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Kia ora koutou, he mihi mahana ki a koutou.

My name is Dr. Peter Jansen and I’m going to talk to you about disparities in Māori health.

State of Māori health

In New Zealand, Māori people have the worst health inequality of any group. Māori die sooner, and are sicker than our Pākehā counter parts.

Even if you take account of things like poverty, we have more strokes; and we also have less access to clinically competent and culturally appropriate services. All of this has been studied at length. One summary from Ministry of Health report states that Māori spends a relatively greater proportion of their shorter lives disabled. Why is that?

We’ve got more illness than Pakeha and non-Māori, we’ve got more heart disease more diabetes’s more respiratory disease more cancer more everything and that’s in part because we have more modifiable risk factors. Things, like smoking and being overweight, are modifiable. We can do something about this. You and I can address this.

Māori are also more likely to live with lower incomes, have worse jobs, have less access to housing and less access to education. These are places where we can all make a difference.

A concerning issue is that Māori people have less access to health services that provide for their greatest needs. Māori people need health services that are clinically competent and culturally competent.

The assumptions of health practitioners

Why is it that Māori die sooner? We’ve talked about modifiable risk factors, but part of the reason is that once Māori end up in care or in front of their general practitioner or in front of a surgeon or another health professional, we know there is a difference in the healthcare that’s received.

A New Zealand study published in 2002 showed that Māori can be diagnosed at the same rate as non-Māori regarding depression but are much less likely to get effective treatment. So why is that? Why would it be that after taking the trouble to go and see their general practitioner and getting and effective diagnoses we end up with less treatment? Why do we get less effective treatment?

Essentially it boils down to the assumptions of the health practitioner. All of us do it, you and I do it when we see people, we assume things based on appearance, on ethnicity, on gender, on age on all sorts of things and then we act on them. The way to avoid that is to step back and say what does this person need?  Regarding their healthcare and then negotiate a good treatment plan with the person.

We also see from other sources of data such as ACC that Māori get less effective treatment, and that’s shown in the average cost per claim, apparently it’s cheaper to treat Māori. What that means is that Māori get less volume of treatment for the same type of claim, once again there is something going on in the mind of the treating health practitioner that said this person needs more, this person needs less based on their ethnic background. We want to address those things.

Call to Action

I want to remind you that a key objective of this online course is to equip you with some knowledge, skills and some tools to use with communities, with whānau, and with patients. We also want to support fellow health professionals so that Māori can get a fair deal. We know if you do well for Māori in New Zealand everybody wins.

No reira tēnā koutou.

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