Understanding Māori health disparities

A chapter in an important textbook helps ensure health professionals understand the health issues of Māori.

E tautoko ana tētahi wāhaka ki roto i tētahi pukapuka matua whakahirahira i kā mātaka hauora kia mārama i kā take hauora Māori.

Understanding pathophysiology is an international textbook used for training health professionals in the disease processes that interfere with the proper functioning of the human body. When the first Australasian edition was produced it included a chapter on Australian indigenous health but nothing about Māori. Associate Professor Karole Hogarth, who had already written two chapters for the book, pointed out this omission to the publisher, who responded by inviting her to contribute a new chapter on Māori health.

Karole worked with a colleague at Otago Polytechnic School of Nursing, Mereana Rapata-Hanning. They agreed that it would be necessary to provide background to any discussion of the health disparities suffered by Māori. Breaches of the Treaty of Waitangi have contributed to those disparities but the Treaty is now also part of the solutions. Background information about Māori culture also had to be included, to help health practitioners treat people in their cultural context. For example if one ill child presents with an infection, a holistic approach is needed to look not just at the child's whole health but also the wider whānau.

It is important to consider the social determinants of health, both to understand the causes of health disparities and to address obstacles to successful treatment. But there are also genetic factors influencing Māori health, for example a gastric cancer gene. The two factors can compound, for example both genetic and environmental factors contribute to poor oral health in Māori.

The chapter on Māori health was included in the second Australasian edition, published in 2015. The third edition came out in 2018. It is being used here in teaching the Bachelor of Nursing and also the Competency Assessment Programme for internationally qualified nurses coming to practise in New Zealand. It has helped ensure these graduates enter nursing practice with an improved understanding of Māori health issues.

He pukapuka matua ā-ao a Understanding pathophysiology e mahia ana hei whakakuku mātaka hauora i kā hātepe mate e raweke ana i te mahi tika o te tinana. I te whakaputaka tuatahi, he wāhaka e pā ana ki te hauora o kā tākata moemoeā o Ahitereiria, heoi, kāore he kōrero e pā ana ki te iwi Māori. I tūtohu a Ahoraki Tuarua Karole Hogarth, nāna ētahi wāhaka e rua i tuhi kē mō te pukapuka, ki te kaitā, nāna i tono ki a ia, me tuhi ia i tētahi wāhaka hou mō te hauora Māori.

I mahi tahi a Karole rāua ko tētahi hoamahi i Te Kura Matatini ki Otago o Te Kura Tapuhi, ko Mereana Rapata-Hanning tērā. I whakaae rāua tahi, me whakauru i kā tāhuhu kōrero mō kā tōrite hauora Māori. Kua whakapākia kā tōrite e kā wāwāhika ture Tiriti o Waitangi, ekari, ko te Tiriti hoki tētahi o kā whakatikatika ināianei. I whakaurua hokia ētahi kōrero mō te ao Māori, hei tautoko kā mātaka hauora kia rokoātia kā tākata i tō rātou ake āhuataka tika. Hei tauira, pēnā ka tae mai tētahi tamaiti māuiui ki tētahi pokeka, me whakamahi i tētahi huarahi torowhānui kia aro katoa ki te hauora o te tamaiti, o te whānau whānui hoki.

He mea whakahirahira kia whaiwhakaaro i kā take ā-pāpori hauora hei whakamārama i kā pūtake o kā tōrite hauora, hei aro atu ki kā arai ki kā maimoataka akitu. Ekari, he take iraka hoki e whakaaweawe i te hauora Māori, he tauira, ko te mate taurekareka puku. Ka taea e kā take e rua te pāhekoheko, he tauira, ka whakaaweawe kā take iraka me kā take ā-taiao i te hanga mate ā-waha mō te iwi Māori.

I whakauru te wāhaka e pā ana ki te hauora Māori i te whakaputaka tuarua Australasian, i puta i te tau 2015. I puta mai te mea tuatoru i te tau 2018. E mahi ana tērā ki konei i te mahi whakaako ki te Tohu Paetahi Tapuhi me te Competency Assessment Programme mō kā tapuhi kua tohua kētia e haere mai ana ki Aotearoa ki te whai mahi. Kua hua tēnei tuhika, ka uru ēnei kaiwhiwhi tohu ki te mahi tapuhi me tētahi whakamāramataka pai ake i kā take hauora Māori.

June 2019