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Journal Article


Disparities in Indigenous Health: A Cross-Country Comparison Between New Zealand and the United States



The Issue

The indigenous populations of New Zealand (Maoris) and the United States (American Indians/Alaska Natives) have much in common: both have worse health outcomes than their white counterparts, and both have been the focus of national strategies to reduce their disease burdens and improve their access to quality health care.


What the Study Found


This Commonwealth Fund–supported study compared the health status of Maoris with that of American Indian/Alaska Native (AI/AN) populations. For nearly every health indicator assessed, disparities between the indigenous and white populations were more pronounced among Maoris than among AIs/ANs. For example:

  • While overall life expectancy was higher in New Zealand than in the U.S., Maori females had a life expectancy 9.4 years less than non-Maori females. By contrast, AI/AN females had a life expectancy of 5.8 years less than white females in the U.S.
  • Maoris' age-adjusted mortality rates were higher than those for whites in New Zealand. In the U.S., AIs/ANs had lower age-adjusted death rates than whites for most causes of death.
  • There were no disparities between whites and AIs/ANs in the U.S. with regard to immunization rates.




The study's finding that Maoris face greater disparities across most of the indicators of health status than American Indians/Alaska Natives suggests that ethnic health disparities are not intractable. In the future, New Zealand should evaluate the effectiveness of new strategies to address Maori needs and reduce health disparities.

Publication Details



D. Bramley, P. Hebert, L. Tuzzio et al., "Disparities in Indigenous Health: A Cross-Country Comparison Between New Zealand and the United States," American Journal of Public Health, May 2005 95(5):844–50.