{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:04:01Z","timestamp":1784066641908,"version":"3.55.0"},"reference-count":0,"publisher":"Pasifika Medical Association Group","issue":"1638","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NZMJ"],"abstract":"<jats:p>New Zealand\u2019s 2001 Primary Health Care Strategy set a bold goal of reducing health inequities through a population health approach\nwith innovative models of care and a revised funding framework. Twenty-five years later, significant disparities persist. This paper\nutilises recent literature alongside a case study derived from a recent evaluation of a long-term conditions programme in primary\ncare. The evaluation found significant barriers to a successful model of care. These included a generic user-pays model that did not\naccommodate low health literacy, poverty-related constraints, geographic isolation, disability or the need for culturally safe care.\nSystem-level obstacles such as complex referral pathways, inadequate training, insufficient resourcing and static funding mechanisms\nfurther entrenched inequity.\nThe article concludes that persistent inequities for some groups in Aotearoa New Zealand demonstrate that innovative programmes\nalone cannot overcome structural, resourcing and policy deficits. A fundamental reorientation of primary healthcare funding and\ndesign that integrates socio-economic, cultural, environmental, commercial, digital and geographical determinants is required.\nEmbedding cultural safety to honour the diversity in our communities, along with an appropriate allocation of resources for primary\nhealthcare in both rural and urban settings, is necessary to work towards equitable health outcomes in Aotearoa New Zealand.<\/jats:p>","DOI":"10.26635\/6965.7192","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T21:23:28Z","timestamp":1784064208000},"page":"106-112","source":"Crossref","is-referenced-by-count":0,"title":["The canary in the coal mine: inequitable healthcare for those living with multimorbidity in Aotearoa New Zealand"],"prefix":"10.26635","volume":"139","author":[{"given":"Anna","family":"Askerud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"McKinlay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Doolan-Noble","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11177","published-online":{"date-parts":[[2026,7,17]]},"container-title":["New Zealand Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T21:23:32Z","timestamp":1784064212000},"score":1,"resource":{"primary":{"URL":"https:\/\/nzmj.org.nz\/journal\/vol-139-no-1638\/the-canary-in-the-coal-mine-inequitable-healthcare-for-those-living-with-multimorbidity-in-aotearoa-new-zealand"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":0,"journal-issue":{"issue":"1638","published-online":{"date-parts":[[2026,7,17]]}},"URL":"https:\/\/doi.org\/10.26635\/6965.7192","relation":{},"ISSN":["1175-8716"],"issn-type":[{"value":"1175-8716","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]}}}