Recently, the Southern District Health Board reviewed a conflicting report that laid out in great detail the different life expectancies in Otago and Southland whether you are Maori or another ethnicity. Health reporter Mike Houlahan reviews the report and efforts to make sure things change.
It is often said that the Maori perform poorly in almost any health statistic.
It is one thing to say such a thing, but quite another to face this reality, as the Southern District Health Board recently did.
He asked his Maori health strategy and improvement manager, Gilbert Taurua, to write a report on acceptable death rates for Maori, and earlier this month he reviewed his findings. during a sometimes moving meeting.
“These are our parents, these are our siblings, these are our children,” said Moana Theodore, board member.
“Tomorrow is the anniversary of my father’s death and he died of an acceptable illness, and if he had had the life expectancy of a non-Maori man or woman he would have seen being born his grandchildren, he would have seen the acceptance and use of te reo.
“He would have helped with that, he would have walked me down the aisle, and he would have seen me get my doctorate, and he didn’t understand it.”
In medical jargon, an “acceptable” death is death before the age of 75 that is considered premature and could have been avoided had the patient received effective and timely care.
Non-Maori have always outlived Maori, a gap that narrowed until the 1980s, when it started to widen again – in 2016, the Maori death rate was more than twice the rate of non-Maori. Maori.
There is a bit of good news in the South; Statistically, Maori live a little longer here than in many other parts of New Zealand, and between 2007 and 2014, Maori life expectancy increased by around two years, to 78.
But this is all relative – the life expectancy of non-Maori has increased by roughly the same amount.
A southern Pakeha will live about four years longer than a Maori, and a person of Asian descent can expect to live past 85.
“It was a little touching, although it probably didn’t mean anything to anyone they didn’t already know,” Taurua said.
“Preventable deaths have increased over the years, so things haven’t improved.”
By far the No.1 killer in southern Maori is heart disease.
Suicide occupies a worrying second place, followed by respiratory diseases and cancer.
“We recently performed an audit of our cardiology department in Dunedin and found that Maori patients were not going through these departments a lot given the prevalence,” Taurua said.
“But we have to think about not only treatment, but also prevention and pathways in the community before these people need hospital treatment, so I guess that’s a challenge for GPs as well.
“I am not convinced that all Maori with significant cardiovascular disease are referred to secondary services.”
While the health service can do a lot to improve the way it cares for Maori, other factors come into play.
Motor vehicle crashes disproportionately kill southern Maori above other ethnicities, and choices in nutrition, housing and lifestyle also add to the favorable death toll.
“Tobacco is a major killer of our people and unfortunately we have a large number of young Maori women who have this tendency,” Mr. Taurua said.
“Diabetes also underlies
a lot of heart disease. “
Council member Tuari Potiki said Taurua’s report should make these problems real for people.
“We all have similar stories about parents and grandparents who passed away too soon. I’ve lost half a dozen or more of my best friends – the oldest of us was 63.
“This is the reality; this is not a theoretical academic article. These are holes in our whanau; holes that cannot be fixed.
“I am tired of going to meetings and approving measures, but we are not doing anything … Of the boards I have attended, this is the one that is most committed to fighting against disparities and inequalities, but despite that, I feel like we’re not doing enough to change it. “
So how do things change?
The SDHB, which last year increased its budget dedicated to the fight against health inequalities, intends to do so again for next year in a budget that must be confirmed by the Ministry of Health.
Earlier this year, the board of directors again committed to signing a memorandum of understanding with southern runaka to work together to improve Maori health outcomes.
It recently pledged to implement the recommendations of an independent report on its mental health and addiction services, which called for a significant budget increase for Maori patients and a genuine commitment to addressing issues of mental health and addiction. equity.
The Covid-19 pandemic also strengthened the board’s relationship with the Maori, as it worked closely with the Maori kaupapa providers to ensure that the Maori – who had a much higher per capita death rate that Pakeha during the 1918 influenza pandemic – be vaccinated at the same rate as everyone else.
“I think the relationship has always been relatively strong, but I think Covid has initiated a greater level of cooperation between DHB and these suppliers,” Taurua said.
“We have been working transparently with them regarding the deployment of the Covid vaccine, and we sing the praises of our suppliers because they are able to reach the most remote areas of our locality more easily than us, which is a real strength. “
Thanks to the government’s health reforms, SDHB has less than a year to go before its disbandment, but it is determined to do something about acceptable Maori mortality before its own demise.
“This is a long-standing problem that has been accepted as part of our New Zealand health care system,” said Dr Theodore.
“It is unacceptable that we have accepted it, and that must change.”