Lecture 8 - Maori health (not full) Flashcards
Measuring Maori Health - why?
- To understand……
- Maori are a key……
- Inform….
- Monitor…..
- Asess impacts of……
- Responsibilities relating to the……
- Public Health &……
- Understand health needs, differences and priorities (of many pop groups esp Maori)
- Key population group (first ppl here)
- Inform policy, services, practice (particularly in health)
- Monitor over time (get trends and monitor health status)
- Assess impacts of interventions (within health context)
- Responsibilities relating to the Treaty of Waitangi
- Public Health and Disability Act 2000 – needs of populations, reducing health disparities (particular mentions and obligations that’s legally requires to measure and monitor needs of esp Maori)
Ethnicity……
No fixed one factor about being classed in ethnicity
What can you say about the number of Maori?
Number of Maori continued to increase in last 25 years as number and percentage of population (also, some people descended from Maori but didn’t identify with Maori ethnicity)
What can you say about the age structures of Maori and European?
Maori have a much younger population
25% of all children in NZ, 30% of all babies born so it’s a diverse and growing population
Challenges for Maori health data collection and analysis
5 points
- Definitions.
- Often analysis of routine data.
- Reliance on collection of ethnicity data (including consistent method of collection). e.g. census and needs to be same questions and must be collected to monitor Maori Health over time
- Compare data from different sources? Need data to be consistent if wanna compare
- Research studies and surveys – often constrained by sample sizes (produce limitations about how much we can use info and what we can derive from that info)
Maori Heath Status - Summary
- What kind of mortality?
- Disparities with non maori but what three kind?
- SES is a key factor but doesn’t……
- Diff patterns means…..
• High and premature mortality.
• Disparities with non-Māori
– All age groups.
– Male and female.
– Most conditions.
- SES is a key factor but does not explain/ account for all of the difference.
- Different patterns mean different priorities (of health. This means very different approaches are required i.e. same solution won’t work in total population - need focusses initiatives
Determinants of Maori Health
• Decades of Disparity III
– Within each socio-economic group, Māori mortality
is higher.
– Differences in SES between Māori and non-Māori account for just under half of all mortality differences.
• Other factors influence these differences too.
Defining health and Maori health
- Maori - perspectives on health based on……
- More than…..
- Also related to….. - Various Maori health models include this approach
- Te…..
- Te…..
• Māori perspectives on health based on a wellness or holistic model:
– More than physical or biological aspects.
– Also related to emotional and spiritual factors.
• Various Māori health models include this approach:
– Te Whare Tapa Whā
– Te Wheke
Te Whare Tapa Whā
What are the four walls and the floor?
Spiritual, mental + emotional, social and physical
Floor = Whenua
This model is Maori model of health (not health model for Maori) so transferable
Approaches to Maori Health
6 points
- POLICIES & STRATEGIES
• Commitment to Treaty.
• Improving Māori health and
reducing inequaliMes.
• “Māori have…the poorest health status of any ethnic group in NZ. This is not acceptable.”
• “To create a policy framework for a new method of government interacMon with Māori service providers and improve the responsiveness of social services to Māori through promoMng whānau-centred service delivery.” - MĀORI HEALTH PROVIDERS
• Over 240 Māori health providers.
• Deliver health and disability services using
Māori concepts and frameworks.
• Not just for Māori but are used by predominantly Māori. - HEALTH SECTOR INTERFACE WITH TIKANGA MĀORI
- INCREASING ACCESS TO SERVICES
- Access is a huge barrier so they’ve now got mobile dental buses that go to remote areas - MĀORI REPRESENTATION IN HEALTH GOVERNANCE STRUCTURES
- MĀORI HEALTH WORKFORCE DEVELOPMENT
e. g. scholarships for Maori health researches
Conclusions
• Epidemiology is…….
• ______ of Māori population is important.
• ______ and _____ ______ data is imperative.
• ______ across many health indicators.
• Many and varied ______ – SES is
important but does not explain all.
• A range of ______ exist and are required.
Conclusions
• Epidemiology is an important tool.
• Demography of Māori population is important.
• Quality and consistently collected data is imperaMve.
• Inequities across many health indicators.
• Many and varied determinants – SES is
important but does not explain all.
• A range of approaches exist and are required.
Why is it important to consider Māori health?
The Treaty of Waitangi is the foundation document for New Zealand society. As applied to health, one of the core Treaty principles is to ensure that Māori have at least the same level of health as non-M ori, while safeguarding M ori cultural concepts, values, and practices.
As a group, Māori commonly experience worse health outcomes compared to people who identify as NZ European. Many of the causes/risk factors influencing the experience of inequalities in health outcomes by Māori are modifiable, and if appropriate interventions are developed and implemented, these may result in the closing of the gap between Māori and NZ European health outcomes. This will result in an increase in the overall level of health for Māori people.
What are some of the difficulties when measuring Māori health?
Defining and classifying who is of Māori ethnicity is an ongoing problem with measuring Māori health. The denominator currently used for Māori relies on Census data. However, there are problems with the accuracy and consistency in the collection of ethnicity data by health agencies (information that is used in the numerator). For epidemiological measures of occurrence of Māori health to be valid, the numerator and denominator must use the same definition for Māori ethnicity. (The numerator always has to be a subset of the denominator. If you use a different definition of Māori in the numerator, you are likely to include people in the numerator as Māori who would not be included in the denominator.)
Describe the relationship between socio-economic status and Māori health.
Māori are disproportionately represented in the lower socio-economic groups, and lower socioeconomic groups tend to have poorer health outcomes in comparison to higher socioeconomic groups. To complicate this picture further, across all socioeconomic groups poorer health outcomes exist for Māori in comparison to other ethnic groups (except those of Pacific ethnicity). Socioeconomic differences between Māori and non-Māori account for just under half of the mortality differences between these two groups.
