Climate change impacts on inequitable access to healthcare in Aotearoa New Zealand — The Association Specialists
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  3. Climate change impacts on inequitable access to healthcare in Aotearoa New Zealand

Climate change impacts on inequitable access to healthcare in Aotearoa New Zealand (23558)

Jesse Whitehead 1 , Mitchell Pincham 1 , Shugi Samba Sibam 1 , Sam Quinsey 2 , Marcus Blake 2
  1. Te Ngira: Institute for Population Research, University of Waikato, Hamilton, Waikato, New Zealand
  2. Centre for Australian Research into Access (CARA), Deakin Rural Health, Geelong, Vic, Australia

Background
Aotearoa is vulnerable to natural disasters, and with global heating extreme weather events will become more intense and frequent.[1,2] Research has identified health impacts of extreme weather events in Aotearoa but was unable to accurately quantify disruptions to health service accessibility.[3] Legislation requires national- and regional-level health disaster planning focused on equitable responses,[4] but there is a knowledge and implementation gap at the local-level. This paper aims to understand inequities in access to health services in Aotearoa after an extreme weather event.

Methods
An exploratory quantitative analysis used publicly available geospatial data to estimate distance to nearest General Practitioner (GP) and hospital for every address (2.3 million) in Aotearoa under ‘normal’ conditions. The road network dataset was modified to reflect closures following Cyclone Gabrielle and access to health services estimated under new conditions. Statistical Area 2 boundaries were used to link data on access disruptions to census-derived demographic and socioeconomic information. Estimates of access to services before and then after Cyclone Gabrielle were compared.

Results
Cyclone Gabrielle related road closures severely disrupted health service accessibility. Approximately 80,000 addresses were isolated from a GP, and ~100,000 were isolated from hospital services. Increased travel distances to a GP and hospital affected approximately 38,000 and 101,000 addresses respectively. Importantly, areas experiencing “high” or “very high” levels of access disruption were more likely to be rural. The most remote (R3) communities experienced the largest disruptions to health service access. Māori, and people aged 65 or older were most likely to live in areas experiencing very high disruption.

Conclusion
This research demonstrates a viable approach to creating dwelling-level accessibility datasets and evaluating the impacts of extreme weather on inequities in health service access, adding to evidence that rural and Indigenous communities are likely to be most severely impacted by climate change.

  1. Blaikie, P., Cannon, T., Davis, I., & Wisner, B. (2014). At risk: natural hazards, people's vulnerability and disasters. Routledge. https://doi.org/10.4324/9780203714775
  2. Smith, K., Fearnley, C.J., Dixon, D., Bird, D.K., & Kelman, I. (2023). Environmental hazards: assessing risk and reducing disaster. Routledge. https://doi.org/10.4324/9781351261647
  3. Laking, G., Caddie, M., Thorpe, H., McClutchie, J., Chaffey, D., Maxwell, H., Philip-Barbara, H., Bell, J., Horgan-Heke, E., Langridge, F., Exeter, D., Eggleton, K., Sing, F., Egli, V., Colbert, J., Sluyter, J., van der Werf, B., Ikiua, O., & McCool, J. (2024). Te Weu me Te Wai – Research into health and wellbeing impacts of adverse weather conditions – Final Report for Ministry of Health | Manatū Hauora. https://teweu.nz/extreme-weather-events-impact-on-health-wellbeing-in-tairawhiti/
  4. Health New Zealand Te Whatu Ora. (2025). Emergency management. https://www.tewhatuora.govt.nz/health-services-and-programmes/emergency-management.