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Turia: When 'same' actually means 'different'?

General Debate: When 'same' actually means 'different'?

Wednesday 10 May 2006

General Debate: Tariana Turia; Co-leader Maori Party

Tena koe, tena koe te whare.

Seven years ago in 1999, visiting public policy expert Dr Camara Jones noted:

“Understanding the impacts of socio-economic effects on health, and how this contributes to ethnic disparities in health, does not go far enough.

If we are really going to eliminate health disparities we need to understand the contemporary structural factors ….that is, we need to address the institutionalised racism if we are really going to make change”.

Seven weeks ago, the United Nations Special Rapporteur, Professor Rodolfo Stavenhagen, reported that:

“Significant racial inequalities continue to exist in health, housing, employment, education, social services and justice”.

Madam Speaker, the Māori Party is here today to say we will not wait another seven years, another seven weeks, another seven days, to put up with the price of racism.

This week, the reputable academic partners of Statistics New Zealand, Public Health Intelligence and the Wellington School of Medicine joined forces with the Ministry of Health to report that higher mortality for Māori relative to non-Māori cannot be explained purely by the over-representation of Māori in lower social classes.

This analysis can no longer be ignored or dismissed by a range of riddles that diminish research if it comes from the United Nations; from an anthropologist; from an international expert.

This is New Zealand’s aptly named public health intelligence which is

urging us to seek explanations for the ethnic disparities in mortality.

Decades of Disparity III reports that the impact of racism on ethnic inequalities in health is likely to be mediated through both socio-economic (institutionalised racism) and non socio-economic (inter-personal and internalized racism) pathways.

In essence, this final report in a series of three examining disparities between Māori and non-Māori from the early 1980s to the mid 1990s reinforces the impact of personal, cultural and institutional racism in this nation.

And we are not alone.

Another reputable source, the British Medical Journal, describes a growing literature showing an association between racism, morbidity and mortality. The BMJ editorial states:

“Cross sectional studies in the United States report associations between perceived racial discrimination and hypertension, birth weight, self related health, and days off sick. In a recent study from the United Kingdom victims of discrimination were more likely to have respiratory illness, hypertension, a long term limiting illness, anxiety, depression, and psychosis”.

It therefore stands to reason that countering racism must be considered a major public health issue.

If the R word is too scary, think about these three questions:

* Why is survival from cancer, even adjusting for age and stage; lower among Māori than non-Māori?

* Why do Māori and Pacific people have similar rates of coronary artery bypass grafts and angioplasty as European people; despite having greater need?

* Why is it that although the prevalence for paediatric asthma is similar for Maori and non-Maori; Maori children have:

- more severe symptoms when they present to the health provider;

- require hospitalisation twice as often as non-Maori;

- and are less likely to receive adequate asthma education or even be prescribed preventive medication?

The analysis is clear, consistent, and convincing.

Differences in access to, and quality of, health care, create different outcomes for Māori compared to non-Māori.

Considering racism to be a cause is an important step in developing a research agenda and response from health services. And it is about time.

We must start getting real about the links between racism and health if we are really and genuinely committed to preventing disease, prolonging life, and promoting health. There is no time to wait. Only then will the Maori Party be able to accept the catch-cry of ‘one law for all’.


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