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Showing posts with label Maori health. Show all posts
Showing posts with label Maori health. Show all posts

Wednesday, November 11, 2015

Canterbury Maori Health Stats...

Latest District Health Board Maori profile makes interesting reading.

Using the NZDep2013 index of small area deprivation, the report shows 40% of Canterbury Māori lived in the four most deprived decile areas, compared to 25% of non-Māori.


Maori and non-Maori Deprivation in Canterbury



Maori in Te Waipounamu have less access to marae than our Te Ika a Maui cousins and whanaunga...




Rates of hospitalisation for mental disorders were 38% higher for Māori than for non-Māori, and we know the post-disaster landscape is still negatively impacting on our mental health in Otautahi.

"Among Māori females, the most common cause of admission was mood disorders, with 50 admissions per year on average.  The rates of admission for bipolar disorders and depressive episodes were higher for Māori women than for non-Māori women, as was the admission rate for anxiety or stress related disorders.

Among Māori males, the overall admission rate was 61% higher than the non-Māori rate. Admissions for schizophrenia type disorders were the most common, at a rate 2.6  times that of non-Māori. The second most common cause of admission was for mood disorders, with a rate 48% higher than the non-Māori rate, followed by substance use disorders. Admissions for anxiety or stress-related disorders were 65% higher than the non-Māori admission rate." (p. 26-27).


Full Report:
Robson B, Purdie G, Simmonds S, Waa A, Andrewes J, Rameka R. 2015. Canterbury District Health Board Māori Health Profile 2015. Wellington: Te Rōpū Rangahau Hauora a Eru Pōmare.



Thursday, November 20, 2014

Special Issue of MAI Journal on Maori Resilience

Just published free and online by Nga Pae o te Maramatanga's MAI (Maori and Indigenous) Journal along with five other teams researching the concept of resilience for Maori.
In my article, titled "Maori and the Christchurch Earthquakes: the interplay between Indigenous endurance and resilience through urban disaster" - I discuss the challenges for urban Indigenous communities - Maori are 85% urban - and analyse survey data that shows whanau size and pre-disaster economic security are key causal components for those Maori who have maintained or even improved their well-being in a post-disaster landscape.
The lead article is by Mera Penehira, Alison Green, Linda Tuhiwai Smith andClive Aspin - “Māori and Indigenous Views on R & R: Resistance and Resilience” - and explores resilience discourse through the development of Māori and Indigenous frameworks. Is the concept of resilience is simply the most current means by which the State encourages Māori to reframe the experience of colonisation as one of successful “adaption” to adversity?
Conceptualising the Link Between Resilience and Whānau Ora: Results From a Case Study” by Amohia Boulton and Heather Gifford presents a qualitative case study undertaken with a Māori health provider and discusses the link between resilience and the concept of whānau ora.
Jordan Waiti and Te Kani Kingi’s contribution titled “Whakaoranga Whānau: Whānau Resilience” explores “resilience strategies” and the multiple ways in which whānau contribute to the development of their members and the various mechanisms employed to foster growth and security. It is argued that understanding how whānau operate has implications for service delivery and policy design.
In “End-of-Life Care and Māori Whānau Resilience”, Tess Moeke-Maxwell, Linda Nikora and Ngahuia Te Aweokotuku discuss the cultural resources which assist Māori whānau in being resilient when caring for a family member at the end of life. The study illustrates that the economic and material ramifications of colonialism significantly impact on Māori at the end of life, influencing the ability of whānau to identify and access much needed resources and palliative care support.
In their second contribution to this issue, titled “Community-Based Responses to High Rates of HIV among Indigenous Peoples”, Clive Aspin, Mera Penehira, Alison Green and Linda Tuhiwai Smith compare findings from Australia, Canada and New Zealand and explore how community-based initiatives play a vital role in overcoming the challenges Indigenous people face in dealing with HIV and other chronic conditions.
Many thanks to reviewers and the editorial team, and especially to Amoia Boulton and Heather Gifford who have shepherded us through a long and tortuous process! The Issue will be formally launched on the first day of the International Indigenous Development Research Conference, Auckland, November 25-28, 2014.

Monday, April 07, 2014

Maori and Climate change

The latest report from the IPCC firms up their previous conclusions on a) the planet warming, and b) this warming being primarily human-induced.

While the full report is a massive collaborative effort, I'll just make a few comments on the impacts on Indigenous Peoples. Chapter 25 is on Australasia with an impressive list of authors (that includes one of my Masters supervisors Prof. Jon Barnett). I know several of those authors cited (click on link for full references) and respect their work. My comments - in red... - are merely my own thoughts and challenges.


The projected impacts of climate change on Māori society are expected to be highly differentiated, reflecting complex economic, social, cultural, environmental and political factors (high confidence). Since the AR4, studies have been either sector-specific (e.g. Insley, 2007; Insley and Meade, 2008; Harmsworth et al., 2010; King et al., 2012) or more general, inferring risk and vulnerability based on exploratory engagements with varied stakeholders and existing social, economic, political and ecological conditions (e.g. MfE, 2007b; Te Aho, 2007; King et al., 2010).

