Evidence map›Paper›PMID 42015140›Full record

ArticleInternational journal for equity in health2026

Access to bariatric surgery in Aotearoa, New Zealand - a scoping review.

Noah Appleby, Elaijah Tuivaiti, Makayla Kahi, Matire Harwood, Grant Beban, Suheelan Kulasegaran, Alana Cavadino, Vanessa Selak, Jamie-Lee Rahiri

Abstract readScoping Review
In one paragraph

Article in International journal for equity in health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Noah ApplebyFaculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand. napp650@aucklanduni.ac.nz.
Elaijah TuivaitiFaculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand.
Makayla KahiFaculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand.
Matire HarwoodDepartment of General Practice and Primary Health Care, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand.
Grant BebanDepartment of General Surgery and Trauma, 2 Park Road, Grafton, Te Whatu Ora, Te Toka Tumai Auckland, Auckland, 1023, New Zealand.
Suheelan KulasegaranDepartment of Surgery, North Shore Hospital, Te Whatu Ora Waitematā, 124 Shakespeare Road, Takapuna, Auckland, 0620, New Zealand.
Alana CavadinoSection of Epidemiology & Biostatistics, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand.
Vanessa SelakSection of Epidemiology & Biostatistics, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand.
Jamie-Lee RahiriDepartment of General Practice and Primary Health Care, University of Auckland, 85 Park Road, Grafton, Auckland, 1023, New Zealand.

Funding

Health Research Council of New Zealand (24/628)
6 · The paper itself

Abstract

backgroundDespite the high burden of obesity-related disease among Māori, the indigenous people of Aotearoa, New Zealand (NZ), Pacific peoples, and people who live rurally experience inequitable access to publicly funded bariatric surgery. This scoping review examines barriers, facilitators, and inequities in access to bariatric surgery, identifying key themes and gaps in the current literature.

methodsA Kaupapa Māori-aligned methodological stance was employed to ensure culturally safe data interpretation and analysis. PubMed, Scopus, Embase, Medline, CINAHL, and Cochrane were searched to identify studies published between January 1st, 2000, and April 30th, 2025. Case reports, editorials, conference abstracts, and non-New Zealand studies were excluded.

resultsTwenty-five studies met eligibility criteria. Significant disparities in access were found by ethnicity, geography, and socioeconomic status. Māori, Pacific, rural, and socioeconomically deprived populations experience higher rates of attrition and face greater barriers, including restrictive preoperative requirements, regional variability in referrals due to unclear processes. Men were underrepresented and tended to present with higher comorbidity at the time of surgery. Facilitators included strong personal and whānau motivations, culturally responsive care, and community-integrated models.

conclusionsAccess to bariatric surgery in NZ presents as an amalgamation of systemic and structural inequities, persisted by a lack of coordinated national data to inform clinical decisions. Although equity indicators consistently influenced access, few studies addressed their root causes or intersectionality. Culturally grounded models like Kaupapa Māori and Pacific-led programmes show promise. Continued investment in equity-focused research and policy is critical to ensure those most in need receive care and health services meet their legislative responsibilities to deliver equitable health care.

Indexed as

Bariatric SurgeryHealthcare DisparitiesHealth Services AccessibilityHumansMaori PeopleNew ZealandObesityAccess to careBariatric surgeryCulturally responsive careHealth equityMāori healthPacific health

Identifiers

PMID42015140
PMCPMC13235133

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.