{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:46:13Z","timestamp":1787028373808,"version":"build-2736575974"},"reference-count":54,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["19-147"],"award-info":[{"award-number":["19-147"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>M\u0101ori, the Indigenous people of Aotearoa New Zealand, experience wide-ranging inequities compared with non-M\u0101ori. This survey aimed to explore the holistic health, wellbeing, and disability experiences of New Zealand\u2019s Indigenous M\u0101ori population from a M\u0101ori worldview, addressing gaps in culturally relevant data often overlooked by standard health surveys. A robust cross-sectional survey was conducted with 7359 participants of M\u0101ori descent using Kaupapa M\u0101ori Research principles. Data were analysed using the Te Pae M\u0101hutonga framework, a M\u0101ori health promotion model. Participants demonstrated strong cultural identity, with 32.3% understanding spoken M\u0101ori fairly well and 97.3% defining a broad non-nuclear concept of wh\u0101nau (family). While over half reported high life satisfaction, 58.4% experienced discrimination, mainly based on ethnicity and appearance. Access to healthcare revealed that 32.6% were unable to contact a general practitioner due to cost. Socioeconomic challenges were prevalent; nearly a quarter borrowed from family or friends to meet daily living costs, and over a third economized on fresh produce to save money. This study reveals significant gaps in mainstream health data and demonstrates that a culturally aligned, methodological approach is feasible and crucial for informing policies that address the needs and rights of M\u0101ori, as guaranteed under Te Tiriti o Waitangi. These results could inform global, indigenous research addressing culturally relevant health, wellbeing and disability inequities.<\/jats:p>","DOI":"10.3390\/ijerph22060829","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T12:24:18Z","timestamp":1748003058000},"page":"829","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["M\u0101ori Health, Wellbeing, and Disability in Aotearoa New Zealand: A National Survey"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7087-2531","authenticated-orcid":false,"given":"Tristram R.","family":"Ingham","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Otago Wellington, Wellington 6021, New Zealand"},{"name":"Foundation for Equity and Research New Zealand, Wellington 6012, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1595-016X","authenticated-orcid":false,"given":"Bernadette Huatau","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Otago Wellington, Wellington 6021, New Zealand"},{"name":"Foundation for Equity and Research New Zealand, Wellington 6012, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1602-4421","authenticated-orcid":false,"given":"Meredith A.","family":"Perry","sequence":"additional","affiliation":[{"name":"School of Physiotherapy, University of Otago, Dunedin 9016, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1620-473X","authenticated-orcid":false,"given":"Andrew","family":"Sporle","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Auckland, Auckland 1010, New Zealand"},{"name":"iNZight Analytics Ltd., Auckland 1010, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7815-6318","authenticated-orcid":false,"given":"Tom","family":"Elliott","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Auckland, Auckland 1010, New Zealand"},{"name":"iNZight Analytics Ltd., Auckland 1010, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Toko","family":"King","sequence":"additional","affiliation":[{"name":"Te R\u014dp\u016b Rangahau Hauora a Eru P\u014dmare, Department of Public Health, University of Otago Wellington, Wellington 6021, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Baker","sequence":"additional","affiliation":[{"name":"Baker Consulting Ltd., Wellington 6011, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0318-1201","authenticated-orcid":false,"given":"Barry","family":"Milne","sequence":"additional","affiliation":[{"name":"COMPASS Research Centre, University of Auckland, Auckland 1010, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tori","family":"Diamond","sequence":"additional","affiliation":[{"name":"iNZight Analytics Ltd., Auckland 1010, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda Waimarie","family":"Nikora","sequence":"additional","affiliation":[{"name":"Ng\u0101 Pae o