CardiologyTier 2Topic

The incidence of, and the risk factors for, cardiovascular disease in individuals and patient groups - Māori and Aboriginal and Torres Strait Islander peoples

The gap

Cardiovascular disease (predominantly ischaemic heart disease) occurs at substantially higher incidence and younger age in Maori and Aboriginal and Torres Strait Islander populations compared with the general Australian/NZ population - a major, largely preventable health equity gap
Aboriginal and Torres Strait Islander Australians - IHD mortality roughly 1.5-2x that of non-Indigenous Australians, with onset at a substantially younger age
Maori in New Zealand show a similar pattern of excess cardiovascular mortality and earlier onset relative to non-Maori New Zealanders

Higher prevalence of conventional risk factors - smoking, diabetes, obesity, hypertension - compounded by social determinants: lower socioeconomic status, reduced access to primary care and preventive services, geographic remoteness limiting specialist/interventional access, and the cumulative effects of intergenerational trauma and structural discrimination
Rheumatic heart disease remains disproportionately prevalent in these populations (especially remote communities) - a further distinct contributor to cardiovascular burden not explained by atherosclerotic risk factors alone

Guidelines recommend earlier and more frequent cardiovascular risk assessment in Aboriginal and Torres Strait Islander adults (from a younger age than the general population) given this excess and earlier-onset risk

Culturally safe, accessible care models (including Aboriginal Community Controlled Health Services) improve engagement and outcomes; addressing risk factor burden requires the same interventions as the general population but delivered through equitable-access pathways

Rheumatic heart disease, diabetes, smoking, remote/rural healthcare access disparity

Closing this gap is an explicit national health priority; outcomes improve substantially with equitable access to guideline-concordant care, indicating the disparity is largely a systems/access issue rather than an intrinsic biological one

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