Opening the Window: What Aotearoa Data Now Tells Us About Disability – and What Comes Next
A Window on Disability has been released by the Health Quality & Safety Commission Te Tāhū Hauora, a landmark report developed in partnership with the Donald Beasley Institute and Nicholson Consulting.
This mahi has been a privilege.
It represents the combined effort of disabled people, whānau, researchers, clinicians, and data specialists committed to one shared purpose: building a stronger evidence base to support improved experiences, appropriately designed services, and ultimately better lives for disabled people in Aotearoa.
At Nicholson Consulting, we are proud to have contributed to this work, not just as data practitioners, but as partners committed to equity, and outcomes that genuinely serve people and communities first.
Why this report matters
Disabled people should have the opportunity to survive, thrive, and lead ordinary lives alongside their friends and whānau.
Yet until now, we have not had a clear, system-level view of how well our health system is working for disabled people.
Why? Because disability has been largely invisible in our health data.
Most national health datasets do not record disability status. Existing data is fragmented, undercounts Māori and Pacific peoples, and does not reflect how disability changes over time.
This report changes that.
By connecting data through the Integrated Data Infrastructure (IDI) and combining it with disabled-led research and lived experience, it shows—at scale—what becomes visible when disability data is finally brought together.
What the data reveals
The findings are clear, and they are confronting.
A system not delivering equitable outcomes
Disabled people die from treatable conditions at five times the rate of non-disabled people.
Māori disabled people experience even deeper inequity, with rates nearly ten times higher than non-disabled populations.
These are not isolated issues; they are the result of structural barriers across the entire life course.
Barriers despite engagement
Disabled people are engaged with the health system:
97% are enrolled with a GP (higher than non-disabled people).
And yet:
One in three report unmet need for care.
Emergency department use is three times higher.
Hospitalisation rates are up to four times higher, with longer stays.
This is the inverse care law in action — those who need care most are least able to access it effectively.
Inequities across the life course
Maternity and early life
Disabled people are less likely to receive timely maternity care, have higher pre-term birth rates, and report poorer experiences with their maternity care.
Children and young people
The system shows early signs of responsiveness — but inequities emerge quickly:
Dental hospitalisations up to 9x higher
Significant unmet need for care and equipment
Adulthood
Barriers deepen:
Higher rates of chronic conditions, including diabetes and cancer
Significantly higher anxiety, depression, and psychological distress
Greater unmet need for mental health support
Older adulthood
Increased hospital use, longer stays, and inconsistent community support highlight a system not yet designed for the complexity of ageing with disability.
Compounding inequities
Disability does not exist in isolation.
Outcomes are significantly worse where disability intersects with:
Māori and Pacific identity
Socioeconomic deprivation
Multiple impairments
These compounding factors reinforce the urgent need for culturally grounded, Te Tiriti‑aligned responses.
What needs to change
The report provides a clear direction:
We need to know
Disability must be visible in our data — consistently, accurately, and across all systems.
We need to train
Disability capability must be embedded across the health workforce.We need to employ
Disabled people must be represented throughout the system — including leadership.We need to involve
Decisions must reflect the principle: nothing about us, without us.
Looking forward…
This report is not the end - it is a beginning.
It provides the evidence needed to act.
It affirms what disabled people have long known through lived experience.
And it creates an opportunity for Aotearoa to build a health system that truly enables everyone to survive, thrive, and lead ordinary lives.
We are deeply grateful to have worked alongside the Donald Beasley Institute and Te Tāhū Hauora on this kaupapa.
Together, we have opened the window.
Now, we move forward – together!