Half of Māori and Pacific deaths in New Zealand have been found to be potentially avoidable - a finding which medical experts say is a national travesty.
It compares to 23 per cent for non-Māori and non-Pacific people, and is partly the result of racism which is built in to New Zealand's health system.
The findings were so alarming that they should be on the computer screensavers of any planning staff working in health organisations, the New Zealand Medical Journal said in a strongly-worded editorial published today.
"The 7.0-7.4 year shortened life expectancy for Māori and 5.9-6.0 year for Pacific is a travesty and a lost opportunity within families, communities and Aotearoa," the editorial authors said.
While there were multiple factors in the avoidable death statistics, it said racism was the "ethnic health inequities elephant in the room".
"It is a term that causes quiet discomfort - or at times not quiet. Yet, if we do not talk about racism and call it by name, its ubiquitous hold on health cannot be challenged."
One of three new studies on health equity looked at the contribution of avoidable deaths to different life expectancies for Māori, Pacific and other people.
Avoidable deaths were defined as ones which could have been avoided by access to timely and high-quality intervention, or by addressing broader health risks like a person's socioeconomic status or environmental factors like the quality of their housing.
It found that between 2013 and 2015, 53 per cent of Māori deaths and 47 per cent of Pacific deaths were from potentially avoidable causes. Avoidable deaths within these groups were a significant contributor to the lower life expectancies for these ethnic groups, the researchers said.
The main contributors to avoidable death rates were heart disease and trachea, bronchus and lung cancers. For Māori males, suicide and car accidents also played a major role.
Lady Tureiti Moxon, managing director of primary health organisation Te Kōhao Health Ltd, said the figures might be shocking to some but she was very familiar with them.
"Our people aren't getting the diagnostics or seeing specialists when they should be seeing them. Therefore, they get put at the back of the line and miss out.
"Then people will ask 'Why didn't they present earlier?'. They are presenting all along but nobody is actually treating them with any urgency. Then they get full-blown cancer or diabetes."
She said racism in the health system was often subtle.
"Health professionals blame the [Māori] person for being sick. And they are told they can't have this operation until they've lost weight or given up smoking.
"This is instead of making a referral, or a plan. It perpetuates a view that we are undeserving. And it's constant, throughout the system."
Moxon is part of a claim before the Waitangi Tribunal on Māori health outcomes. She is lobbying for a Māori health agency outside of the Ministry of Health.
The authors of the NZMJ study said the change of Government had led to a greater focus on equity in the health system, and the Ministry of Health was now prioritising it.
They said there needed to be a clear focus on equity throughout health and social services. The role of healthcare services in improving health equity, in particular the role of racism, needed to be recognised, they said.