Abstract
Asthma is a complex respiratory condition that has a high prevalence and significant health burden in New Zealand (NZ). Proximal deter- minants of asthma development and severity are well established; however there exists an underappreciation of more upstream determinants that are guided by political, environmental and social elements. In particular, NZ’s housing policy, climate change challenges and unaffordability of nutritious foods are significant root drivers of asthma de- velopment in the present and into the future. Importantly, upstream social determinants have an inequitable impact on asthma burden for Māori and Pacific peoples in NZ. Such disparities are perpetuated by broader elements of colonisation, institutional racism and inequitable policy development. An analysis of the distal drivers of asthma in NZ reveals a necessity for health professionals to question our nation’s priorities and advocate for the targeting of upstream population level health determinants that promote equitable asthma outcomes.
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