 to 80-year-old age group, for non-Ma¯ori, non-Pacific it’s about 2 per cent. For Ma¯ori it’s 20 per cent – it’s 10 times higher.”

If there was a “rapid out-of-control spread”, as seen overseas, and healthcare had to be rationed that would “amplify existing racism in the healthcare system”.

“For example, if triage decisions are based on [the] existence of underlying health conditions, this will automatically disadvantage Ma¯ori.”

Yesterday, the total count of confirmed and probable cases rose to 1409. Ma¯ori made up 8.5 per cent and Pasifika 4.5 per cent.

Sporle said to keep Ma¯ori cases low, self-isolation policies for vulnerable age groups needed to be lowered. “So not 70 but 60, and even lower for those with pre-existing health conditions.”

Access to data was also important for healthcare workers in vulnerable communities.

“The Government is not doing enough on this. Fair enough no one has practice at this kind of thing, but we are four weeks in.

“We need good ethnic information for testing and that has to happen at a local level so they can spot the patterns in case of an outbreak and respond quickly.

“Wellington is not going to know where the vulnerable local communities are. We now have really good Ma¯ori health providers, and Ma¯ori public health force. They will be able to identify the individuals most at risk.”

Sporle says checkpoints set up by iwi in absence of action by local authorities were essentially preempting those safe havens. Ma¯ori recognise this ‘one size fits all’ approach does not work – and it never has. It is no surprise community checkpoints [are] popping up.”

We now have really good M¯aori health providers. . . They will be able to identify the individuals most at risk. Andrew Sporle