Should Pacific People be Homogenised When Considering Their Need for CVD Health Services? A Systematic Review of the Epidemiology and Management of CVD Among Pacific People

Pacific people experience inequities in the burden of cardiovascular disease (CVD) globally. Health services responsible for meeting the health needs of Pacific people, including those in NZ, generally homogenise this group in terms of health service delivery. We conducted a systematic review to determine whether the epidemiology and management of CVD among Pacific people varies according to Pacific-specific ethnicity or place of birth. The review covered the period 1959–February 2021. Key words were cardiovascular, pacific, pacific-specific, epidemiology, management, equity. The full review protocol is available at https://osf.io/x7nr6/. Twenty-three texts were identified, of which only six were of good quality. Much of the literature was outdated and interpreted from non-Pacific perspectives. There was little literature on the management of CVD by Pacific-specific ethnicity and/or place of birth. The findings of included literature indicate that there do appear to be differences in the epidemiology and management of CVD by Pacific-specific ethnicity or place of birth. The most recent NZ-based report estimated the prevalence of ischaemic heart disease (IHD) as highest among Cook Islands Māori (138 per 1,000 age-standardised population (p<0.001)) and lowest among Niuean (107.8) in metro-Auckland. Health services need a contemporary, Pacific-led understanding of the epidemiology and management of CVD among Pacific people to determine the appropriate configuration and monitoring of services to address the CVD health needs of Pacific peoples in NZ.