Lecture 19 Maori health 1

Question 1

Describe Maori health status using life expectancy

Answer 1

Life expectancy difference between 7 and 8 years for Maori vs non Maori

Question 2

Describe Maori health status using general patterns in mortality & major causes of death

Answer 2

Maori have premature mortality rate, with higher numbers of youth in the population. Major causes of death is Circulatory system diseases, Cancer, Accidents, Respiratory, Diabetes and Suicide.

Question 3

Describe Maori health status using general patterns in morbidity:

Trends in CVD epidemic and suicide

Answer 3

While the CVD epidemic is waning and Cancer is increasing.

Youth suicide higher in Maori whereas adult suicide higher in non Maori.

Question 4

Where are the examples of disparities seen in Maori Health

Answer 4

Unequal access to SDH, Higher mortality rates for all non elderly ages.
Maori over represented in more deprived quintiles
Less interaction with health services and
participation in the health workforce.
Higher death rates for all causes: NCDs, CDs and injury.

Question 5

What are the trends in Maori health relating to SES

Answer 5

Maori are over represented in more deprived communities that have poorer health outcomes. Also within each decile, Maori have systemic disparity.

Question 6

What are the 3 determinants of Ethnic inequalities in Health

Answer 6

1. Differential access to health determinants or
   exposures leading to differences in disease
   incidence
2. Differential access to health care
3. Differences in quality of care received

Question 7

What are the two drivers of the ethnic inequalities of health

Answer 7

Structural contribution: relating to the organisation of resources and opportunities in NZ society by ethnicity.
Societal contribution: the values, assumptions and beliefs about the deservedness of different populations

Question 8

What were the main historical events behind these factors

Answer 8

Colonisation, Declaration of independence, land confiscation and Treaty of Waitangi- heralding an era of depopulation, disease and dispossession

Question 9

What are the main articles of the Treaty of Waitangi that relate to some inequities for Maori

Answer 9

Aritcle 1: construction of the state sector, who got to vote- disregard for Maori voice and authority
Art 2: Gave Maori sovereignty over their own lands -> not followed
Art 3: Different/ denied citizenship

Question 10

Why is the Maori text increasingly recognised?

Answer 10

More Hapu signed the Maori text and those who signed it fully knew what they were agreeing to. International legal principle gives it preference.

Question 11

What beliefs did Colonisation bring that still persist today

Answer 11

Colonists harboured

• assumption of inferior and superior peoples
• religious (papal bull), economic and scientific “civilisation”
• deserving and undeserving

Question 12

Define the type of intervention used to target structural issues

Answer 12

Leveling intervention: levels opportunity and risk, removing structural barriers: not privileging- escalator for 3rd class

Question 13

Define the type of intervention used to target societal issues (social intervention)

Answer 13

A rights based approach aimed at changing social understanding (not individual behaviours)

Question 14

What was 2 things from treaty implication that led to Maori land being sold/ confiscated

Answer 14

Pre-emption clause of the ToW, had to sell land to the Crown and this is the historical basis of settler wealth.
Through the Maori Land Court in the 1860s land had to be held in individual titles which made it easier for Pakeha to buy Maori Land

Question 15

What is are the 5 main effects of Land alienation for Maori

Answer 15

• Social disruption of community
• Breakdown of political power and alliances
• Economic resource depletion and poverty
• Resentment by indigenous peoples
• Associated with greater infant mortality: low child: woman

Question 16

What two things that contributed to different or denied citizenship - Art 3

Answer 16

• Old Age pensions 1898-

-Social Security Act 1938
Underpayment of Social security continued until after WW1

Question 17

Whats the main message

Answer 17

things were done differently for Maori - rights to land, citizenship and this has lead to different outcomes in poverty, exclusion. And these different levels were accepted

Question 18

Describe the bad things about the Old Age Pensions in 1898

Answer 18

had equal provisions for Maori and Pakeha (no asian) but Maori access was difficult- had to register thru Maori Land Court.
Maori were regularly removed from rolls and a reduced amount paid.

Question 19

What are the effects of inferior citizenship

Answer 19

• Entrenchment of poverty, dependency
• Increased barriers to development
• Acceptance of inequity by colonists
• Resentment+ anger among Maori
• Social breakdown, crime, high risk behaviours

Question 20

What was the big misunderstanding from the treaty

Answer 20

The Maori thought they were keeping sovereignty while British thought they were ceding it to them. Then europeans who hadn’t depended on Maori just disregarded their right to land just came and took their land.