Waikato DHB report reveals staggering inequity gap for Māori in healthcare

Waikato DHB report reveals staggering inequity gap for Māori in healthcare
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A new report has revealed the staggering inequity gap experienced by Māori and Pacific people in the Waikato District Health Board.

The report, titled Rapua Te Ara Matua, was published by the DHB on Tuesday and examines the long-term impact and how it affected Māori over their lives.

It presents a "distressing life journey" for Māori children born in the region today, with Māori falling behind in almost all areas of health covered, including:

  • Attendance of hospital appointments,
  • Early registration with a midwife,
  • Immunisation,
  • Oral care.

They are also overrepresented in the areas of:

  • Obesity,
  • Smoking tobacco through pregnancy, 
  • Diabetes,
  • Avoidable deaths. 

The most significant gap is in oral care. Māori and Pacific children are much more likely to have tooth cavities before their fifth birthday than people who identify as European/Other.

The equity gap is approximately 30 percent between Māori children and European/Other, and there is a gap of 20 percent between Pacific children and European/Other.

Other major issues were 20 percent equity gaps between Māori people and European/Other in both early registration with a midwife and smoking tobacco through pregnancy.

Māori men have an average life expectancy of 72 years, in contrast to 80 years for European/ Other.

Overall, the report found "systems and structural changes are needed to address the resulting gaps in health equity".

"The challenge is to design a health system which prioritises the healthcare needs of those who have the least access to adequate income, healthy secure housing, and other determinants of health," the report said.

Riki Nia Nia, Waikato DHB's executive director for Māori, equity and health improvement, said in many areas the gap is closing but there is still a  persistent gap between Māori and non-Māori.

"Behind each set of figures or spike in a graph there are individuals and whānau who experience hardship and loss, of opportunities to live a full life, or the loss of life or loved ones to causes which may have been preventable," Nia Nia said.

"For some these figures may be quite confronting, but the reality is that for many people these inequities are well known and long-standing."

DHB chief executive Dr Kevin Snee said the report confirms how urgent it is to make real progress.

"We acknowledge that there are numerous factors which contribute to inequities, including many which are outside the health sector, but as a DHB we do have considerable means to drive change and there are examples presented in this report to show where deliberate and targeted actions have been effective. We have committed to taking action in those areas for which we have oversight and are asking our partners and those across all sectors to work with us."  

The report said to effectively address the gaps, the DHB needs to consider a Māori-led approach, intersectoral engagement, and long term funding, resources and evaluation.

The DHB is calling for a whole-of-system approach to improve health and wellbeing outcomes for Māori and Pacific peoples.

Nia Nia said they are taking the view that services should be built around people rather than the other way around.

"It is clear that meaningful change will require everyone working together. Our hope is this report will encourage greater support and urgency to address inequities and that there is no tolerance for these persistent gaps between people living together in our communities."