A Step Toward Health Equity As Rates Of Māori Hospital Admissions For Asthma Fall

Findings from Reducing Ethnic Inequities: Patterns of Asthma Medication Use and Hospital Discharges in Māori in Aotearoa New Zealand highlight a 32% drop in asthma hospitalisations for Māori over the last four years, following an increased provision of the 2-in-1 budesonide/formoterol maintenance and/or reliever therapy, as recommended in the Asthma and Respiratory Foundation of New Zealand asthma guidelines.

The study, led by MRINZ Director Professor Richard Beasley, found a 111% increase in budesonide/formoterol inhaler use among Māori in the last four years.

"The findings highlight the high quality of primary care in New Zealand and the emphasis on addressing the health needs of Māori to reduce their disproportionate burden of disease,” said Professor Beasley. "This evidence exemplifies how GPs are adapting their prescribing practices in line with evidence-based recommendations, ensuring patients benefit from advances in treatment. It also underscores the leadership of the Asthma and Respiratory Foundation of New Zealand in developing and implementing contemporary asthma guidelines."

“These results are encouraging and show that improved asthma treatment regimens can have a real impact in reducing the risk of life-threatening asthma attacks among Māori. While this progress is heartening, there remains a two-and-a-half-fold disparity in hospitalisation rates between Māori and non-Māori, stressing the need to address broader health barriers,” says Professor Beasley.

The study’s authors advocate for initiatives to address the social determinants of health, such as safe housing, healthcare literacy, and reduced healthcare costs—critical areas in the journey toward true equity in respiratory health.

Dr Matire Harwood (Ngāpuhi), one of the investigators for the MRINZ-led study and a GP, states, “These findings highlight the meaningful progress being made when evidence-based treatments are implemented in a way that resonates with Māori health needs. The significant drop in asthma hospitalisations for Māori is heartening and shows the impact of equitable access to optimal care.”

She continues, “However, the persisting inequities remind us of the urgent need to address the root causes of these health disparities. Solutions that empower Māori—through accessible, culturally safe care and systemic change—will help create sustainable improvements in respiratory health outcomes.”

Asthma remains a prevalent health challenge among Māori, often worsened by limited healthcare access, environmental disparities, and socioeconomic factors. The flexibility of the budesonide/formoterol 2-in-1 inhaler, in which patients with asthma only need a single inhaler for both regular scheduled maintenance and as-needed reliever use, has proven especially beneficial in communities with less consistent access to healthcare, enabling greater adherence to preventive care.

The study’s insights offer a model that could benefit Indigenous communities globally, showing the value of trials in partnership with Indigenous peoples to achieve equitable access to advanced treatment with health benefits for all.

STUDY LINK

https://onlinelibrary.wiley.com/doi/10.1111/resp.14865

KEY POINTS AT A GLANCE

• The ‘Reducing Ethnic Inequities: Patterns Of Asthma Medication Use And Hospital Discharges In Māori In Aotearoa New Zealand’ study conducted by the Medical Research Institute of New Zealand (MRINZ) reports substantial advancements in asthma management for Māori, highlighting a 32% reduction in asthma hospitalisations associated with a 111% increase in the use of budesonide/formoterol maintenance and/or reliever therapy
• Despite the positive findings, the research reveals a persistent two-and-a-half-fold disparity in asthma hospitalisation rates between Māori and non-Māori, indicating that while progress has been made, significant health inequities remain.
• The 2 in 1 combination inhaler enables the patient to self-titrate the preventer component of their treatment through the vehicle of their reliever use, reducing the risk of asthma attacks by between 1/3 and 2/3rds, depending on the underlying severity of their asthma.
• The study advocates addressing the social determinants of health, such as healthy housing, improved health literacy, and reduced healthcare costs, to further close the gap in respiratory health outcomes for Māori.
• The findings not only provide insights into local asthma management strategies but also serve as a model for other countries with indigenous or marginalised populations facing similar respiratory health inequities, emphasising the potential effectiveness of budesonide/formoterol regimens in addressing these challenges

BIOS

Medical Research Institute of New Zealand

Rangahautia Te Ora

The Medical Research Institute of New Zealand (MRINZ) is Aotearoa New Zealand’s leading independent medical research institute. MRINZ research is guided by a simple philosophy: it must challenge dogma, increase knowledge, and have the potential to improve clinical practice and outcomes, both in Aotearoa New Zealand, and internationally. Committed to contributing toward a more equitable society that celebrates Te Ao Māori and upholds Te Tiriti o Waitangi, MRINZ’s research teams are dedicated to investigating important public health problems, delivering high quality evidence on which to improve the management of disease and patient care.

Professor Richard Beasley, MRINZ Director, Asthma Programme lead

Richard Beasley, MBChB, MD, DSc, CNZM, is a physician at Wellington Regional Hospital, Director of the Medical Research Institute of New Zealand, Professor of Medicine at Victoria University of Wellington, and Visiting Professor, University of Southampton, United Kingdom. Richard received the 2024 Royal Society Te Apārangi Rutherford Medal for four decades of transformative contributions to asthma research and treatment. His research interests in respiratory medicine are primarily in the fields of epidemiology and clinical management.

Dr Matire Harwood, MRINZ Deputy Director, Māori Health lead

Matire Harwood is from Ngāpuhi with whakapapa connections to Ngāti Rangi, Te Mahurehure and Ngāti Hine. She is a General Practitioner at Papakura Marae Health Centre in Auckland, a Senior Lecturer and PhD supervisor in Māori Health at the University of Auckland, and a Senior Clinical Research Fellow with the MRINZ. Matire leads the MRINZ programme for Māori Health, informing the design and analysis of wider MRINZ research to maximise impact for Māori, and to support training early career Māori researchers. Matire is a leading researcher in Māori health with over 90 publications and is the editor of the Māori Health Review (MHR), a summary of significant medical research affecting Māori.

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