Supporters of the Maori Health Authority or Te Aka Whai Ora say that we must have a separate agency to ensure Maori have equitable health outcomes and because the previous public health system was systematically racist.
There is actually no evidence of “systematic racism” although the statistic regularly quoted to support it involves life expectancy.
The most recent calculation of Maori life expectancy at birth, according to the Stats NZ Infoshare data base, is that Maori die seven years before non-Maori.
Numerous medical professionals, economists and researchers have pointed out that health outcomes are more often related to lifestyle, living arrangements and income than ethnicity.
Even the Waitangi Tribunal in 2001 alluded to similar ideas with this comment in its Wai 692 report on Napier Hospital: “For many Ahuriri Maori, the health outcomes remain poor. A significant proportion of the ill health suffered by Ahuriri Maori was preventable but was not prevented.”
The same report went on to say “we conclude therefore that while the Treaty did create an enduring right to transitional protection against particular adverse effects, it did not establish a permanent Maori entitlement to additional health service resources as district from that of New Zealanders as a whole.”
The Waitangi Tribunal, under Judge Wilson Isaac, was therefore saying 22 years ago that there was no obligation for the Crown to establish a separate health authority for Maori.
But attitudes have changed - radically. So have health outcomes for Maori.
Let’s return to Infoshare.
The life expectancy for a Maori male increased from 66.6 in 1996 to 73.4 in 2018, which is the most recent year for which numbers are available. That’s an extra 6.8 years of life, an improvement of just over 10 percent.
In the same time non-Maori men have increased their life expectancy from 75.4 in 1996 to 80.9 in 2018. That’s just over 7 percent.
So the increase in life expectancy is faster for Maori than for non-Maori.
For women the numbers tell a similar story. The life expectancy for a Maori woman increased 6 years or over 8 percent between 1996 and 2018.
For non-Maori women the rate of increase was 4.7 percent or just under 4 years.
Now let’s consider the country’s death rates. As I reported yesterday the general population is dying at the fastest rate in a quarter of a century. In the year to June 30 this year we died at a rate of 7.43 per 1000 of population.
But the Maori death rate was much lower at 5.35.
Five years ago the numbers were 6.91 for the population as a whole but only 4.9 for Maori and all the way back to a decade ago, the 2013 figures were 6.78 and 4.18.
So I don’t get this. We are told that we need at great expense a separate Māori Health Authority to improve Maori health outcomes.
Yet we have Maori life expectancy increasing at a faster rate than non-Maori, and Maori dying at much slower rate than the population at large.
Am I missing something?
Those numbers suggest the National and Act Party’s policy to disestablish Te Aka Whai Ora is sound and evidence based.
Peter Williams was a writer and broadcaster for half a century. Now watching from the sidelines. Peter blogs regularly on Peter’s Substack where this article was sourced.
Numerous medical professionals, economists and researchers have pointed out that health outcomes are more often related to lifestyle, living arrangements and income than ethnicity.
Even the Waitangi Tribunal in 2001 alluded to similar ideas with this comment in its Wai 692 report on Napier Hospital: “For many Ahuriri Maori, the health outcomes remain poor. A significant proportion of the ill health suffered by Ahuriri Maori was preventable but was not prevented.”
The same report went on to say “we conclude therefore that while the Treaty did create an enduring right to transitional protection against particular adverse effects, it did not establish a permanent Maori entitlement to additional health service resources as district from that of New Zealanders as a whole.”
The Waitangi Tribunal, under Judge Wilson Isaac, was therefore saying 22 years ago that there was no obligation for the Crown to establish a separate health authority for Maori.
But attitudes have changed - radically. So have health outcomes for Maori.
Let’s return to Infoshare.
The life expectancy for a Maori male increased from 66.6 in 1996 to 73.4 in 2018, which is the most recent year for which numbers are available. That’s an extra 6.8 years of life, an improvement of just over 10 percent.
In the same time non-Maori men have increased their life expectancy from 75.4 in 1996 to 80.9 in 2018. That’s just over 7 percent.
So the increase in life expectancy is faster for Maori than for non-Maori.
For women the numbers tell a similar story. The life expectancy for a Maori woman increased 6 years or over 8 percent between 1996 and 2018.
For non-Maori women the rate of increase was 4.7 percent or just under 4 years.
Now let’s consider the country’s death rates. As I reported yesterday the general population is dying at the fastest rate in a quarter of a century. In the year to June 30 this year we died at a rate of 7.43 per 1000 of population.
But the Maori death rate was much lower at 5.35.
Five years ago the numbers were 6.91 for the population as a whole but only 4.9 for Maori and all the way back to a decade ago, the 2013 figures were 6.78 and 4.18.
So I don’t get this. We are told that we need at great expense a separate Māori Health Authority to improve Maori health outcomes.
Yet we have Maori life expectancy increasing at a faster rate than non-Maori, and Maori dying at much slower rate than the population at large.
Am I missing something?
Those numbers suggest the National and Act Party’s policy to disestablish Te Aka Whai Ora is sound and evidence based.
Peter Williams was a writer and broadcaster for half a century. Now watching from the sidelines. Peter blogs regularly on Peter’s Substack where this article was sourced.
4 comments:
I wish to comment on this statement:-
"Supporters of the Maori Health Authority or Te Aka Whai Ora say that we must have a separate agency to ensure Maori have equitable health outcomes and because the previous public health system was systematically racist."
I worked for over 50 years as a practicing pharmacist.
In that time I worked in all facets of pharmacy, in multiple cities and towns, providing health care to the public.
Pharmacy is very hands-on, direct person to person health service.
We pharmacists all treated all patients as individuals and tailored our approach to them in the manner that was appropriate to them as individuals to help them understand their medications and dosage times etc. There was NEVER any racial discrimination towards patients.
I can state categorically that I never saw or experienced any "systematic racism" in the practice of pharmacy in New Zealand.
NONE whatsoever !
It is a outright LIE to accuse health care workers of "systematic racism" against Maori people., and I stand here to refute this vile unfounded accusation on behalf of all pharmacists.
Equitable outcomes can be arrived at in two ways, either by improving outcomes for Maori, or (much easier!) making for worse outcomes for everyone else.
Perhaps instead of drilling Maori into kids at school, we should be drilling in respect and consideration for all kids they have interactions with. There could be an emphasis on courtesy and care for all others around them. Then the racism that does exist (usually learned at home) could be softened and mitigated in each child's personal experience.
When they grow up they would wonder why on Earth we would need separate health systems for different races.
MC
Am I missing something?
Possibly, possibly not.
I don’t know enough to confidently say this, but it’s possible the lower death rate reflects the different age structures of Māori and non-Maori populations: generally, old people die at higher rates than young people. Based on the first reasonably recent figures I could find in a very quick internet search, the median Maori age is about 11 years less than the national median age (thus the gap will be greater still for Maori compared to non-Maori) and this gap is partly the consequence of noticeably higher Maori birth rates, 2.5 births per adult Maori woman compared to to 1.87 nationally - and again the gap will be greater still for Maori compared to non-Maori - it is still not impossible for systemic (not ‘systematic’) racism in health care to negatively affect Maori health.
However, evidence available to the general reader of the health system’s racism and its cure by Maori health providers is statistically and sociologically naive and contradicted by more detailed evidence.
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