Te Ara Hauora: The Pathway for Maori Health and Maori Development

• Relevance of the Foresight Project to Maori Health and Maori Development
• Determinants of Maori Health
• Competencies to Fill the Gaps: Linking Maori Development and Research
• What the Foresight Project Can Offer Maori
• Notes
• References

Relevance of the Foresight Project to Maori Health and Maori Development

New Zealand Maori as tangata whenua are indigenous and unique to this country. It is crucial that the knowledge needs of Maori are understood and acknowledged within New Zealand’s investment in research, science and technology. No other country is responsible for this challenge.

A key part of meeting the challenge will be to prioritise health outcomes which will contribute to the broad goal of Maori development as well as Maori health development.

Optimal health outcomes for Maori will be achieved through the combined efforts of Maori as individuals and as collectives positively contributing to their own health outcomes. Maori development will also facilitate the development, resourcing and provision of programmes and services to Maori through the Maori health sector as well as the mainstream health sector. For the purposes of this paper, the Maori health sector includes Maori who are providers, policy makers, Maori health researchers, funders and consumers, iwi and Maori authorities and whanau and hapu. Research is needed to inform the various activities, roles and responsibilities of each of these key stakeholders who will contribute to advancing Maori health outcomes.

Determinants of Maori Health

Beaglehole predicts that while New Zealand life expectancy is projected to increase between 1996 and 2020, the gaps in health outcomes and health status between Maori and non-Maori will barely change and may worsen.  ¹   In 2020, Beaglehole states, the leading causes of death and disability in New Zealand will be much as they are now. For Maori, these are cancer, ischaemic heart disease, unintentional injury, hypertensive disease, diabetes and SIDS.

Key factors that influence Maori health status include the socioeconomic environment, health behaviours and access to health care. Factors such as differences in uptake and effectiveness of services, for example, mean Maori have lower rates of immunisation and poorer uptake of well-child services. Maori have high rates of smoking and other behavioural risk factors that contribute to poor health. Genetic disposition to diseases such as diabetes and rheumatic fever contributes in a minor way to the excess burden of disease in Maori.

Maori concepts of hauora or well-being place the Treaty of Waitangi at the centre of good health. A continued and expanded focus on Maori health development issues as a priority is critical to achieve equitable health outcomes that benefit Maori and the wider New Zealand society.

The Treaty of Waitangi relationship between Maori as tangata whenua and the New Zealand Government will continue to be a major driver of Maori aspirations for the future across all areas of development.

Competencies to Fill the Gaps: Linking Maori Development and Research

In seeking Maori development, it has been recognised that the Treaty of Waitangi and Maori experiences, priorities and knowledge are central to improved Maori health, education, economy, housing and resource management. It involves developing Maori communities and requires improved organisational capacity to underpin Maori knowledge and solutions. There is a need to shift current competencies through available research and knowledge, workforce training and recruitment, funding and decision making so that they align with the needs of Maori health and Maori development.

Table 1 illustrates the types of linkages that may need to be developed. These relate particularly to the development of Maori knowledge or matauranga Maori; development of Maori workforce and analytical skills, increased knowledge of culturally effective services, intersectoral collaboration and devolving decision making, Maori-centred funding, contracting and provision of research to Maori.

What the Foresight Project Can Offer Maori

The Ministry of Research, Science and Technology (MoRST) through the Foresight Project, is aiming to promote a convergence of ideas and opportunities between the various sectors involved to generate new funding categories focused on outcomes. For example, health, housing and welfare may be considered in the context of how they contribute to ‘well-being’.

This approach suits the Maori interest in holistic approaches to achieving individual and community health and well-being. Gains in Maori health need to be viewed as part of a wider agenda for Maori advancement in key areas such as health, education, housing and resource development.

1. Research / knowledge
2. Suitably skilled workforce
3. Funding
4. Decision making