Lecture 33: Maori health global

Question 1

What leverage can we draw on to fix systemic disparities for Maori?

Answer 1

The Right to Health

Question 2

What are the two major rights based instruments relevant to Maori Health

Answer 2

Universal Declaration of Human rights (1948-UN Gen assemb). International Covenant on Economic, Social and Cultural rights (1966-UN)

Question 3

What the features of Universal Declaration of Human Rights (1948) UDHR

Answer 3

This contextualised the determinants of health as important for health outcomes and acknowledged that health included and transcended medical care (security, living standards)

Question 4

What are the features of the international covenant on economic, social and cultural rights

Answer 4

Art 12 explicitly states “right to health”. Gives an expectation that governments should be prioritising and promoting the right to health for their nation. This is progressive, to the best of ability going to the highest attainable health standard.

Question 5

What is the difference between the Right to Health and the Right to be Healthy and where is this clarified

Answer 5

The Right to Health is more related to population based approach of human rights and equity, itemising freedoms and entitlements to, giving obligations to the state, but the state cannot guarantee the individual health of the individual because it is still affected by other factors not controlled by state. Clarified in ICESCR, 2000, comment 14

Question 6

What are the 3 obligations of the state with relation to the Right to Health of citizens

Answer 6

Respect (no discrimination)
Protect (no interference from 3rd parties)
Fulfil (adopt measures to achieve equity)

Question 7

What are the two ways to classify Maori and which is used in Health statistics

Answer 7

By descendance: census and by ethnicity: used for health statistic

Question 8

Maori health is exemplified by systemic disparities in 4 things

Answer 8

Health outcomes
Exposure to the determinants of Health,
Health system responsiveness and
Representation in the health workforce

Question 9

What are the 3 determinants of Ethnic inequalities in Health

Answer 9

Differential access to health care received, differential exposure to the determinants of health and differential quality of care received

Question 10

What is the Right to Health actually mean

Answer 10

The right to the enjoyment of the highest attainable standard of physical and mental health available in a community

Question 11

What are the two ways that R2H relates to human rights law framework

Answer 11

1. The inequities are results of laws/policies that distribute opportunities in a discriminatory manner and limit full participation
2. Health is acknowledged as political and health policy as having a legal dimension rather than being at pure political discretion.

Question 12

Give one example of an intervention that employs the R2H approach

Answer 12

Tobacco regulation

Question 13

Why does the R2H target anti discrimination and what is the States obligation in relation to this

Answer 13

Even if not intentional discrimination causes impairment of enjoyment of rights - violation to R2H so State has moral nad legal obligation to prohibit, eliminate and act affirmatively anti discrimination.

Question 14

As R2H is generally implemented at a national level, what is a national framework for R2H in NZ that has 10 rights.

Answer 14

The code of Health and Disability Service Consumers Rights

• 10 rights: freedom from discrimination, services of appropriate standard
• aligns with Human Rights act, NZ public Health and Disability Act although R2H no explicit
• Part of a response to ethical issues in health service research

Question 15

What is a NZ R2H related act that relates to Maori

Answer 15

NZ Public Health and Disability Act

• Main purpose to foster community participation in health system
• reducing inequalities
• Treaty of Waitangi clause that no one will have special privileges based on race

Question 16

How is the Treaty of Waitangi help Maori Health - mostly as a platform to talk about the R2H and

Answer 16

Affirms indigenous rights as does Declaration of Independence.

• Good governance
• Active protection of taonga : health
• Ngati porou claim : inequities as a breach of the Treaty.

Question 17

What is an international R2H framework that is just specifically for Indigenous peoples

Answer 17

UN declaration on Rights of Indigenous Peoples:

Mainly acknowledges that indigenous peoples rights not fully realised seeks to amend this.

Question 18

What are the 5 key aspects of R2H

Answer 18

An inclusive right 
Contains freedoms 
Contains entitlements
Non discrimination is a key principle
Services/goods/ facilities must be available, accessible, acceptable and of good quality.