Health care systems in transition: New Zealand: Part I: An overview of New Zealand's health care system (original) (raw)
Related papers
Journal of Primary Health Care
INTRODUCTION: Pacific people suffer disproportionately poorer health and reduced life expectancy at birth compared to the total New Zealand population. AIM: To assess causes of excess morbidity in the Pacific population, and identify lesser known or previously unknown causes which require further investigation. METHODS: We obtained public hospital discharge data from July 2000 to December 2002. The population data were from the 2001 Census. Standardised discharge ratios were calculated to compare Pacific peoples with the total New Zealand population. RESULTS: Pacific peoples were six times more likely to have a diagnosis of cardiomyopathy and gout, and four to five times of rheumatic fever, gastric ulcer, systemic lupus erythematosus (SLE), and diabetes. Respiratory diseases, skin abscesses, heart failure, cataracts, cerebral infarction and chronic renal failure were also significant causes of excess morbidity. Unexpected causes of excess morbidity included candidiasis, excess vomit...
Implications of policy and management decisions on maori health: Contemporary issues and responses
International Journal of Health Planning and Management, 1987
By the close of the 19th century, there was a strong possibility that the Maori race might not survive, and the government was advised by a Dr Featherston: 'Our plain duty is to smooth down their dying pillow. Then history will have nothing to reproach us with' (Newman, 1881). Muskets, infectious diseases, alcohol and starvation contributed to the reduction of the population from an estimated 200 OOO (pre-European contact) to 42 OOO (1906 census). Dr Featherston's prediction may well have come true, had it not been for the energies and adaptability of a relatively small group of youthful Maori leaders who launched a revival movement that in 50 years turned the 'dying race' into a highly virile one. Today the Maori population is in excess of 390000, and makes up 12 per cent of the total population. It is youthful, over 65 per cent being under the age of 25 (non-Maori 40 per cent), but only 3.9 per cent over age 60 (non-Maori 14.9 per cent). Maori fertility is at a higher level (2.6) than that of non-Maori (1.9), and Maori babies make up over 13 per cent of all births.
Emerging needs, evolving services: The health of Pacific peoples in New Zealand
Kotuitui: New Zealand Journal of Social Sciences Online, 2008
From 0.1% of the total population in 1945 to 6.9% in 2006, Pacific peoples now resident in New Zealand highlight significant health policy and service delivery issues within an increasingly diverse society. over the last decade, marked differences in the health status of Pacific New Zealanders and Palagi New Zealanders have been well documented, showing high levels of disparity and continuing negative trends. This paper provides a broad overview of the history of Pacific health and health initiatives in New Zealand from the 1940s through to the mid 2000s, highlighting the interface between Pacific peoples and the New Zealand health sector. While the New Zealand Government has become increasingly responsive to Pacific health needs, significant disparities remain between Pacific and Palagi populations. Furthermore, many of the encouraging health initiatives introduced in the past decade remain at risk due to a variety of factors, including a need to strengthen the Pacific health workforce and management expertise.
2000
This thesis examines the effects of public sector restructuring on Maori health development during the 1990s, primarily through an analysis of health sector reform, changes to health policy direction, and the response of Government to Maori development issues. The relationship between health development and socioeconomic status is also examined in order to determine what the cost of the economic and political climate of the decade has been for Maori. A key focus is the partnership, and obligations thereof, established by the Treaty of Waitangi between Maori and the Crown. As Government has acknowledged the Treaty as the founding document of Aotearoa New Zealand, any discussion of Maori health must start with the Treaty as a basis. The theoretical framework adopted employs social policy and sector analysis in order to assess whether health outcomes for Maori have improved during the 1990s. Institutional influence on the policy process is also examined as part of this framework. The influence of these procedures on policy development and general health outcomes for Maori during the 1990s is assessed, while health outcomes for Maori women in particular are discussed as a case study. This thesis examines why disproportionate health development still occurs in terms of Maori and non-Maori health despite Maori health having been designated a health gain priority area since 1984, and Government requirements that mainstream accountability to Maori be improved. As part of this examination, health promotion and intervention strategies have been assessed as these are seen as an effective first point of contact for groups traditionally disadvantaged in terms of health outcomes. Moreover, areas have been highlighted fo where improvement to policy could enhance positive Maori development, as positive Maori development is seen as essential to improving health outcomes for Maori. Regional policy efforts for promoting Maori health gain are also examined.
Cohort Morbidity Hypothesis: Health Inequalities of Older Māori and non-Māori in New Zealand
New Zealand population review, 2014
This paper describes the mortality trends from 1948 to 2008 between Māori and non-Māori populations. Using the cohort morbidity hypothesis, we propose that health disparities between the populations can be partially explained by different levels of early-life exposure to infectious diseases. We conducted regression analysis and found strong associations between early- and old-age mortality for cohorts. Childhood mortality, rather than mid-life mortality, accounted for greater variance in older age. The mortality trend of the 1948 Māori birth cohort is similar to the 1902 non-Māori birth cohort 46 years earlier. Implications are discussed.
The ‘Treaty’ and ‘treating’ Māori health: politics, policy and partnership.
This paper seeks to engage in the Treaty of Waitangi and its relationship in improving Māori health outcomes in Aotearoa New Zealand. The current literature about this relationship, although useful, finds Māori and their health in a very precarious and vulnerable position. At an institutional level, the ability to ‘break through’ many of the social and political barriers that constrain Māori from being able to exercise their ‘tino rangatiratanga’ (self-management) remains clearly visible. Despite the legal obligation of health institutions to uphold the principles of the Treaty of Waitangi, Māori are not enjoying the same health standards as non-Māori. The paper posits that the health sector continues to perpetuate notions of ‘treating’ Māori more so than Māori navigating the process of health ‘revitalisation’. A major shift institutionally is required to re-assert Māori health as a basic human right and to re-configure Māori health gains as part of being a healthy nation.