Infection fatality rate does not account for potential differences in transmission and incidence by ethnicity, risk factors for accelerated transmission include crowded housing affecting a quarter of Maori and almost half of Pacific people.
Nicholas Steyn, Dr Rachelle Binny, Kate Hannah, Professor Shaun Hendy, Associate Professor Alex James, Professor Tahu Kukutai, Dr Audrey Lustig, Dr Melissa McLeod, Professor Michael Plank, Dr Kannan Ridings, Andrew Sporle


In this study, we estimate potential inequities in COVID-19 infection fatality rates in Aotearoa New Zealand by ethnicity in the event that a future reincursion of COVID-19 leads to widespread community transmission.


We combine demographic and health data for ethnic groupings in Aotearoa New Zealand with international data on infection fatality rate for different age groups to estimate inequities in infection fatality rate by ethnicity.


If age is the dominant variable, the estimated infection fatality rate for Māori is about 50% higher than for New Zealand European/other. If underlying health conditions (which correlate with age) are more important than age per se, the estimated infection fatality rate for Māori is more than 2.5 times higher than New Zealand European/other, and the infection fatality rate for Pacific people is almost double that of New Zealand European/other.


Data on COVID-19 incidence and outcomes in the context of ethnic minority or Indigenous populations that experience inequities in health and healthcare is currently scarce. Making robust comparisons and informing interventions to eliminate inequitable outcomes requires not only more data, but data that is accessible to decision makers in a timely fashion. This reinforces the importance of systematic, comprehensive and timely data collection in Aotearoa New Zealand in order to manage this and any future epidemics.

This study has focused on the infection fatality rate, which does not account for potential differences in transmission and incidence by ethnicity. Risk factors for accelerated transmission include crowded housing, which affects approximately 25% of Māori and 45% of Pacific people. In addition, multi-generational households increase the risk of transmission to older groups. These compounding factors mean that Māori and Pacific peoples are at risk of bearing a disproportionate health burden from COVID-19.

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First published: Sep 4, 2021
COVID-19 Modelling Aotearoa
[COVID-19 Modelling Aotearoa](, is a cross-organisation and transdisciplinary group of academic researchers and scientists that were brought together by Te Pūnaha Matatini to help Aotearoa New Zealand face the COVID-19 pandemic. Our work is underpinned by Te Tiriti o Waitangi, fast and committed peer review, and ethics. These parameters ensure that the modelling developed by our broad team is uniquely equipped to provide scientifically robust results which are fit for Aotearoa New Zealand and support our decision-making.