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Rangatahi Māori, the Indigenous adolescents of Aotearoa New Zealand, consistently have poorer health outcomes than Pākehā (New Zealand European and other European or “White”, cultural majority) adolescents. Government policies frequently state Māori health equity is a priority, yet this is seldom realised. We explore priorities for rangatahi M āori health by presenting indicators from a cross-sectional survey series and examining contrasting policy areas: tobacco control and healthcare access.

Methods: Cross-sectional representative surveys of Aotearoa New Zealand secondary school adolescents were undertaken in 2001, 2007, 2012 and 2019. Key adolescent health indicators are presented for Māori and Pākehā adolescents and two public health areas are explored.

Findings: Rangatahi Māori reported consistently high levels of self-reported general health, parental caring and feeling part of school from 2001–2019. There was a large decline in smoking at least monthly (27.9% in 2001, 95% CI’s 25.4-30.3; 6.7% in 2019, 95% CI’s 5.5-7.9), and substantive reductions in binge drinking and risky driving. However, there was little change in consistent contraception use, which remained low (51.8% in 2019), and there were concerning increases in depressive symptoms, experiences of racism, and forgone healthcare. Comparison between Māori and Pākehā revealed a pattern of consistent inequity for most indicators, in relative terms. Tobacco control efforts have been sustained and comprehensive and have incorporated Māori leadership, political will, Mātauranga Māori (Māori knowledge systems), and rangatahi (youth) Māori-specific …