te M\u0101ramatanga, University of Auckland, Auckland 1010, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e065430","DOI":"10.1136\/bmjopen-2022-065430","article-title":"Estimating the economic costs of Indigenous health inequities in New Zealand: A retrospective cohort analysis","volume":"12","author":"Reid","year":"2022","journal-title":"BMJ Open"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1016\/S0140-6736(06)68890-9","article-title":"Effects of self-reported racial discrimination and deprivation on Maori health and inequalities in New Zealand: Cross-sectional study","volume":"367","author":"Harris","year":"2006","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Harris, R.B., Stanley, J., and Cormack, D.M. (2018). Racism and health in New Zealand: Prevalence over time and associations between recent experience of racism and health and wellbeing measures using national survey data. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0196476"},{"key":"ref_4","unstructured":"United Nations (2007). United Nations Declaration on the Rights of Indigenous Peoples, United Nations."},{"key":"ref_5","unstructured":"United Nations (2006). United Nations Convention on the Rights of Persons with Disabilities, United Nations."},{"key":"ref_6","first-page":"118","article-title":"Meihana model: A clinical assessment framework","volume":"36","author":"Pitama","year":"2007","journal-title":"N. Z. J. Psychol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3539","DOI":"10.1111\/jocn.15859","article-title":"Creating an Indigenous M\u0101ori-centred model of relational health: A literature review of M\u0101ori models of health","volume":"30","author":"Wilson","year":"2021","journal-title":"J. Clin. Nurs."},{"key":"ref_8","unstructured":"Tribunal, W. (2023). Haumaru: The COVID-19 Priority Report, Legislation Direct."},{"key":"ref_9","unstructured":"Stats NZ (2025, May 04). Te Kupenga, Available online: https:\/\/www.stats.govt.nz\/information-releases\/te-kupenga-2018-final-english."},{"key":"ref_10","unstructured":"New Zealand Treasury (2025, April 20). Te Tai Waiora: Wellbeing in Aotearoa New Zealand 2022, Available online: https:\/\/www.treasury.govt.nz\/sites\/default\/files\/2022-11\/sp-te-tai-waiora-wellbeing-aotearoa-nz-24nov22_2.pdf."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1080\/01419870.2022.2081512","article-title":"Who are the M\u0101ori \u201cin-between\u201d? Indigenous diversity and inequity across descent, ethnicity and Iwi knowledge","volume":"46","author":"Greaves","year":"2022","journal-title":"Ethn. Racial Stud."},{"key":"ref_12","unstructured":"Ministry of Health (2025, April 20). Annual Update of Key Results 2022\/23: New Zealand Health Survey, Available online: https:\/\/www.health.govt.nz\/publications\/annual-update-of-key-results-202223-new-zealand-health-survey."},{"key":"ref_13","unstructured":"Smith, L.T. (1999). Decolonising Methodologies: Research and Indigenous Peoples, New York & Otago University Press. Zed Books."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ingham, T.R., Jones, B., Perry, M., von Randow, M., Milne, B., King, P.T., Nikora, L.W., Sporle, A., and Te Ao M\u0101rama Study Group (2023). Measuring Maori Health, Wellbeing, and Disability in Aotearoa Using a Web-Based Survey Methodology. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20186797"},{"key":"ref_15","unstructured":"Stats NZ (2022). Experimental Administrative Population Census: Data Sources, Methods, and Quality, Stats NZ. [2nd ed.]."},{"key":"ref_16","first-page":"8","article-title":"Te Pae M\u0101hutonga: A model for M\u0101ori health promotion","volume":"49","author":"Durie","year":"1999","journal-title":"Health Promot. Forum New Zealand Newsl."},{"key":"ref_17","unstructured":"Stats NZ (2025, April 20). What About Me?. Available online: https:\/\/www.whataboutme.nz\/#."},{"key":"ref_18","unstructured":"Stats NZ (2021). Data Standard for Gender, Sex, and Variations of Sex Characteristics, Stats NZ."},{"key":"ref_19","unstructured":"Stats NZ (2025, April 20). Ethnicity Data Collection Standards v2.0, ARIA Your Concept and Classification Management System, Available online: http:\/\/aria.stats.govt.nz\/aria\/?_ga=2.199996458.547787243.1621201268-647135710.1590034663."},{"key":"ref_20","unstructured":"Stats NZ (2025, April 20). Iwi and Iwi-Related Groups Statistical Classification V1.0.0, Available online: https:\/\/aria.stats.govt.nz\/aria\/#ClassificationView:uri=http:\/\/stats.govt.nz\/cms\/ClassificationVersion\/QjykuWT5BTJrGdVs."