The inequity of morbidity: Disparities in the prevalence of morbidity between ethnic groups in New Zealand.

Objective: The burden of chronic disease is not evenly shared within our society. In this manuscript, we use comprehensive national-level data to compare morbidity burden between ethnic groups in New Zealand.

Methods: We investigated the prevalence of morbidity among all New Zealanders aged 18+ (n = 3,296,837), stratified by ethnic group (Māori, Pacific, Asian, Middle Eastern/Latin American/African, European/Other), using national-level hospitalisation and pharmaceutical data and two measures of morbidity (the M3 and P3 indices).

Results and conclusions: We observed substantial disparities for Māori and Pacific peoples compared to other ethnic groups for the vast majority of commonly-diagnosed morbidities. These disparities appeared strongest for the most-common conditions - meaning that Māori and Pacific peoples disproportionately shoulder an increased burden of these key conditions. We also observed that prevalence of these conditions emerged at earlier ages, meaning that Māori and Pacific peoples also experience a disproportionate impact of individual conditions on the quality and quantity of life. Finally, we observed strong disparities in the prevalence of conditions that may exacerbate the impact of COVID-19, such as chronic pulmonary, liver or renal disease. The substantial inequities we have presented here have been created and perpetuated by the social determinants of health, including institutionalised racism: thus solutions will require addressing these systemic issues as well as addressing inequities in individual-level care.