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Flashcards in Maori Health Deck (37)
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1

Where are systematic disparities exemplified in regards to Maori health (vs non maori)?

- in health incomes
- in exposure to detriments of health
In health system responsiveness
- in representation in health work force

2

Do Maori or non-Maori have a higher life expectancy?

Non-Maori

3

Where are Maori health disparities seen? (Eg diabetes)

Cardiovascular disease (highest)
Cancer (second highest)
Injury
Diabetes
Mental health including self harm
Infectious diseases
Disability
Participation in health workforce

4

What interventions could the titanic have?

Structural or social interventions

5

What are structural interventions?

Getting rid of barriers to healthcare (for example, more lifeboats, or more access of Maori to angioplasty or cabg

6

What are social interventions?

Rights based approach, commitment to review and 'level playing field'

7

What is NOT a good intervention?

Individual accountability (eg swimming lessons for the titanic)

8

Why should you not provide interventions for everyone?

It's a waste of resources

9

Do Maori have an increased deprivation?

Yes, the average decile 1 death rate in Maori is higher than a decile 10 non-Maori

10

Define disparity, inequality and inequity

Different
Unequal
Unjust

11

Why is equal not always equitable?

In examples with Maoris with a higher ischaemic heart disease, is equal fair if they need more procedures?

12

What are the determinants of ethnic inequities in health?

1. Differential access to health determinants or exposures leading to differences in disease incidence
2. Differential access to health care
3. Differences in quality of care received

13

What's an example of differential access to health determinants or exposures leading to differences in disease incidence?

Higher deprivation in Maori populations (as poorer housing, lower income and less access to health services all result in a lower health outcome)

14

What's an example of differential access to health care?

Higher death rate due to ischaemic heart disease among Maori

15

What's an example of differences in quality of care received?

International report:
Minorities feel less likely they have been listened to, have less time with health care providers and inadequate explanations of problems, unanswered questions, more dissatisfaction with health care services

16

Two components of Maori health with historical underpinnings?

Structural contribution
Societal contribution

17

What is structural contribution?

The power, resources and opportunities of NZ society are organised by ethnicity (so there are barriers)

18

What are societal contributions to Maori health?

Values and assumptions widely held in NZ society about the deservedness of different groups of people (so, asking who is more privileged ie: has better healthcare because of presumptions etc)

19

Brief history of Maori health?

Early contact: Maori initially flourished
Official engagement: colonisation, Declaration of Independence, treaty of waitangi
-era of depopulation, disease and dispossession

20

Implications of colonisation?

Racist assumption
Superiority
Entitlement
Land use
...leads to today's societal barriers

21

What is article 1 of the treaty?

Construction of state sector, justice system, education, health, welfare

22

What is article 2 of the treaty and how is this disregarded?

Article 2 states the rights of Chiefs and tribes to keep their land (unless they wish to sell it to the crown). However, Maori land courts in 1860 still proceeded (so, laws and policies disregarded article 2)

23

What is the treaty implication of Maori land?

It's the historical basis of settler wealth: Maori Land Court 1860s
Active procurement, by dodgy means

24

Land alienation relationship to health?

Social disruption of community
Breakdown of political power and alliances
Economic resource depletion and poverty
Resentment by indigenous people

25

What policies disregarded article 3 (equal citizenship for all New Zealanders)?

Old age pensions 1898
-equal provisions for Maori and pakeha (Asian excluded)
-Maori access difficult through Maori land court
Maori regularly removed from rolls
Reduced amount paid to Maori

26

Discuss the social security act

Underpayment continued until after ww2

27

How does unequal citizenship affect health?

Entrenchment of poverty and dependency
Increased barriers to development
Acceptance of inequity by non-indigenous groups
Resentment, frustration, anger
Social breakdown, crime, high risk behaviour

28

When were the pre-emption Clause of the treaty established?

1840-1865

29

What was the pre-emption clause of the treaty?

Only the crown could buy Maori land, part of the "land claims accordance" in 1841
-although this was standard practice, it was deemed unfair due to monopoly

30

When was the social security act?

1938