The Māori economy depends on climate-sensitive primary industries with vulnerabilities to climate conditions (high confidence; Packman et al., 2001; NZIER, 2003; Cottrell et al., 2004; TPK, 2007; Tait et al., 2008b; Harmsworth et al., 2010; King et al., 2010; Nana et al., 2011a). I think this too narrow a framework to examine the impacts: most Maori are barely aware of this so-called 'Maori economy'. We are highly reliant on the wider NZ economy. Much of Māori-owned land is steep (>60%) and susceptible to damage from high intensity rainstorms, while many lowland areas are vulnerable to flooding and sedimentation (Harmsworth and Raynor, 2005; King et al., 2010). Land in the east and north is also drought prone, and this increases uncertainties for future agricultural performance, product quality and investment (medium confidence; Cottrell et al., 2004; Harmsworth et al., 2010; King et al., 2010). The fisheries and aquaculture sector faces substantial risks (and uncertainties) from changes in ocean temperature and chemistry, potential changes in species composition, condition and productivity levels (medium confidence; King et al., 2010; see also 25.6.2). At the community and individual level, Māori regularly utilize the natural environment for hunting and fishing, recreation, the maintenance of traditional skills and identity, and collection of cultural resources (King and Penny, 2006; King et al., 2012). Maori are 84% urban and pursue urban pastimes. This does not mean the natural environment is not important - reconnecting with marae and hapu lands and waters is regularly argued for by our rangatahi - but it does reflect a lifestyle choice and commitment.  Many of these activities are already compromised due to resource-competition, degradation and modification (Woodward et al., 2001; King et al., 2012). Climate change driven shifts in natural ecosystems will further challenge the capacities of some Māori to cope and adapt (medium confidence; King et al., 2012).


Māori organizations have sophisticated business structures HAHAHAHAHAHAHAHAHA, governance (e.g. trusts, incorporations) and networks (e.g. Iwi leadership groups) across the state and private sectors (Harmsworth et al., 2010; Insley, 2010; Nana et al., 2011b), critical for managing and adapting to climate change risks (Harmsworth et al., 2010; King et al., 2012). Future opportunities will depend on partnerships in business, science, research and government (high confidence; Harmsworth et al., 2010; King et al., 2010) as well as innovative technologies and new land management practices to better suit future climates and use opportunities from climate policy, especially in forestry (Carswell et al., 2002; Harmsworth, 2003; Funk and Kerr, 2007; Insley and Meade, 2008; Tait et al., 2008b; Penny and King, 2010). Māori knowledge of environmental processes and hazards (King et al., 2005; King et al., 2007) I think we have to be careful we don't paint ourselves in a methodological corner as our traditional knowledge is fragmented and a fraction of what we need to know about the world! as well as strong social-cultural networks are vital for adaptation and on-going risk management (King et al., 2008); however, choices and actions continue to be constrained by insufficient resourcing, shortages in social capital, and competing values (King et al., 2012). Competing values is a simple label hiding a complex dissonance between different Maori organisations and philosophies. Some would argue we are at war with ourselves. Combining traditional ways and knowledge with new and untried policies and strategies will be key to the long-term sustainability of climate-sensitive Māori communities, groups and activities (high confidence; Harmsworth et al., 2010; King et al., 2012).


So the emphasis is now on adaption, certainly less alarmist than previous reports (and perhaps a nod there to the difficult politics of climate change?). But the constraints on Maori adapting to massive environmental change has been irreparably altered by colonisation! While this is implicitly acknowledged (and the Australian situation is much worse; the section preceding Maori - 25..8.2.1 - presents the case for Aborigines and Torres Strait Islanders).


Tuesday, October 08, 2013

Maori Wellbeing in Otautahi: a commentary on the CERA survey

A survey of wellbeing undertaken by the Canterbury Earthquake Recovery Authority (CERA, click here) shows an alarming pattern of Maori suffering some of the worse effects on well-being of the 2011-12 earthquakes.

For example, those saying their quality of life has decreased since the earthquakes (54% of 2,300 respondents) are more likely to be:
·         Living in temporary housing (70%)
·         Of Māori ethnicity (68%)
·         Aged 35 to 49 (60%) or 50 to 64 (62%)

There's more, like those more likely to say they have experienced stress 'always or most of the time' (23% of respondents) includes a disproportionate number of Māori respondents (36%).

This remarkable result seems to have been ignored or has simply failed to get any traction. 

Our research - updated at http://www.lincoln.ac.nz/conversation/maori-resilience/ - is saying the same thing. 

