摘要：Objectives. We compared the health statuses of the indigenous populations of New Zealand and the United States with those of the numerically dominant populations of these countries. Methods. Health indicators compared included health outcome measures, preventive care measures, modifiable risk factor prevalence, and treatment measures. Results. In the case of nearly every health status indicator assessed, disparities (both absolute and relative) were more pronounced for Maoris than for American Indians/Alaska Natives. Both indigenous populations suffered from disparities across a range of health indicators. However, no disparities were observed for American Indians/Alaska Natives in regard to immunization coverage. Conclusions. Ethnic health disparities appear to be more pronounced in New Zealand than in the United States. These disparities are not necessarily intractable. Although differences in national health sector responses exist, New Zealand may be well placed in the future to evaluate the effectiveness of new strategies to reduce these disparities given the extent and quality of Maori-specific health information available. The indigenous peoples of New Zealand and the United States have much in common. Both have had a history of colonization. In addition, they have become, in numerical terms, “minority” populations relative to the predominant European and White groups in each country. Maoris (who represent 10%–15% of New Zealand’s population) and American Indians/Alaska Natives (who represent 1%–1.5% of the US population) also exhibit substantially poorer health outcomes than the majority populations over a range of health indicators. 1, 2 Reducing health disparities has recently become a central focus of health care policies in both countries. In New Zealand, the national health strategy aims to reduce inequalities in health status and to ensure accessible and appropriate services for Maoris, Pacific peoples, and those of low socioeconomic status. 3 In the United States, Healthy People 2010 is the federal government’s blueprint for building a healthier nation. 4 It is designed to achieve 2 major overarching goals: increasing Americans’ quality of life and years of healthy life and ending racial/ethnic disparities in disease burden. Our study’s aims were to compare the health status of the indigenous populations of New Zealand and the United States with that of the majority (European/White) populations of these countries over a range of health-related indicators, including health outcomes (i.e., life expectancy, infant mortality, mortality risk ratios), preventive services (i.e., immunization, cervical cancer and breast cancer screening coverage), modifiable risk factors (i.e., smoking, obesity, diabetes), and treatment services (i.e., access to coronary artery bypass grafting, coronary angioplasty, renal transplantation). We discuss gaps in the current availability of health indicator data. The 2 countries differ in regard to the approaches they are taking to reduce the large disparities in the health status of indigenous populations. There are a number of reasons for these different approaches, including differences in historical understandings of the nature of health disparities, the way in which the health sector is organized, legislative and funding incentives associated with reducing disparities, and the availability of indigenous data to monitor disparities.
