Improving outcomes by targeting healthcare access and equity

Globally, chronic health conditions have placed resourcing demands upon already strained healthcare systems, thereby further exacerbating inequities.

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Our ageing population and a forecasted increase in immigration mean demand on our health system is unlikely to decrease in the future.

At the University of Waikato we understand that primary care is crucial to improving health outcomes and reducing overall healthcare costs.

Our academics are producing impactful research to support primary care health systems, including tackling healthcare inequities, preventing illnesses or detecting illnesses early, addressing healthcare workforce shortages and collating evidence to aid health policy.

In 2024 our researchers used national-level data on lung cancer and breast cancer to reveal disparities in wait times, access to surgery and treatment between Māori and Pākehā patients. Our research highlights that inequities persist and gives greater visibility to the need for timely and equitable treatment.

Our researchers uncovered that patients diagnosed with lung cancer through emergency departments in the Waikato had more advanced-stage disease and lower survival rates than those diagnosed by their general practitioner. This further validates our aim to strengthen primary healthcare.

Our team of diabetes researchers is working alongside primary health organisations (PHOs) to forge new pathways for diabetes patients, particularly Māori who are disproportionally impacted. We showed that technology-enhanced, culturally informed primary care results in sustained improvements for Indigenous patients with type 2 diabetes.

Also, our research identified high rates of psychological distress in people with type 1 diabetes, particularly females and Māori, providing an objective rationale for routine screening of psychological distress in diabetes care.

As a university in heartland Waikato, we are committed to improving healthcare access for those in traditionally underserved regional and rural areas. In 2024 our researchers collaborated with academics across the country to address the challenge of geographic equity in health service design because, as we discovered, New Zealand's most remote communities use health services the least, even though they have the highest rates of preventable deaths. This work is vital evidence to aid in making better policy decisions.

The University listened to our Primary Health Organisation (PHO) collaborators and other healthcare providers to address primary care workforce shortages. To this end, the University signed a Memorandum of Understanding with three PHOs to create a regional network of training facilities to support interprofessional clinical placements across a range of primary care health professions.

Moreover, we are building new pathways to train and fast track graduate health workers.

In 2024 we continued to be the leading provider for postgraduate nursing students and laid the groundwork for our Masters of Clinical Practice Midwifery and our Master of Pharmacy Practice, which welcome their first cohorts in 2025.

2024 Highlights

We recognise the power of local and global partnerships between researchers, practitioners and patients to address shared healthcare challenges. Addressing the combined challenges of climate change, natural disasters, population ageing, and chronic disease requires moving beyond 'business as usual' and working in partnership to identify and implement societal improvements.

In 2024 we forged new relationships and built on current collaborations to improve the health and wellbeing of people in New Zealand and across the globe.

Supporting disease prevention and early detection

Early detection and prevention reduces demands on over-burdened secondary and tertiary healthcare services and has significant impacts on our quality of life. Primary healthcare providers are vital for early diagnosis and preventative education.

In 2024 our researchers interrogated data and synthesised evidence on major health issues that matter to New Zealanders – diabetes, cancer, and rural health.

Our researchers are pinpointing the numbers and identifying treatment patterns and outcomes to better understand the barriers and facilitators for structuring primary healthcare that works optimally for all New Zealanders, at all stages of life, wherever they live.

Global partnerships to inform policy for equitable and resilient health systems

The University of Waikato and Hiroshima University are leading a multi-organisational research collaboration to establish resilient health systems that support healthy and equitable communities through a constantly changing future.

With support from Royal Society of New Zealand Te Apārangi and the Japan Society for the Promotion of Science, the initiative is focused on learning from healthcare responses to natural and climate-related emergencies in New Zealand and Japan and exploring the impact of different healthcare systems on rural communities, with a strong focus on Indigenous innovation.

In 2024 our research team visited Japan to share critical insights into rural healthcare delivery, chronic disease management, and emergency response through site visits.

Our researchers are creating new knowledge to identify the strengths and areas for improvement of two different healthcare systems that must respond to the  multifaceted challenges of surging healthcare demands, climate change and demographic change.

