Diabetes continues to have a devastating impact on Māori communities across Aotearoa, but one Northland health provider is demonstrating that culturally grounded, whānau-centred care can make a real difference.
Speaking on Radio Waatea, Dr Mataroria Lyndon, Medical Advisor for Ngāti Hine Health Trust, outlined the Trust’s work to improve health outcomes by combining clinical expertise with kaupapa Māori approaches to health and wellbeing.
The Trust has become a leader in tackling diabetes in Te Tai Tokerau through prevention programmes, education initiatives and workforce development, recognising that reversing the growing burden of diabetes requires far more than simply prescribing medication.
A Growing Health Challenge
Diabetes remains one of New Zealand’s most significant public health issues, with Māori developing Type 2 diabetes at younger ages and experiencing higher rates of serious complications than non-Māori.
The condition contributes to increased rates of kidney disease, heart disease, stroke, vision loss and lower limb amputations, placing enormous pressure on individuals, whānau and the health system.
Dr Lyndon says improving outcomes requires earlier diagnosis, better education and long-term support delivered in ways that reflect Māori values and lived experiences.
Rather than focusing solely on treating illness once it develops, Ngāti Hine Health Trust has invested heavily in prevention, community engagement and ensuring frontline healthcare workers have the skills needed to identify problems before they become life-threatening.
Building a Skilled Māori Health Workforce
One of the Trust’s major initiatives has been training healthcare workers in diabetic foot assessment and care.
Foot complications remain one of the most preventable yet serious consequences of diabetes, often leading to infection, hospitalisation and amputation when not detected early.
By strengthening the capability of local clinicians and community health workers, the Trust hopes to reduce avoidable complications while keeping care closer to home.
This workforce development also supports broader efforts to build Māori-led health services capable of responding to the unique needs of local communities.
Whānau-Centred Care
Central to the Trust’s approach is the belief that health cannot be separated from whānau, culture and community.
Rather than treating diabetes as an isolated medical condition, kaupapa Māori services consider the wider factors influencing health, including housing, nutrition, financial pressures, mental wellbeing, connection to culture and support networks.
This reflects Te Whare Tapa Whā, the Māori model of health developed by Sir Mason Durie, which recognises that wellbeing depends on balance across four interconnected dimensions: physical health, mental and emotional wellbeing, spiritual wellbeing and whānau relationships.
Many kaupapa Māori providers also incorporate services such as mirimiri, rongoā Māori, health coaching and community-based support alongside conventional medical care to improve engagement and long-term outcomes.
Closing the Equity Gap
Despite ongoing efforts, Māori continue to experience significant health inequities across almost every major health indicator.
Current Ministry of Health data shows Māori life expectancy remains around six years lower than that of non-Māori, with diabetes, cardiovascular disease and respiratory illness among the major contributors to that gap.
Government health strategies increasingly emphasise Pae Ora – Healthy Futures, aiming to improve health outcomes across every stage of life, from maternal health through to care for kaumātua.
Health leaders say achieving equity will require sustained investment in Māori providers that understand local communities and deliver services grounded in tikanga and whanaungatanga.
Access to the Right Medicines
Access to diabetes medicines has also become an important part of the national conversation.
Recent changes expanding funded access to newer diabetes medications have been welcomed by many clinicians, particularly where Māori and Pacific patients carry a disproportionate burden of disease.
Specialists have argued that prioritising medicines for Māori and Pacific communities is based on clinical need rather than ethnicity alone, reflecting the significantly higher rates of diabetes complications experienced by those populations.
Evidence and Equity
The wider discussion about Māori health continues to include debate over how evidence-based medicine and mātauranga Māori work together within the health system.
A recently published article in the Journal of the New Zealand College of Clinical Psychologists argues that changes to psychology and health regulation should continue to be grounded in robust scientific evidence while carefully evaluating proposed reforms. The paper discusses ongoing debate around evidence, cultural competence and the role of mātauranga Māori in health professions.
For Dr Lyndon and Ngāti Hine Health Trust, however, the immediate priority remains ensuring whānau receive timely, culturally safe care that helps prevent diabetes before complications arise.
As diabetes rates continue to climb across Aotearoa, Māori health providers say the greatest gains will come from combining clinical excellence with strong relationships, local leadership and services that place whānau at the centre of every decision.
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