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COVID-19 Mortality in Aotearoa New Zealand: Inequities in Risk
COVID-19 Mortality in Aotearoa New Zealand: Inequities in Risk
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Until January 2022, Aotearoa New Zealand experienced very low rates of COVID-19 and, therefore, few hospitalisations or deaths due to the virus. However, with the Omicron variant quickly becoming established in our community, from 1 January to 26 August 2022, a total of 1,797 people sadly died due to COVID-19 (that is, where COVID-19 was related to the cause of death). This number excludes people who died with, but not because of, COVID-19. This equates to 34 in every 100,000 New Zealanders having died due to COVID-19 during this time period.
Our death toll has been far lower than that experienced in other countries such as the USA and UK, both having around 300 in every 100,000 people die due to COVID-19. However, our successful prevention and control strategies did not benefit all of our communities equally. Therefore, the Public Health Agency has undertaken an analysis of mortality to understand inequities in the risk of death from COVID-19, and in particular for Māori and Pacific peoples, and examine factors that may drive the differences in risk.
Ethnicity and age
The strongest risk factor for COVID-19 mortality is age, and this is consistent with what has been seen overseas. The risk of people dying was also strongly related to ethnicity with Māori and Pacific peoples having more than twice the risk of death compared with European and Other groups. At a total population level, the risk for Māori appears lower than the rest of the population – with a total of 158 deaths in the Māori community, which corresponds to a risk of 19.7 per 100,000 people. However, when the risk was compared within age groups, the risk for Māori was higher than the ‘European and Other’ ethnicity group. For example, in those aged 70–79 years, there were 43 deaths (a risk of 170.3 per 100,000) among Māori and 264 (82.2 per 100,000) for ‘European and Other’, and in those aged under 60 years this was 24 (3.4 per 100,000) and 35 (1.5 per 100,000) deaths, respectively. The overall risk for Māori and Pacific Peoples was lower than the general population because they are a younger population and young people have much lower risk than the elderly.
Deprivation
People living in highly deprived areas, also had disproportionate risk. Those from the most deprived communities were three times more likely to die from COVID-19 than those from the most affluent communities.
Comorbidities
The study has also found that people who had any comorbidities (underlying health conditions) had more than six times the risk than people without comorbidities. For people under the age of 60, almost all who died had a known underlying health condition. In young Māori and Pacific peoples, over half their excess risk compared with ‘European and Other’ was due to having an underlying condition. It has already been established that Māori and Pacific peoples are more likely to develop health conditions at earlier ages compared with other ethnicities, putting their younger people at much higher risk of death from COVID-19 when compared with younger people of other ethnicities.
Vaccination
For all ethnicities, being vaccinated provided substantial protection. Across all New Zealanders, having two or more doses of a vaccine reduced the risk of death by 62 percent compared with having fewer than two doses. The protective effect of a third dose (booster) will be addressed in a future report. Whilst the success of our vaccination campaign has contributed significantly to the low risk of death in Aotearoa, it has not provided equitable health outcomes across all communities.
Next steps
To address the inequities highlighted within the report, Manatū Hauora, Te Whatu Ora, and Te Aka Whai Ora will continue to engage with Māori through the National Iwi Chairs Forum, Māori and Pacific health providers, community groups, and other organisations to inform the overall COVID-19 response and ensure improvement for Māori and Pacific peoples.
Key messages for the public
COVID-19 is still around – it has not gone away, and it can still cause hospitalisations and deaths, so it is still important to follow good public health measures to protect yourself and your loved ones. This includes handwashing, staying at home if sick and getting tested. If you get tested, it means you can access support, especially antivirals, which can help those who are at risk of severe illness from COVID-19.
Pharmac has recently announced that COVID-19 antivirals are available for all Māori and Pacific people over the age of 50 and everyone else over the age of 65, as well as those with chronic conditions/disabilities. The Pharmac criteria can be found on the Pharmac website.
This report has shown how protective vaccination is against hospitalisations and deaths. It is therefore very important, if you haven’t already, to get vaccinated and boosted. Vaccination is highly effective at reducing the severity of COVID-19.
For those with chronic conditions, such as diabetes, kidney and heart disease, ensuring that you are managing your health well is very important. Making sure that you take your regular medications as prescribed and seeing your GP if needed, are other important ways to protect yourself.