Leaders slam appalling state of Maori health

Being Maori is the highest risk factor for bad health and an early death in New Zealand. So what's the cure? Ruth Hill reports.

If bird flu suddenly wiped out 10 per cent of the population, it would be considered a national emergency. Yet right now a disaster on this scale is occurring in New Zealand, says Maori Party co-leader Tariana Turia.

The latest life expectancy figures released by Statistics New Zealand show that a newborn non- Maori girl can expect to live more than than 12 years longer than a Maori boy born on the same day, based on current death rates.

Mrs Turia said the gap in life expectancy was "like an epidemic wiping out 10 per cent of the Maori population. It is utterly appalling, and a national disgrace that this country does not expect that tangata whenua should live as long, or as well, as others, but we have come to regard this situation as normal and it barely rates a mention in the news . . .

"Many of those people died prematurely from chronic and debilitating illnesses, which mean that the quality of their living years is diminished."

Professor Tony Blakely, director of the Health Inequalities Research Programme at Otago University's Wellington School of Medicine, fears the looming economic recession will erode the small gains Maori have made.

In the post-war period, Maori life expectancy improved markedly as many moved to urban areas and found better-paid work, higher- quality housing and better nutrition. "In the 30 years after World War II, the gap closed from 18 or 19 years to eight or nine."

During the 1980s and early 1990s – when unemployment spiked at 25 per cent for Maori, benefits were massively cut and market rents introduced for state houses – Maori life expectancy flat-lined and actually reduced in some age groups. "The incoming Government must ensure the impact of the economic downturn is not disproportionately shared by one sector of the population as it was last time."

The director of the Eru Pomare Maori Health Research Centre, Bridget Robson (Ngati Raukawa) said the phrase "closing the gaps" became political poison after ex- National Party leader Don Brash's infamous Orewa speech in 2005. It was a rallying cry for self-styled "middle New Zealand" who felt "race-based policies" were benefiting Maori over Pakeha.

In response to the backlash, the $360 million Closing the Gaps programme was quietly strangled.

Yet there were more Maori health providers in the 1990s than there are today, thanks to the National-led government's promotion of a competitive market, she said.

Dr Robson said she admired Australia's multi-agency approach, with the ambitious goal of closing the gaps in a generation.

"They actually have specific intermediate goals, like ensuring all people with heart disease are receiving timely treatment within five years."

Health was not just about health services – it involved job security and earning enough to buy healthy food and quality housing, she said.

Dr Robson said Working for Families had lifted many families out of poverty, but discriminated against children of beneficiaries. Between 40 and 50 per cent of Maori children live in benefit- dependent families. "We shouldn't be punishing the children."

At the root of the ethnic disparities was "endemic" institutional racism – not intentional discrimination by individuals, but racism involving processes and structures that favoured some groups. For instance, all doctors want the best for their patients – but a middle-class Pakeha who looks likely to have medical insurance may be offered options, such as seeing a private specialist and bypassing the public system or getting into it quicker.

Dr Robson said she was always on the alert for "victim blaming", such as putting health disparities down to smoking and poor diet. "I'm all for autonomy and empowering people to change their own lives, but we have to have the environment that makes it possible for them to make good choices."

Health services need to be "by Maori, for Maori", whanau-centred and holistic, she said.