I think the biggest challenge is to assert the plight of Nga Mata Waka in the new city. Ngai Tahu at least have had their mana whenua status affirmed in the Canterbury Earthgquake Recovery Act (enacted on Apriul 18th, just 4 weeks after the most damaging 22-2 event). Tautoko! But for the rest of us - and we'll know how many remain once the full census data is made available - we seem to have no official channels for what we use to call Taha Maori! 






Thursday, September 27, 2012

Indigenous Health

Just back from the 5th Biennial International Network of Indigenous Health Knowledge and Development Conference held on the St Lucia campus of the University of Queensland Brisbane. The conference theme was Building Resilience: Renewing Individuals, Families and Communities. There was some depressing data presented including some health indicators for Maori that showed increasing rates of rheumatic fever and heart disease and figures showing Aboriginal children are being removed from the families at rates higher than the forced removals from last century.

High turnout from Maori showing we have comparatively secure funding and extensive programmes. I stress comparatively as many Indigenous programmes are under huge pressure as support (by which is meant funds!) are withdrawn as the ongoing financial recession continues to bite.

Members of Homai Hoatu. Have guitar, will travel...

Tuesday, September 25, 2012

We told you so...

As a researcher who regularly - but not solely - uses qualitative data, I'm often challenged by quantitative-centric colleagues as to the veracity of my findings and the robustness of my data. Which is fair enough. If I've got interesting numbers, and I do look out for them, I'll build them into my work as and where they are valid and robust although it must be said that numbers can be as woolly as drunken hearsay ($38 billion Maori economy anyone?!).

I accept we're often too quick to take on narrative approaches and re-articulate the stories of participants for their supposed insights. But here's a very interesting take on narrative from economist Robert Schiller who accepts "people remember – and are motivated by – stories, particularly human-interest stories about real people."

No shit Sherlock.

This morning I heard three inspiring Indigenous women who spoke at the opening of the 5th Biennial International Network of Indigenous Health Knowledge and Development conference at St. Lucia camous of the University of Queensland. Each began with the story of their own families which framed their lives and work. While Tariana Turia threw in some numbers six children, 20-something grandchildren, some more grand children (the exact numbers escape me!), it is the interconnections of whakapapa and the lived experiences of a family that define who she is.

Schiller's point seemed to be that how people hear and retell stories about the financial crisis somehow affects their actions and responses. Again this is hardly new but perhaps a page has been turned in the methodologies available to economic analyses.







Tuesday, August 07, 2012

Maori Poverty 2: 'Cheaper to let Maori children die...'

A study by Clair Mills,  Rhema Vaithianathan and Paparangi Reid show the dire state of Maori health. In brief...

•  15,376 ‘excess’ avoidable hospital admissions for Māori children during the period 2003 to 2007;
•  36% of hospitalisations classified as ‘potentially avoidable’;
•  Tamariki Māori accessed GP consultations at a lower rate than non-Māori;
•  Pharmaceutical claims for non-Māori children were 15 % higher, with non-Māori laboratory claims  55% higher than Māori;
•  ACC claims for Māori children 32% lower than non-Māori, and median cost lower;
•  Specialist outpatient visits by Māori children 86% lower than those of non-Māori children.


Frightening, and shameful. 

Of course the Star Sunday Times opening sentence is designed to garner a response, begging the question why it hasn't received more attention, but reinforcing the NZCCSS study that shows Maori and Pasifika communities shoulder a disproportionate load in rebalancing the country's books. 

Considering the study was for the years prior to the current economic malaise, we're going to be more frightened, and more ashamed.

Tuesday, April 24, 2012

Maori suicide

Hot of the press, but with results only up to 2009, headlines tell a somewhat distorted picture ...
'Suicide rates drop, but still more work to be done' sez the NZ Herald.
No mention of Maori - a void in the media I've noted before with unemployment figures. Let's dig into the report and see what we have...

  • There were 83 Māori suicide deaths in 2009, a rate of 13.1 per 100,000 Māori population (this is the lowest Māori rate since 1999);
  • This compares to 10.6 non-Māori deaths per 100,000 in 2009.
  • In the same year there were 28 suicide deaths among our Pacific whanaunga ... 
  • ...and 25 among Asian ethnic groups.

These results differ somewhat from another report (from Chief Coroner, Judge Neil MacLean), albeit provisional ....

Provisional suicide rates by ethnicity per 100,000 population between July 2007 and June 2011 (n=2170)

Here's the comparison in an easy graphic:
Either way, it's bad. One hopes the new funding announced for youth mental health may arrest these terrible stats, although old men are proving sadly susceptible to going sideways of this mortal coil.

Where to get help:
If it's an emergency and you feel like you or someone else is at risk, call 111. Or call Youthline 0800 376 633, Lifeline 0800 543 354, Depression Helpline 0800 111 757, What's Up 0800 942 8787 (noon-midnight).
Suicide Prevention Information New Zealand has more information. Visit: www.spinz.org.nz.
The Ministry of Health also offers information atwww.depression.org.nz, and a teen specific website at www.thelowdown.co.nz


Simon Lambert

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