Health disparities between Māori and non-Māori have been distinguishable for long time and are still evident in today’s society. The strong disadvantage of Māori wellbeing is evidenced by poor health outcomes due to socio-economic and life style factors, availability of health care and even some discrimination (Ellison-Loschmann & Pearce, 2006). Statistics provided by Alcorn (2011) have further cemented these differences as these show that the occurrence of cancer is four times higher in Maori then non-Maori and the survival rates are distressingly lower. In children as well, the incidence of rheumatic fever being diagnosed of those who are Maori decent is 20 times higher then those of European. Further more, the life expectancy differences between Maori and non-Maori is estimated at being 8 years shorter. In New Zealand, the social and economic factors are the most dominate causes leading to health disparities for Tangata Whenua. Research suggests that people who have poor socio-economic status present with increased risk of contracting diseases that are damaging to their health and wellbeing (Carroll, Casswell, Huakau, Howden-Chapman & Perry, 2011). Normally, being lower on the socio-economic scale and having an increased risk of health related problems, care would be more accessible and of greater quality for those in need but in New Zealand, Maori are still receiving inadequate access to health care.
Although there are many socio-economic factors that play a role towards Tangata Whenua in accessing appropriate health care, a major one of these is cost related factors. Over the past 4 years, the Ministry of Health have completed surveys about the health of New Zealand adults and children, each time an issue related to cost has appeared in the key findings for Maori health. The Ministry of Health survey (2012) showed that cost prevented 45% of Maori from visiting a GP when they needed to and 18% did not collect a prescription due to cost, where as only 14% of non-Maori were prevented from seeing a GP in relation to cost. Continuing on, in 2013,14 and 15 there was a unmet need for those under 6 years old or those who required after hours medical attention due to cost (Ministry of Health). This suggests that the cost of health care is a signification barrier towards Maori population. If lower income communities cannot afford the cost of health care, it is a direct link towards having poorer health and causing an overall effect on Maori’s hauora.
Another socio-economic barrier that Māori face when accessing health care is lack of transport. Over the years, the Ministry of Health have found that the lack of transport available, either personal or public, is a barriers towards why people don’t access health care when needed. In 2012, the Ministry of health revealed statistics that show 8.6% of Māori families cannot access transport to get to a GP clinic, this is three times higher then those who are non-Māori. It is hard to pinpoint a specific reasoning towards having lack of transport as there can be numerous obstacles such as, having no car in general, solely relying on public transport and the potential of unavailable public transport at the time and to the location of GP clinic or health service required (Raerino, Macmillan & Jones, 2013). This is another limitation in which prevents Māori from accessing health care services and negatively impacting on their wellbeing.
Māori’s inadequate access to health care can be linked towards potential discrimination received when help is sought. Discrimination occurs daily and can be described as having different actions towards others according to their race, age or sex (Jones, 2000). The fear of having racial discrimination when in a health care setting is a major influence on the Māori population and their health outcomes. Harris et al. (2012) created a study that explored racial discrimination and stated it was experienced highest in Māori while suggesting that having had experienced discrimination and deprivation correlates with inequalities in health outcomes. Harris, et al (2012) reinforces throughout the study that discrimination is a direct risk factor towards health systems not supplying adequate enough health care and further decreasing the positive health outcomes of Tangata Whenua.
Due to the number of socio-economic factors and health disparities, these have been recognised and there have been strategies developed and put in place to reduce the presenting issues. Improving health disparities and access to care for Māori should see an increase in adequate health outcomes (Ellison-Loschmann & Pearce, 2006). It is hopeful that these strategies, policies and initiatives being developed will guide health care services to have improved access for Māori while providing sufficient care that will bring Tangata Whenua and their overall wellbeing to the same levels as non-Māori. Health services and care providers having a holistic approach and facilitating a cultural neutral environment while allowing Māori culture and practise to be brought into consideration when applying care will diminish the worry of discrimination and provide security towards Tangata Whenua in accessing care when it is needed (Alcorn, 2011). In support of this, having simple cultural safety education can allow general health services to be able to facilitate for Māori and their needs and in wake, contribute to increased quality of care (Jeffreys, 2015).
One of the strategies put in place is He Korowai Oranga, which was brought in 2013/14 by the Ministry of Health to guide the government along with health and disability services in providing the best outcome of care for Māori. It involves the elements of Pae Ora, Whānua Ora, Mauri Ora and Wai Ora (healthy futures, families, individuals and elements) which are influenced by the Treaty of Waitangi and the principles established by the Treaty of partnership, participation and protection (Ministry of Health, 2014). The Treaty of Waitangi is a formal agreement created in 1840 between the British settlers and Māori, the Treaty allowed British to have settlement in New Zealand while guaranteeing Māori rights protection (Williamson & Harrison, 2010). After the signing of The Treaty of Waitangi, the British introduced firearms and infectious diseases in which both had an overwhelming effect on Māori death rates and brought forward the health inequalities between Māori and non-Māori that were meant to be protected by the Treaty and still seen in health disparities to this day (Ellison-Loschmann & Pearce, 2006). To improve these disparities and working with Māori by using partnership to work in cooperation with iwi, hapū and whānua as well as Māori communities to encourage Māori health gain through course of action but for this to happen effectively Māori have to participate in all levels of the health sector to make sure any decision-making or change is inclusive of Māori. Lastly, ensuing protection of Māori and providing the same level of health as non-Māori while being cautious of cultural concepts, values and practices (Ministry of Health, 2014).