Aotearoa New Zealand’s Changing Demographic Landscape and Implications for the Health System

Love Umesi, Health New Zealand
Shefali Pawar, Health New Zealand

New Zealand’s health system is navigating profound demographic change, marked by a rapidly ageing and increasingly diverse population. By 2048, the population is projected to reach 6.2 million, but growth rates are slowing due to declining fertility and an ageing age structure. National growth conceals persistent and widening subnational disparities: rural areas continue to lose young people to out-migration, accelerating local population ageing and decline, while urban centres—especially Auckland—concentrate much of the nation’s growth. The changing demographic structure presents unique challenges for the health system. Over the next decade, demand for health services is expected to rise sharply, with a 25% increase in inpatient admissions and a 20–21% increase in emergency department and outpatient contacts. Concurrently, the health workforce itself is ageing, with fewer young professionals entering the sector than those nearing retirement, particularly in rural areas. Ethnic diversity is also increasing, with Maori, Pacific, and Asian communities projected to comprise a larger share of the population by 2043. This growing diversity requires health services to be more culturally responsive and equitable. Addressing these demographic shifts will require targeted workforce planning, strategies to attract and retain younger professionals, and a focus on workforce diversity and gender balance to ensure sustainable, high-quality health service delivery.

Keywords: Population Ageing, Spatial Demography, International Migration, Fertility

See paper.

  Presented in Session P4. Migration, Urbanization, Refugees; Economics: Population & Development; Climate Change, and Spatial Demography