Health equity means that every person has a fair opportunity to be as healthy as possible — and that no one is disadvantaged from achieving that potential because of their social position or other socially determined circumstances.

This is different from health equality, which means everyone receives the same treatment or resources. Equity acknowledges that some people need more support, or different kinds of support, to reach the same outcomes.

Why Māori Health Equity Matters

Māori experience significantly worse health outcomes than non-Māori across a wide range of measures — from life expectancy and chronic disease rates to access to timely healthcare and mental health support. These disparities are not inevitable, and they are not explained by genetics or culture.

They are the result of historical and ongoing inequities in the conditions that shape health: income, housing, education, employment, access to services, and the effects of colonisation.

The Social Determinants of Health

Public health researchers and organisations, including the World Health Organization, describe these background conditions as the social determinants of health. They include:

  • Income and economic security — whether people can afford food, housing, and healthcare
  • Education and early childhood development — which affect lifelong health trajectories
  • Employment and working conditions — insecure work and low-wage conditions are associated with poorer health outcomes
  • Housing — overcrowding and poor housing quality contribute to respiratory illness and other conditions
  • Access to healthcare — geographic, financial, and cultural barriers can prevent timely care
  • Discrimination and racism — structural racism shapes access to opportunities and creates chronic stress that affects physical and mental health

A genuine health equity approach addresses these conditions. It does not simply encourage individuals to make healthier choices without addressing whether those choices are available or accessible.

Te Tiriti o Waitangi and Health Equity

In Aotearoa New Zealand, health equity for Māori is inseparable from the principles of te Tiriti o Waitangi. The Crown has obligations under te Tiriti to actively protect Māori health and wellbeing — this means not just delivering services, but addressing the structural conditions that produce health disparities in the first place.

Hāpai Te Hauora’s work is grounded in this framework. We advocate for policies, programmes, and systems that treat health equity as an obligation, not an aspiration.

What This Means in Practice

Addressing health equity requires action at multiple levels simultaneously — from individual and community support to systemic policy change. It requires asking not just “what is wrong with this person?” but “what conditions made this person’s health more difficult to maintain?”

It also requires that Māori communities have genuine power and decision-making authority over the policies and services that affect them — not just consultation, but leadership.

This explainer is part of Hāpai Te Hauora’s public education resources. For more, see our Resources section.