July 01, 2024
The death of Maori health aspirations came like a thief in the night
Posted On July 1, 2024
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Today, it represents the forced demise of an initiative more than a century in the making – The Māori Health Authority.
Health disparities between the Māori and non-Māori populations in New Zealand are both stark and persistent. These disparities are rooted in historical injustices, socio-economic inequalities, and systemic biases within the healthcare system. Addressing them requires a comprehensive approach that acknowledges the unique cultural, social, and economic challenges faced by the Māori people.
The Treaty of Waitangi, signed in 1840, promised to protect Māori interests and ensure equitable outcomes. However, colonial policies and practices led to significant land dispossession, cultural dislocation, and socio-economic marginalization. These historical injustices have had long-term impacts on Māori health and well-being.
Socio-economic factors such as income inequality, unemployment, poor housing conditions, and limited access to education significantly contribute to health disparities. Māori are overrepresented in low-income brackets and are more likely to live in overcrowded and substandard housing. These conditions contribute to higher rates of infectious diseases, chronic illnesses, and mental health issues.
Systemic bias within the healthcare system further exacerbates health disparities. Māori patients often face discrimination and receive lower quality care compared to non-Māori. Studies have shown that Māori are less likely to be referred for specialist care, receive fewer diagnostic tests, and are prescribed fewer medications for chronic conditions.
Cultural misunderstandings and a lack of culturally competent care can also lead to poorer health outcomes. Many healthcare providers lack an understanding of Māori health beliefs and practices, which can result in miscommunication and mistrust. This cultural disconnect can deter Māori from seeking medical care and adhering to treatment plans.
Racism, both overt and institutional, plays a critical role in perpetuating health disparities. Māori frequently encounter racism in healthcare settings, which can lead to feelings of alienation and reluctance to seek medical help. Discriminatory policies and practices within the healthcare system, such as inadequate funding for Māori health services, further entrench these disparities.
There has always needed to be pathways to equity
Addressing Māori health disparities requires a multifaceted approach that includes:
Empowering Māori Communities: Strengthening Māori leadership and self-determination in health decision-making is crucial. This involves supporting Māori-led health organizations and initiatives that prioritize culturally appropriate care and community engagement.
Cultural Competency Training: Healthcare providers must receive comprehensive training in cultural competency to better understand and respect Māori health beliefs and practices. This can improve patient-provider relationships and lead to more effective and respectful care.
Addressing Socio-Economic Inequities: Policies aimed at reducing poverty, improving housing conditions, and increasing educational and employment opportunities for Māori are essential. Addressing these root causes can lead to significant improvements in health outcomes.
Combating Racism: Efforts to eliminate racism and discrimination within the healthcare system must be prioritized. This includes implementing anti-racist policies, increasing diversity among healthcare providers, and fostering an inclusive and equitable healthcare environment.
Improving Data Collection and Research: Enhanced data collection and research on Māori health can provide valuable insights into the specific needs and challenges faced by Māori communities. This information is vital for developing targeted interventions and measuring progress.
The aspiration of a Māori Health Authority was designed to enable these things and instead it became a political football of the right of politics in what I would call to be as a descent in madness – and yet those health disparities I talk of continue; in fact it’s hard to find one that doesn’t remain so – Māori cancer rates, diabetes, cardio-vascular disease, liver and kidney health – child immunisation rates. Suicide rates and mental health – the list is as long as it is exhaustive. The health disparities between Māori and non-Māori in New Zealand are a profound injustice that reflects broader social and economic inequities. Addressing these disparities requires a commitment to equity, cultural competence, and systemic change. By prioritizing Māori health and well-being, New Zealand can move towards a more just and equitable society where all individuals have the opportunity to thrive.
No model is perfect – models in and of themselves take time to embed and take hold. The Māori Health Authority is that example – but its also wrong to throw the baby out with the bath water – at the end of the day all we are doing is kicking the can down the road and as a result all we are doing is prolonging a highly preventative disease.
Radio Waatea and its board would like to advise that the opinions expressed in this article are those of Matthew Tukaki and not necessarily the views of Radio Waatea, its Management or its Board. Matthew is also the former Chairman of Suicide Prevention Australia and Director of the New Zealand Governments National Suicide Prevention Office. Matthew was also Chair of Australia’s National Suicide Prevention Coalition.