This unique international collaboration is identifying opportunities for system-level improvement that will be able to inform policy development in both countries.

Citations

Ethnic inequities in use of breast conserving surgery and radiation therapy in Aotearoa/New Zealand: which factors contribute? Breast Cancer Research and Treatment, 205(3), 641–653. Boyle, L., Lawrenson, R., Nosa, V., Campbell, I., & Tin, S. T. (2024). doi.org/10.1007/s10549-024-07289-8 
Ethnic differences in time to surgery for women with early stage breast cancer in Aotearoa/New Zealand: a population-based study. The Lancet Regional Health - Western Pacific, 47, 101091. Boyle, L., Lawrenson, R., Ronald, M., Campbell, I., Nosa, V., & Tin, S. T. (2024). doi.org/10.1016/j.lanwpc.2024.101091 
Technology-enhanced, culturally- informed primary care results in sustained improvements in biomarkers for Indigenous patients with type 2 diabetes – a pilot study. Journal of Primary Health Care, 17(1), 83–87. Chepulis, L. M., Crosswell, R., Moorhouse, S., Morton, H., Oehley, M., Paul, R., & Crocket, H. (2024). doi.org/10.1071/hc24056 
Equity of travel to access surgery and radiation therapy for lung cancer in New Zealand. Supportive Care in Cancer, 32(3). Gurney, J., Davies, A., Stanley, J., Whitehead, J., Costello, S., Dawkins, P., Henare, K., Jackson, C. G. C. A., Lawrenson, R., Scott, N., & Koea, J. (2024). doi.org/10.1007/s00520-024-08375-9 
Treatment Patterns for End-Stage Kidney Failure in Patients With Systemic Lupus Erythematous. JCR Journal of Clinical Rheumatology, 30(5), 183–187. Lao, C., Van Dantzig, P., Rabindranath, K., White, D., & Lawrenson, R. (2024). doi.org/10.1097/rhu.0000000000002088
Treatment patterns in patients with systemic lupus erythematosus in New Zealand. Lupus, 33(11), 1260–1273. Lao, C., Van Dantzig, P., Tugnet, N., Lawrenson, R., & White, D. (2024). doi.org/10.1177/09612033241274911
Does diabetes affect breast cancer survival? Cancer Reports, 7(3). McClintock, J. M., Chepulis, L., Blackmore, T., Fraser, S., & Paul, R. G. (2024). doi.org/10.1002/cnr2.2040
Psychological distress in Aotearoa New Zealand adults with type 1 diabetes. Journal of Health Psychology. Lawrenson, R., Lao, C., Stanley, J., Teng, A., Kuper-Hommel, M., Campbell, I., Krebs, J., Sika-Paotonu, D., Koea, J., Meredith, I., & Gurney, J. (2024). doi.org/10.1177/13591053241289189
Rural–urban variation in the utilisation of publicly funded healthcare services: an age-stratified population-level observational study. New Zealand Medical Journal, 137(1590), 33–47. Nixon, G., Davie, G., Whitehead, J., Miller, R., De Graaf, B., Liepins, T., Lawrenson, R., & Crengle, S. (2024). doi.org/10.26635/6965.6274
Facilitators and barriers for implementation of health programmes with Māori communities. Implementation Science Communications, 5(1). Oetzel, J., Ngawati, R., Penetito-Hemara, D., Puke, T. T., Henry, A., Povaru-Bourne, S., & Sika-Paotonu, D. (2024). doi.org/10.1186/s43058-024-00567-y

Sustainability stories

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Researchers are giving a voice to our planet by using the language of science to reveal the critical role that Antarctica plays in shaping our climate. 

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Climate change impacts all facets of the way society interacts with the environment, especially how and when to use space and resources wisely. 

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The University of Waikato is at the forefront of creating transformation that serves people, businesses and the environment. 

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Globally, chronic health conditions have placed resourcing demands upon already strained healthcare systems, thereby further exacerbating inequities. 

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The University of Waikato is a leader in marine conservation research, committed to protecting and restoring the health of our oceans and coastlines. 

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Our world is facing a range of deeply interconnected challenges that pit profit against our planet.