Maori Health Review

Making Education Easy Issue 3 – 2007

Maori Health Review
Maori Health Review
Maori Health Review

Disparities in health: common myths and uncommon truths

Authors: Reid P et al

Summary: The authors discuss disparities in health for Mäori in relation to measures of socioeconomic deprivation. They identify 3 specific areas of importance with regard to disparities. The first is a ‘distribution gap’. This relates to the skewed geographic distribution of Mäori toward more deprived areas: 56% live in areas ranked in the 3 lowest deciles. There is also an ‘outcome gap’, which relates to differences in outcome which are still observed once deprivation is controlled for. The third area is a ‘gradient gap’. This is described as the relationship between ethnicity and increasing deprivation. It appears that increasing deprivation compounds risk for Mäori but not for Pakeha. The authors suggest that the design and provision of healthcare services should be informed by both a disparities focus, and a development focus.

Comment: An oldie but a goodie, what more can I say? This paper was one of the first to show that inequalities in health outcomes for Mäori are not fully explained or driven by differences in deprivation. The authors ‘bust’ many of the myths for Mäori health research and confirm that we have a right to define ourselves, that accurate ethnicity data must be collected and analysed in a way that allows Mäori to monitor health policy and services.

Reference: Pac Health Dialog. 2000; 7(1):38-47 PMID: 11709879

Panui – upcoming events of interest to Mäori health providers and researchers

Summary: Te Ohu Rata o Aotearoa (Mäori Medical Practitioners) Hui aTau and Scientific Meeting 2007, 5th and 6th May, Tangata Marae Matamata This is the eleventh annual meeting for Te ORA. The theme the conference is ‘Tohungia te pae tawhiti – Determining the future’ with a focus on achieving equity in health outcomes for Mäori and setting a timeline for that goal. For more information, contact Lorraine Byers at 0800 4 TEORA (0800 4 83672) or Launch for ‘Hauora IV – Mäori Health Standards 1991 to 2004’ Known for providing high quality Mäori health statistics, the latest in the Hauora series - Haoura IV - will be launched on 28 June 2007 at the Wellington School of Medicine. Hauora IV not only provides the latest in Mäori health data. Expert commentaries are also presented in chapters that cover many of the major health issues faced by Mäori including diabetes, cancer, cardiovascular disease and mental health. Four Hauora workshops will be provided in order to acquaint people with the data. These will be held in Hawkes Bay, Auckland, Christchurch and Wellington in late 2007/early 2008. For more information contact Dr Fiona Cram on email

Can human rights discourse improve the health of Indigenous Australians?

Authors: Gray N and Bailie R

Summary: The authors discuss the use of human rights discourse as a framework for arguing that the Australian Government has an international obligation to improve Indigenous health. Two potential directions for this discourse are examined. These focus on the human right to health, and the interactions between health and human rights. The authors find that there is a limited opportunity to improve the health of Indigenous Australians through international law in relation to both legal and moral imperatives. In their conclusions they note that barriers to using this framework to improve Indigenous health include some which are perpetuated by the Australian Government. However, despite the governments hostility toward including human rights considerations into its public policy decision making, human rights discourse “does provide a sustainable intellectual framework in which to consider the social and structural determinants of health and maintain these issues on the political agenda.”

Comment: As we move from the ‘needs’ based analysis and reasoning to developing a framework to improve Mäori health outcomes that is based on Indigenous and Human rights, it is interesting to read how the Indigenous Australians fared with a similar argument at a national level. The paper is useful to everyone working in health, not just policy makers, as it provides evidence of the ways in which rights of Indigenous people are breached and how these impact on health outcomes.

Reference: Aust N Z J Public Health. 2006; 30: 448-52 PMID: 17073227