Sunday, August 13, 2023

Mike Butler: Racism, Maori health link elusive

The Crown and the Waitangi Tribunal did not have evidence of a causative link between racism, colonialism, and Maori health, so did not want to talk about the issue, economist Ian Harrison found.

His paper titled Racism, colonialism, and Maori health: A review of the evidence, released recently, examines claims in the Waitangi Tribunal’s 2021 Hauora Report on Stage One of its Health Services and Outcomes Kaupapa Inquiry that a gap in life expectancy of seven years between Maori and non-Maori had not “meaningfully” changed over 20 years.

Harrison, who has worked at the Reserve Bank of New Zealand, the World Bank, the International Monetary Fund, and the Bank for International Settlements, concluded that there was “very little robust empirical evidence that racism contributes materially to the gap in life expectancy”.

“The main drivers are different smoking and obesity rates. Other behavioural differences such as higher risk taking (such as higher alcohol consumption rates) may also contribute,” he wrote.

Having faced this objection for decades, the de-colonisers countered by saying that “this is a superficial understanding and that the differences are driven by more fundamental causes such as differential access to resources, which are in turn are the result of colonialism”.

Harrison responded to that by writing that “this claim is never substantiated, and on the limited data on the issue it appears that resources are not really the issue. The gaps primarily come back to behaviour”.

This could be all you need to read about racism and Maori health, but there is more. Harrison puts an intellectual blowtorch to the dodgy rhetoric around New Zealand’s attempt at race-based affirmative action.

For instance, Harrison found that the Waitangi Tribunal’s 2021 Maori health report presents a “very different perspective” from its 2000 Napier hospital report. The tribunal appears blissfully unaware that it is contradicting itself.

The 2000 report “rejected the argument that different health outcomes were in themselves a breach of the treaty and emphasised the relevance of individual agency”, Harrison wrote, adding that “the treaty did not establish a permanent Maori entitlement to additional health service resources as distinct from that of New Zealanders as a whole”.

The Tribunal’s claim that there had been no discernible improvements in Maori health from 2000 to 2020 was simply false, Harrison wrote. “Between 2000 and 2017 Maori life expectancy increased by about three years and the gap to New Zealand European fell by around one a half years”.

Perhaps unsurprising was Harrison’s observation that “the Crown accepted without argument that colonialism had a negative impact on Maori health” because thinking people have come to expect uncritical acceptance of nonsense about Maori negative social indicators from government employees and departments.

Survey data shows that “experience of racism by Maori was not high (around 8 percent) and have been declining over time. About 4 percent claim to have experienced racism in the health system”, Harrison wrote.

By contrast, “Asians experienced the highest levels of self-reported racism but this seldom has an association with health outcomes”.

What is unfair and unjust? Harrison found that there is no searching discussion “of what unfair and unjust means in the health context”.

“Essentially the inequity claims often reduce to little more than an assertion that any disparity in Maori health outcomes is ‘unfair and unjust’”, he wrote.

Another serious lacking in the Tribunal/Ministry narrative “any serious effort to assess the ‘by Maori for Maori’ health management programme over the last 20 years,” Harrison wrote.

Whether it has worked is never questioned. Money continues to be poured into “by Maori for Maori” schemes without any noticeable turnaround in the claimed negative outcomes.

Reasons for lower Maori life expectance are analysed in Part five of the paper.

According to the stats, Asians in New Zealand live longer (85.1 years for men), are thinner (18.5 percent obesity) seldom smoke (3.2 percent) and drink less alcohol (six percent). Maori, at the other end of the spectrum after New Zealand Europeans and Pacific islanders, live shorter lives (73.4 years for men), are fatter (50.8 percent obesity), often smoke (19.2 percent) and drink more (33.1 percent). A table shows the alarming contrast.

A seldom considered fact is that there are many more, poorer European New Zealanders than anyone else. Stats show that they make up a 60.4 percent share of the lowest household income quintile, while Maori make up 16.7 percent.

Harrison’s review of 24 papers shows that “there is limited evidence that personal or institution racism has had a material impact on health outcomes”.

“The studies have only tested associations generally without any serious discussion on whether they reflect causation,” he wrote. “It is just asserted or implied that they do”.

“There were numerous cases where authors may have been influenced by conscious and unconscious bias in their summary discussions that do not match the data,” he wrote.

The New Zealand Medical Council runs the same narrative as the Waitangi Tribunal’s 2020 Te Ora report into health services and outcomes for Māori, “that systemic racism and privilege exists in the health sector”.

“All that the Medical Council has presented to justify their structural racism claim in substance was: A higher ASH (ambulatory sensitive hospitalisations) rate for Maori without any enquiry as to cause; ‘doctored’ evidence on death rates following operations; (and) a recitation of the standard life expectancy data without any enquiry as to cause,” Harrison wrote.

Harrison’s paper is important because so-called Maori negative social indicators continue to be used as the reason why taxpayers should continue to provide additional and arguably unnecessary revenue “for Maori”.

Harrison provides the specific statistics and references needed too cut through the bombast around Maori negative social indicators.

See Racism, colonialism, and Maori health: A review of the evidence, Tailrisk Economics


Erica said...

As was mentioned in Muriel Newman's interview m\, today on RCR
the factors influencing health are : 20% medical treatment
:40% SES: which includes employment , education and salary.
:10% housing
;30% lifestyle choices (diet , drinking ,exercise and smoking )
Affirmative action has been cancelled by the US. Those with a real concern for Maori health would be looking at addressing these real issues mentioned above.
What is being done now will do little to improve Maori health.

Kiwialan said...

Can't let facts and figures get in the way of an opportunity to get one's snout into the treaty trough. Kiwialan.

Kiwi Dave said...

So what resources are unavailable to Maoris which are available to other NZers? Since most NZers, including Maoris, live in towns, land lost long ago as a lost resource is an unlikely, or seriously incomplete, explanation, especially as much of the lost land was sold, rather than confiscated.

One part explanation for disparities in wealth, I don’t know how how important, is that for some time there was a big disparity in number of children per mother - around 1970, IIRC, Maori mothers had double the number of children of non-Maori mothers, which affects both the accumulation and transfer of family wealth and resources.

The current obsession with structural racism and its near invisible actions is similar to the Black Lives Matter movement in the US - they both deny people agency, point to superficially plausible but difficult to detect and measure chains of causation, while ignoring other more obvious and immediate causes.

Anonymous said...

I didn't need a review of the evidence to tell me the facts. Facts and logic are not part of the Maori racist and victim drive to obtain money.

Anonymous said...

So how is the likes of Claire Charters, Willie Jackson, Tuku Morgan, Nania Mahuta, John Tamihere, et al, all seem to have missed the bullet in terms of the systemic racism on the health front and, financially are also doing just fine thanks very much? But they all always just talk of 'poor Maori', who they use as fodder to feather their own very comfortable nests. Why is it they are different? Is it because they had role models and a work ethic instilled when they were young, or has colonialism left its fictional scar on them too?

Don said...

" The fault, dear Brutus, lies not within the stars but within ourselves."
It could be that some individual Polynesians lack self-control and are themselves responsible for over-eating, over-indulging and tempted by criminal activities. Hence the stats for these things are skewed and the blame is laid on colonisation. This leap in logic fits in nicely with politicians never-ending drive to attract more votes.