Only structural change will fix NZ’s glaring health equity gap – what voters should know

Getty Images The performance of New Zealand’s health system – from hospital staffing and resourcing to access to primary care and general practitioners – is a key election battleground once more.

Around 200,000 people, half of them Māori , have no GP.

In the 2024-25 New Zealand Health Survey , one in seven adults (14.9%) reported not visiting a GP due to cost (25.1% for Pacific adults, 18.7% for Māori).

But beneath these system pressures sits a more persistent reality: Māori and Pasifika communities continue to carry the country’s heaviest burden of preventable disease .

Health inequities mean Māori and Pacific peoples are far more likely to develop chronic diseases earlier in life, live with multiple preventable conditions at the same time, and die years sooner than other New Zealanders.

This isn’t because of genetics or individual choices, but because of long-standing structural inequalities shaping income, housing, education, food access and health care.

Multiple preventable risks The latest research puts hard numbers on what the gap means.

Māori males can expect to live 73.7 years, and Māori females 78.0 years, compared with 81.1 and 84.3 years for “European and other” ethnicities.

Pacific peoples sit in between, but still face a five-to-six-year longevity deficit.

No single condition is driving this disparity.

It’s the clustering of multiple preventable risks.

Start with tobacco: the New Zealand Health Survey put overall adult daily smoking at 6.8% of the population, but the ethnic gradient remains sharp: 15.0% for Māori, 10.3% for Pacific peoples, and 5.7% for European/other.

Obesity shows an even stronger gradient .

In 2024-25, 69.5% of Pacific adults and 46.9% of Māori adults were classified as obese, compared with 33.5% of European/other adults, and 17.8% of Asian adults.