Jefferies S, Gilkison C, Duff P, Grey C, French N, Carr H, Priest P, Crengle S
Health Intelligence and Surveillance, Institute of Environmental Science and Research (ESR), Porirua, 5022, New Zealand; Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, 9016, New Zealand.
Health Intelligence and Surveillance, Institute of Environmental Science and Research (ESR), Porirua, 5022, New Zealand.
Public Health. 2025 Jul;244:105732. doi: 10.1016/j.puhe.2025.105732. Epub 2025 May 9.
Aotearoa New Zealand employed one of the most stringent public health pandemic responses internationally. We investigated whether ethnic health equity was achieved in the response and outcomes, from COVID-19 elimination in June 2020 through to Omicron-response easing, including international border reopening, in 2022.
Descriptive epidemiology study.
All COVID-19 cases, patients tested for SARS-CoV-2 and people vaccinated against COVID-19 between 9 June 2020 and 13 April 2022 were examined over three response periods: by demographic features and COVID-19 outcomes, transmission and vaccination patterns, time-to-vaccination and testing rates.
There were 15,693 cases per 100,000, 138·7 hospitalisations per 100,000, and 9·8 deaths per 100,000 people. Pacific peoples and Indigenous Māori had, respectively, 9·3 to 35-fold and 1·5 to 8·3-fold higher risk of COVID-19, 5·1-fold and 2·6-fold higher age-standardised risk of hospitalisation and 9-fold and 4-fold higher age-standardised risk of death, than European or Other. Māori and Pacific peoples had lower vaccination coverage at critical points in the response, and slower access to vaccination (Adjusted Time Ratios for two doses 1·32 (95% CI 1·31-1·32) and 1·14 (1·14-1·14), respectively), than European or Other. Testing rates remained high, especially among Māori and Pacific peoples.
Despite achieving a low overall burden of disease by international comparisons, the multi-faceted New Zealand response did not prevent stark ethnic inequities in access to vaccination and COVID-19 outcomes. Policies which address disparities in upstream determinants, early vaccine programme planning and implementation with high-risk communities, and prioritisation that addresses systematic ethnic disadvantage and promotes health equity in response decisions is recommended.
新西兰（Aotearoa New Zealand）在国际上采取了最为严格的公共卫生大流行应对措施之一。我们调查了从2020年6月实现新冠病毒消除到2022年奥密克戎应对措施放宽（包括重新开放国际边境）期间，在应对措施及结果方面是否实现了种族健康公平。
描述性流行病学研究。
对2020年6月9日至2022年4月13日期间所有新冠病毒病例、接受新冠病毒检测的患者以及接种新冠疫苗的人群，按三个应对阶段进行了检查：根据人口统计学特征、新冠病毒感染结果、传播和疫苗接种模式、接种时间和检测率。
每10万人中有15693例病例、138.7例住院病例以及9.8例死亡病例。与欧洲人或其他种族相比，太平洋岛民和毛利原住民感染新冠病毒的风险分别高出9.3至35倍和1.5至8.3倍，年龄标准化住院风险分别高出5.1倍和2.6倍，年龄标准化死亡风险分别高出9倍和4倍。在应对措施的关键节点，毛利人和太平洋岛民的疫苗接种覆盖率较低，且接种疫苗的速度较慢（两剂疫苗接种的调整时间比分别为1.32（95%置信区间1.31 - 1.32）和1.14（1.14 - 1.14）），低于欧洲人或其他种族。检测率一直很高，尤其是在毛利人和太平洋岛民中。
尽管通过国际比较总体疾病负担较低，但新西兰多方面的应对措施未能防止在疫苗接种机会和新冠病毒感染结果方面出现明显的种族不平等。建议制定政策，解决上游决定因素方面的差异，针对高风险社区进行早期疫苗计划规划和实施，并在应对决策中优先考虑解决系统性种族劣势问题，促进健康公平。