},{"key":"ref_21","unstructured":"Stats NZ (2025, April 20). Urban Rural Classification V1.0.0, Available online: https:\/\/aria.stats.govt.nz\/aria\/#ClassificationSearch:q=urban%2520rural%2520classification&facet.lifecycle=1&fl=name,abb&sort=relevance-&start=0&rows=20."},{"key":"ref_22","unstructured":"Kukutai, T., Sporle, A., and Roskruge, M. (2016). \u2018Expressions of Wh\u0101nau\u2019. Families and Wh\u0101nau Status Report, Superu."},{"key":"ref_23","unstructured":"Washington Group on Disability Statistics (2024). WG Short Set on Functioning (WG-SS), Washington Group."},{"key":"ref_24","unstructured":"Australian Bureau of Statistics (2025, May 04). ANZSCO\u2014Australian and New Zealand Standard Classification of Occupations, Available online: https:\/\/www.abs.gov.au\/statistics\/classifications\/anzsco-australian-and-new-zealand-standard-classification-occupations\/latest-release."},{"key":"ref_25","unstructured":"Atkinson, J., Salmond, C., and Crampton, P. (2019). NZDep2018 Index of Deprivation, University of Otago."},{"key":"ref_26","unstructured":"Stats NZ (2025, April 20). Household Income and Housing-Cost Statistics: Year Ended June 2023, Available online: https:\/\/www.stats.govt.nz\/information-releases\/household-income-and-housing-cost-statistics-year-ended-june-2023\/."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Ingham, T.R., Jones, B., Perry, M., King, P.T., Baker, G., Hickey, H., Pouwhare, R., and Nikora, L.W. (2022). The Multidimensional Impacts of Inequities for Tangata Whaikaha Maori (Indigenous Maori with Lived Experience of Disability) in Aotearoa, New Zealand. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192013558"},{"key":"ref_28","unstructured":"Robson, B., and Reid, M.P. (2001). Ethnicity Matters: Maori Perspectives Paper for the Review of the Measurement of Ethnicity in Official Statistics, University of Auckland. Available online: https:\/\/statsnz.contentdm.oclc.org\/digital\/api\/collection\/p20045coll1\/id\/3706\/download."},{"key":"ref_29","first-page":"174","article-title":"Recognising the Rights of Indigenous Peoples edited by Alison Quentin-Baxter","volume":"13","author":"Bullen","year":"1998","journal-title":"Soc. Policy J. N. Z."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1186\/s12939-022-01782-6","article-title":"Health effects of Indigenous language use and revitalization: A realist review","volume":"21","author":"Whalen","year":"2022","journal-title":"Int. J. Equity Health"},{"key":"ref_31","unstructured":"Tribunal, W. (1986). Report of the Waitangi Tribunal on the Te Reo Maori Claim (WAI 11), Waitangi Tribunal."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/j.1740-9713.2004.00058.x","article-title":"Status syndrome","volume":"1","author":"Marmot","year":"2004","journal-title":"Significance"},{"key":"ref_33","first-page":"1","article-title":"Researching with Wh\u0101nau Collectives","volume":"3","author":"Cram","year":"2010","journal-title":"Mai Rev."},{"key":"ref_34","first-page":"1","article-title":"Wh\u0101nau Ora; He Whakaaro \u0100 Wh\u0101nau: M\u0101ori Family Views of Family Wellbeing","volume":"5","author":"Boulton","year":"2014","journal-title":"Int. Indig. Policy J."},{"key":"ref_35","unstructured":"Dunlop, E.D., Boston, M., and Owen, M. (2023, January 19\u201321). Reimagining Community Resilience through a Te Ao M\u0101ori Worldview. Proceedings of the NZSEE 2023 Annual Conference, Hamilton, New Zealand."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"116028","DOI":"10.1016\/j.socscimed.2023.116028","article-title":"Well-being and cultural identity for Maori: Knowledge of iwi (tribal) affiliations does not strongly relate to health and social service outcomes","volume":"329","author":"Greaves","year":"2023","journal-title":"Soc. Sci. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.socscimed.2018.04.005","article-title":"How is subjective well-being related to quality of life? Do we need two concepts and both measures?","volume":"206","author":"Skevington","year":"2018","journal-title":"Soc. Sci. Med."