The Impact of COVID-19 on Māori Patients Attending Diabetes Annual Review.

Māori, the indigenous population of New Zealand, represent 17.1% of the country's population (Statistics New Zealand 2021) and are over-represented in all negative indices. In particular, Māori are underprivileged in terms of socioeconomics and health due to the residual effects of colonization. The global COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has been one of the most significant public health crises in modern history. Vulnerable populations, such as the elderly and those with underlying health conditions, were and remain at higher risk of severe outcomes. In the New Zealand context and given the health statistics, Māori were identified as a group that was at high risk from COVID-19. Using a mixed method approach, we attempt to identify the reasons why a cohort of New Zealand Māori with type II diabetes mellitus (DM II) and a history of regular attendance failed their Diabetes Annual Review (DAR) post-COVID-19. Twelve Māori participants were recruited (> 18 years) from a Māori Diabetes database of an urban General Practitioners (GP) Clinic in Northland. A 9-point questionnaire and an unstructured telephone conversation utilizing a Kaupapa Māori (Māori philosophy) approach were utilized, and data were collated.  Findings suggest the New Zealand government's COVID-19 vaccine mandates served to exacerbate Māori distrust of health professionals. Trust is the foundation of every successful relationship whether it be business, professional, health, or personal. Health delivery and uptake are based on this foundation. Whatever the reason for the loss of trust in the medical profession, historical colonial trauma, swayed by conspiracy theory, or otherwise, considering this factor should influence the structure and approach of public health initiatives directed toward Indigenous people internationally.