Lecture 2: Maori Health and Health promotion models Flashcards
what are determinants of health?
factors that promote and protect health or cause ill health
- environmental
- socioeconomic
- health services
- persona;/whanau factors (genetic and health practices)
- policy/politics
- social - identity, racism, ableism, sexism and other ‘isms’
explain Dahlgren and Whiteheads model
social determinants of health model
holds age, sex and constitutional factors in the middle but surrounding this includes individuals life style factors, social and community networks and general socioeconomic, cutural and environmental conditions (agriculture and food production, education, work environment, living and working conditions, unemployment, water and sanitation, health care services and housing)
- encourages to look beyond individual factors
explain the ethnic determinants of health model
- Health outcomes such as morbidity, mortality, disability mental health and well-being are driven by body responses to surface causes of illness and disease
- The suurface causes are health services, societal resources, SES, stress, social transmission
- Surface causes are influenced by social status which includes:
SES, Ethnicity, Gender, age, marital status, sexual identity, poor health status etc - Social status in influenced by basic causes which are:
Environments, Racism/privilege, Unequal treatment by societal institutions, Worldview - Social status influenced by colonisation
Europeans believed the way they lived was superior, particularly to people of color. We can see the effects of colonisation even today.
what are the Maori health models?
- Whare tapa wha
- Waka Hourua
- Te Wheke
- Te Pae Mahutonga
What is the Whare tapa wha model?
Mason Durie created it
- 4 sides of the house are components of health and well-being
the 4 components are:
- Taha wairua (spiritual)
- Taha Hinengaro (mental and emotional)
- Taha Tinana (physical)
- Taha Whanau (family and social)
what are the limitations of te Whare tapa wha model?
- whenua is added later
- is missing many components for public health, good health and well-being
explain the meihana model
- meihana model consists of 2 waka haurua which is the importance of the patient and whanau. the health practitioner is a kaupapa whanau member.
- it is important to know ethnicity data of the patient
- whanau acts as a support network, whakapapa and kaupapa whanau
- what connects the two waka (patient and whanau) is tinana, hinengaro, iwi katoa, wairua and taiao.
- wairua refers to mental well-being
- tinana refers to physical
- taiao refers to physical environment and patient service
- iwi katoa refers to services and systems which support the patient/whanau in the health journey
There are then 4 winds which impact the journey of waka to hauora (well-being)
- colonisation
- racism
- migration
- marginalisation
Then there are the ‘currents’ which are components from te Ao Maori which influences Maori patients and whanau
- Ahua - personal indicators of te Ao Maori that are important to patient and whanau
- Tikanga - ways of doing things
- Whanau
- Whenua - land
explain the Te Wheke Rose Pere model
made up of ‘Te Wheke’ which is an octopus.
The head, eyes and each tenticle all have a significant meaning.
Waiora
- the eyes of the sybolic family unit will reflect total well-being
Te Whanau
- the body and head represent the individual whanau unit
Wairuatanga
- the creator is a powerful influence and the uniqueness of being Maori is sustained through this belief
Mana Ake
- awareness of heredity from forebearers
Mauri
- an appreciation of the mauri of individuals, whanau and every whanau within a community
Ha a koro mana kui ma
- links with the heritage passed down by our forebearers
Taha tinana
- specific physical, material, emotional and social needs related to physical survival
Whanaungatanga
- the principle of emotional development in all ages
Whatumanawa
- an understanding of emotional development in all ages
Hinengaro
- learning that arouses, stimulates and uplifts is important
what is the limitations of the Te Wheke model?
- te ao turoa is missing
- not explicit about many of the social determinants of health, colonisation, racism etc
explain the health promotion model
Te Pae Mahutonga
- it brings together elements of modern health promotion
- the four central starts represent four key tasks of health promotion: Mauriora - cultural idenity, Waiora - physical environment, Toiora - healthy lifestyles and Te Oranga - participation in society
- the two pointers represent Nga Manukura - community leadership and Te mana whakahaera - autonomy
what is the Ottawa Charter?
framework for health promotion
five action areas for health promotion were identified in the charter:
- building healthy public policy
- creating supportive environments
- strengthening community action
- developing personal skills
- re-orienting health care services toward prevention of illness and promotion of health
what are risk and protective factors?
- are factors which increase the risk of adverse outcomes or lowers the likelihood of a good outcome (or is associated with better outcomes which are protective factors)
- can be the presence of a factor e.g. smoking, speeding, obesity or the absence/reduced level of a factor which promotes good outcomes e.g. physical activity
what to include when talking about risk or protective factors?
- define or describe the factor
- why is it important for Maori and non-Maori?
health outcomes
social outcomes
societal outcomes - Epidemiology of the factor and associated adverse outcomes by ethnicty
- What can be done to reduce the adverse impacts
reduce the use/impact/reach of negative risk factors
increase the use/impact/reach of positive factors
use a framework to structure these
consider Maori and kaupapa maori approaches - Any other issues/points that are relevant?
what to include when talking about a disease, illness or condition?
- what is the disease, illness or condition
definition, description
epidemiology by ethnicty, equity, inequities
aetiology - Why is it important?
impacts on patients, whanau, community, society
by ethnicity, equity, inequities - What is known about outcomes by ethnicity, equity, inequities in:
prevention
screening
treatment
