Māori have the greatest levels of health inequality in New Zealand, with measures of mortality and morbidity showing significant gaps compared to non-Māori even after controlling for deprivation.

1. Dr Peter Jansen
FRNZCGP (Dist) FRACMA
Senior Medical Advisor
Māori Health Disparities

2. Introduction

Māori have the greatest levels of health inequality
in New Zealand, with measures of mortality and
morbidity showing significant gaps compared to
non-Māori even after controlling for deprivation.

Research in New Zealand shows large disparities in
access to care and outcome in stroke, primary care
services, mental health, cardiac interventions,
respiratory conditions, and cancer amongst others.

3. Māori Health

Māori spend a relatively greater proportion of
their shorter lives disabled.

Higher burden of illness than non-Māori
 Heart disease, Diabetes, Respiratory disease,
Cancer, Other.
 Burden associated with modifiable risk factors
e.g. Smoking, Obesity.
 Markers of deprivation e.g. low income,
access to housing, employment & education.

Limited access to effective health services –
culturally and clinically competent services and
health practitioners.

4. GP Treatment
A Study from New Zealand published in 2002 shows that while Māori can be
diagnosed at the same rate as non-Māori in terms of depression, they are less
likely to get effective treatment.

NZMJ 26 April, 2002, 115; No. 1152

253 consecutive patients in a university general practice (64 Maori)
Comparison of 5 GPs diagnosis with that of independent interviewer,
using BDI administered immediately after GP consult in separate room.

GPs identified ½ of patients with depression
 No differences between Māori and non-Māori
Māori are no more likely to be depressed than non-Māori, but were
significantly much less likely to be prescribed antidepressants.
1 of 24 Māori vs. 24 of 53 non-Māori

5. Lower Access for Māori to ACC
GP GP Rura Physio A & M Emergency Transport Hospital Chiropractor
0
50
100
150
200
250
187
39
22
17
11
6 5
224
39 41
27
11
7 10
Māori non-Māori

6. What does this really mean?
We can all assume things based on appearance, gender, ethnicity, age
etc.

GPs need to step back and think What does this person really need in terms of their
healthcare? and then negotiate a good treatment plan with the person.
We also see from other sources of data such as ACC, that Māori get less effective treatment.
And that's shown in the average cost per claim.
Apparently its cheaper to treat Māori, But that's just a throw away line. What that really means
is that Māori get less volume of treatment for the same type of claim.
Once again there's something going on in the mind of the treating Health Practitioner, that says
this person needs more, this person needs less. Based on their ethnic background.
There used to be only a few dozen Māori doctors, now we have over 400.
And you're part of that same solution.
All of you will go out and be really effective Health workers, Nurses,
Pharmacists, a whole range of Health Professionals.