Ethnic Disparities in Access to Publicly Funded Bariatric Surgery in South Auckland, New Zealand

Background In New Zealand (NZ), Indigenous Māori and Pacific peoples experience a higher burden of obesity and obesity-related disease. Counties Manukau Health (CMH) provides the largest public bariatric service in NZ housing a higher proportion (64%) of non-European groups (Asian, Pacific and Māori). This study investigated whether ethnic disparities in the receipt of bariatric surgery exist within one of the most ethnically diverse populations in NZ. Methods All patients accepted on to the CMH bariatric programme between 1 January 2011 and 31 December 2017 were identified through hospitalisation records. Logistic regression modelling with multivariate adjustment was utilised to assess the likelihood (odds ratio) of receipt of bariatric surgery by ethnicity. Results A total of 2519 referrals were received, of which 1051 proceeded to surgery. The proportion of patients referred who eventually underwent bariatric surgery was significantly higher for Other Europeans (68%) and NZ Europeans (63%) compared to Asian (42%), Māori (41%) and Pacific peoples (28%, p