Taueetia-Su'a, TBrewer, KMAmeratunga, SHanchard, SSelak, VDicker, BRahiri, JLGrey, CHarwood, M2026-01-072026-01-072025-12-18Australian and New Zealand Journal of Public Health, ISSN: 1326-0200 (Print); 1753-6405 (Online), Elsevier BV, 50(1), 100303-. doi: 10.1016/j.anzjph.2025.1003031326-02001753-6405http://hdl.handle.net/10292/20452Objective: We explored service providers’ views on evidence–practice gaps and inequities in heart health care for Māori and Pacific peoples, alongside solutions to address these issues. Methods: Employing Kaupapa Māori and Pacific research methodologies, we recruited Māori, Pacific, and non-Māori/Pacific providers, purposively sampled from a range of disciplines. Semi-structured interviews were conducted individually and in focus groups. Differences in perspectives offered by Māori and Pacific providers are compared to those of non-Māori/Pacific providers. Results: Twenty-three providers, identifying as Māori (6), Pacific (5), or non-Māori/Pacific (12), shared their views of the healthcare system, experiences of providing care, and observations of Māori and Pacific patient and whānau experiences. Results were grouped into three themes: Tikanga Māori and Fa'a Pasifika versus non-Māori/Pacific ways; gaps in the health system for Māori and Pacific patients; and solutions. Māori and Pacific providers emphasised structural determinants, systemic failures and workforce inadequacies underlying inequities. Conclusions: There is a critical need for equity-focused, holistic and relational models of heart health care that are co-designed with Māori and Pacific patients and whānau, and delivered by a culturally safe workforce. Implications for Public Health: Adequately resourced services, designed by and for Māori and Pacific peoples, have the potential to achieve equitable heart health care outcomes.© 2025 The Authors. Published by Elsevier B.V. on behalf of Public Health Association of Australia. This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.Indigenous healthMāoriPacificcardiovascularheartqualitative4203 Health Services and Systems4206 Public Health42 Health SciencesClinical ResearchSocial Determinants of HealthHealth Services8.1 Organisation and delivery of servicesGeneric health relevance3 Good Health and Well Being1117 Public Health and Health Services1402 Applied Economics1605 Policy and AdministrationPublic Health4202 Epidemiology4203 Health services and systems4206 Public healthJournal ArticleOpenAccess10.1016/j.anzjph.2025.100303