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Skevington, S.M. (2020). Is Culture Important to the Relationship Between Quality of Life and Resilience? Global Implications for Preparing Communities for Environmental and Health Disasters. Front. Psychol., 11.","DOI":"10.3389\/fpsyg.2020.01492"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1007\/s11136-016-1311-9","article-title":"The health-related quality of life of Indigenous populations: A global systematic review","volume":"25","author":"Angell","year":"2016","journal-title":"Qual. Life Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s11136-023-03499-7","article-title":"Preference-based measures of health-related quality of life in Indigenous people: A systematic review","volume":"33","author":"Roy","year":"2023","journal-title":"Qual. Life Res."},{"key":"ref_41","unstructured":"Health Quality & Safety Commission (2022). Aotearoa New Zealand Patient Experience Survey, HQSC."},{"key":"ref_42","unstructured":"Webber, A., and McGregor, A. (2019). He Whakaaro: What Do We Know About Discrimination in Schools?, Ministry of Education."},{"key":"ref_43","unstructured":"Ministry of Social Development (2020). Social Inclusion in New Zealand: Rapid Evidence Review, Ministry of Social Development."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s12939-018-0735-y","article-title":"Multiple forms of discrimination and relationships with health and wellbeing: Findings from national cross-sectional surveys in Aotearoa\/New Zealand","volume":"17","author":"Cormack","year":"2018","journal-title":"Int. J. Equity Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"40","DOI":"10.17269\/s41997-019-00242-z","article-title":"Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada","volume":"111","author":"Kitching","year":"2020","journal-title":"Can. J. Public Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1080\/13607863.2011.641518","article-title":"Volunteering predicts happiness among older M\u0101ori and non-M\u0101ori in the New Zealand health, work, and retirement longitudinal study","volume":"16","author":"Dulin","year":"2012","journal-title":"Aging Ment. Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1177\/00187267211003955","article-title":"He aronga takirua: Cultural double-shift of M\u0101ori scientists","volume":"75","author":"Haar","year":"2022","journal-title":"Human. Relat."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1108\/PR-10-2020-0754","article-title":"Is meaningful work always a resource toward wellbeing? The effect of autonomy, security and multiple dimensions of subjective meaningful work on wellbeing","volume":"52","author":"Haar","year":"2023","journal-title":"Pers. Rev."},{"key":"ref_49","unstructured":"Ministry of Business, Innovation, and Employment (2025, April 20). Overview of M\u0101ori Employment Outcomes in Aotearoa New Zealand, Available online: https:\/\/www.mbie.govt.nz\/business-and-employment\/employment-and-skills\/employment-strategy\/maori-employment-action-plan\/annexes\/overview-of-maori-employment-outcomes-in-aotearoa-new-zealand."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1080\/03036758.2022.2109691","article-title":"Deprivation trends in potentially avoidable medical hospitalisations of under-25-year-old M\u0101ori and non-M\u0101ori non-Pacific in Aotearoa New Zealand: A 20-year perspective","volume":"53","author":"Oben","year":"2023","journal-title":"J. R. Soc. N. Z."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1136\/archdischild-2018-314808","article-title":"Pathways to inequalities in child health","volume":"104","author":"Pearce","year":"2019","journal-title":"Arch. Dis. Child."},{"key":"ref_52","unstructured":"Galt, M., and Nees, C. (2022). New Zealand\u2019s Wellbeing: Is It Sustainable and What Are the Risks?, The Treasury."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1080\/00323187.2021.1898995","article-title":"How low can we go? Declining survey response rates to New Zealand electoral roll mail surveys over three decades","volume":"72","author":"Greaves","year":"2021","journal-title":"Political Sci."},{"key":"ref_54","first-page":"142","article-title":"Te Rangahau O Te Tuakiri M\u0101ori Me Ng\u0101 Waiaro \u0100-P\u016btea | The M\u0101ori Identity and Financial Attitudes Study (MIFAS)\u2014Background, Theoretical Orientation And First-Wave Response Rates","volume":"8","author":"Houkamau","year":"2019","journal-title":"Mai J."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/6\/829\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:39:35Z","timestamp":1760031575000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/6\/829"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":54,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["ijerph22060829"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22060829","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,23]]}}}