ISSN 1178-6191

Maori Health Review

Making Education Easy Issue 102 – 2023

Maori Health Review
Maori Health Review

Breaking the inequity loop

Authors: Gurney J & Koea J

Summary: The best way to improve Māori health is to support Māori to lead and drive improvements themselves, according to an analysis from public health experts. The experts apply key lessons from history to the current state of Māori population health, noting that more Māori are needed across all aspects of the health system. They reiterate that equity should be framed as equitable health outcomes, not simply equal sharing of resources. Government policy must accommodate tino rangatiratanga and allow Māori the resources and time to address health challenges, including supporting the Te Aka Whai Ora (the Māori Health Authority).

Comment: Two excellent things here. First, the new platform for communicating important public health messages (www.phcc.org.nz). The second, this excellent piece and the call for action by its authors. Check them both out.

Reference: PHCC. 2023;28 Feb.

Abstract

Determinants of ethnic differences in the uptake of child healthcare services in New Zealand

Authors: Lewycka S et al.

Summary: The strongest drivers of lower rates of timely first-year immunisations and lower general practitioner (GP) satisfaction among Māori compared with NZ Europeans are household composition and household income, according to a Growing Up in New Zealand birth cohort study. The study included 6822 mothers of children born between 2009 and 2010, and used decomposition analysis to assess the drivers behind ethnic differences in uptake of child healthcare services. Despite high intentions to immunise, Māori had lower timeliness of first-year vaccines than NZ Europeans in multivariate models, and were less likely to be satisfied with their GP at 2 years. Addressing healthcare disparities will require interventions specifically tailored to Māori, the study authors concluded, as well as addressing underlying social determinants and structural racism

Comment: There are also ethnic and other inequities in uptake of healthcare at the other end of childhood – rangatahi. It would seem that getting it right at the start may have long-term benefits. Just another plug then for the Best Start Kōwae for māmā and pepi (www.gen2040.co.nz/health-providers).

Reference: Int J Equity Health. 2023;22(1):13.

Abstract

Te maramataka - an indigenous system of attuning with the environment, and its role in modern health and well-being

Authors: Warbrick I et al.

Summary: A conceptual paper has highlighted an indigenous way of understanding the environment, te maramataka, and its connection to health. The paper discusses connections between te maramataka and scientific research on health and the environment, and introduces current and potential applications of te maramataka in improving health and wellbeing. The authors argue that aspirations of good health and wellbeing will not be achieved for Māori unless there is a (re)connection to the natural cycles and rhythms of the environment.

Reference: Int J Environ Res Public Health. 2023;20(3):2739

Abstract

Indigenous knowledge and the microbiome - bridging the disconnect between colonized places, peoples, and the unseen influences that shape our health and well-being

Authors: Warbrick I et al.

Summary: Increasing cross-talk between Indigenous and non-Indigenous scientists and knowledge holders will ensure that the study of the microbiome and its role in improving health has greater reach and more equitable effects. This was the conclusion of a recent paper from Māori health researchers. The paper explores an Indigenous perspective of the microbiome as an unseen influence on health and wellbeing by framing the importance of the natural environment, Indigenous knowledge and leadership, and future research directions that can contribute to this domain. It is intended that the concepts discussed can relate to Indigenous peoples globally.

Comment: Love these two papers – uplifting, great to have the key concepts described like this and see mātauranga Māori being given the mana it deserves. Maybe I should send them to Richard Dawkins, ha ha!

Reference: mSystems. 2023;8(1):e0087522.

Abstract

Ethnic differences in stroke outcomes in Aotearoa New Zealand

Authors: Denison H et al.

Summary: A national cohort study has shown that Māori are more likely to have unfavourable outcomes following stroke than NZ Europeans, after adjusting for traditional risk factors (baseline characteristics, socioeconomic deprivation and stroke characteristics). The study included 5394 NZ Europeans, 762 Māori, 369 Pasifika peoples and 354 Asians who were admitted to hospital with a first stroke between November 2017 and October 2018. The odds of an unfavourable outcome (death, change in residence, or unemployment if working pre-stroke) and of death was increased in Māori vs NZ Europeans at all time points, as was the odds of unemployment at 12 months. There was also evidence of ethnic differences in post-stroke secondary prevention medication. The study authors noted that their findings raise concerns of unconscious bias and institutional racism in stroke services.

Comment: Just to remind us that, although there are inequities in the wider determinants and exposure to them by ethnicity, quality of care within the health system plays an important role, as demonstrated here for people with stroke in Aotearoa.

Reference: Int J Stroke. 2023:17474930231164024.

Abstract

Maori Health Review