My View: Why focussing on Māori health benefits everyone

VIEW - Kevin Ross, Precision Driven Health chief executive and Orion Health director of research

Across the health system and beyond, you cannot ignore the increasing focus on Māori - epitomised by the formation of Te Aka Whai Ora, the Māori Health Authority, in an effort to prioritise Māori in the way care is designed and delivered.

As New Zealand’s Health Data Science Collaboration, Precision Driven Health focuses on Māori gains in the work we do, and recently have written about this both in our series Te Pū Waiora (which reflects Māori leadership and engagement in health data science), and in the PDH partnership report Better Health Through Data Science.

When PDH first published theses I heard some people ask, “Why should we favour one group of people over others?”. It’s as if people think prioritising Māori in health comes at a cost to others in society. Where in fact, the opposite is true.

THE MORAL ARGUMENTS

1. The Treaty of Waitangi makes improving Māori quality of life an imperative:
Aotearoa New Zealand was founded on an agreement between the Crown and Māori to form a nation together which would honour the rights and lives of Māori. Over the years, our health system has been shown time and again to work better for almost anyone else than it does for Māori, failing to live up to the obligations we all have. We have a responsibility to counteract the past with what we do today and live up to our promise.

2. If we don’t focus on our unique people, nobody else will:
Societies naturally first look after their own, and what we learn from one population tends to translate more easily to similar populations than to areas with large differences. Pākehā will benefit more than others from the wealth of knowledge created in Europe and North America; Asian New Zealanders will disproportionately benefit from advances in some of the fastest growing economies of the world. Our Māori and Pacific whānau will receive relatively little relevant attention – unless we stand up and take the lead ourselves.

3. Our incentives perpetuate health inequity:
One of the great limitations of medical progress over time has been the tendency to produce the greatest benefit for the majority, leaving minority groups behind. Our innovators build technology for those who will pay for it, maximising market opportunities. Unfortunately, that compounds at a societal level, where return on investment calculations favour even small gains to the many, over large gains for the few. The net effect perpetuates inequity – minority groups don’t provide enough financial incentive to draw the attention of either our cash-strapped health systems, or our entrepreneurial innovators, exacerbating the differences further.

THE BENEFIT ARGUMENTS

4. We all benefit when those with the poorest outcomes gain:
Healthy people contribute positively to the social, cultural and economic wellbeing of a whole country. Conversely, we all pay for poor health outcomes –- directly for ongoing healthcare, and also through the social and economic costs of having citizens unable to contribute to their full potential. As a taxpayer, it is in my interest for you to have good health. When an identifiable subset of our population experiences disproportionately poor health outcomes, it is in the interest of every citizen to turn that around.

5. Māori knowledge itself will benefit us all:
Traditional western healthcare has been found wanting when it comes to public health crises such as mental health and addiction, and we all recognise intuitively that health is influenced by our whole life experience. The Te Ao Māori world view and knowledge has a rich role to play not only for Māori but also for wider society. The more we engage with Māori and similar communities, the more we will learn how to unlock that potential for us all.

6. If we become good at localising health models for Māori, we can translate what we learn to other minority groups:
Aotearoa New Zealand has many minority groups who experience disadvantage - characterised by disability, disease, age, economic mobility, distance or immigration status to name a few. The process and principles of adapting healthcare to a local population can apply to other important groups. Starting with Māori means that we learn to empower underserved populations, and that knowledge will enhance how we do the same for other minority groups.

7. If we become experts at localising health models for minority populations, we can be world leaders:
Worldwide, a small proportion of every population tends to have worse outcomes, burdening the system for treatment when they should have received prior support for prevention. More often than not, ethnic minorities make up the less fortunate group. By becoming an exemplar for localisation of healthcare for underserved populations, Aotearoa New Zealand will lead. Our academic and public health professionals, and our commercial products, will be sought after to contribute to some of the world’s greatest health challenges. We have all of the ingredients required to show the world how to build an equitable health system.

Are we limiting the societal benefits by focusing on Māori gains? No. In fact, a Māori focus may very well accelerate the positive impact on the wider population. The payoff to all of us from intentionally prioritising Māori health gains is enormous.

Listen to Kevin Ross and former Māori health director, Chad Paraone, discuss the importance of engaging with Māori as leaders, stakeholders and co-designers in health data science projects in episode 34 of eHealthTalk podcast series.

Picture: Kevin Ross, Precision Driven Health (PDH) Chief Executive and Orion Health Director of Research

If you want to contact eHealthNews.nz regarding this View, please contact the editor Rebecca McBeth.

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