M ā ori Health Today: Strategies for Improving M ā ori Health and Well-being Dr Clive Aspin...

Māori Health Today: Strategies for Improving

Māori Health and Well-being

Dr Clive AspinExecutive Research Officer

A presentation to Health Canada21 March, 2005

The National Institute of Research Excellence for Māori Development and Advancement

Presentation outline


• Some facts about New Zealand

• Treaty of Waitangi (1840)• Post-Treaty• Māori health today• Strategies for improvement• Nga Pae o te Maramatanga

The National Institute of Research Excellence for

Māori Development and Advancement

Clive (Ngati Maru)

Present Capital – 2nd home of B,R and I

1st Capital and where TOW was signed

Hobbiton

Where some of LOTR was filmed

Where I live

French settlement

Our Neighbours


Our Place in the World


Aotearoa/New Zealand – some facts


• Population: 4,000,000• Prime Minister: Helen Clark• Head of State: HM Queen Elizabeth II• Governor-General: Dame Sylvia Cartwright• Speaker of the House: Margaret Wilson• 1 in 4 New Zealanders live outside New Zealand• Country in OECD with largest percentage of

tertiary qualified citizens living outside New Zealand

• 15% of population are Māori - arrived approx. 1000 years ago

• Majority of European descent – began arriving approx. 200 year ago – people from UK continue to make up biggest percentage of migrants

• Other ethnic groups include Pacific Islanders, people from Asian countries

A little bit of history…


• 1000 - Arrival of Kupe from Hawaiiki – multiple migrations

• 1642 – Arrival of Abel Tasman

• 1769 – Arrival of James Cook

• 1835 – Declaration of Independence

• 1840 – Signing of Treaty of Waitangi

One of many copies…


Promises of the Treaty of Waitangi (and basis on which chiefs agreed to sign)


• Māori would retain possession of their lands and fishing areas.

• At the same time, Māori would accept the new Colonial government's pre-emptive right to purchase land. All sale of land by either Māori or European would be transacted via the government.

• Māori would accept the sovereignty of the Queen.• Māori would be guaranteed the same rights and

privileges as those of all British subjects.

Some interesting facts…


• Treaty is a contract between two sovereign entities – in this case, Queen Victoria and 500+ chiefs of Aotearoa

• Over 500 signatories• Many chiefs signed with a cross or a copy of

their moko (facial tattoo)• Five women signed but women chiefs were

subsequently prevented from signing• Many chiefs refused to sign• Signed by Governor Hobson on behalf of

Queen Victoria – in his pyjamas

The Treaty of Waitangi - 1840


Early representations of Māori


Fascination and …


…repulsion


Historically, Māori and other indigenous people


• Have been scrutinised by non-indigenous people and researchers according to Western and colonialist paradigms

• Have been marginalised within society

• And, as a consequence, they have been excluded from research and this has contributed to their ongoing marginalisation

Today, research with Māori must…


• Reflect the genuine needs of Māori• Involve communities at all stages of the

research process• Seek appropriate ethical approval• Lead to improvements in well-being• Contribute to the development of the Māori

community• Provide workforce development opportunities• Lead to outcomes that will make a difference

Māori health and well-being today


• Significant disparities continue to exist between Māori and non-

• Lower life expectancy than non-Māori

• Higher rates of psychiatric illnesses

• Higher rates of all cancers, leading cause of death and illness

• Increasing rates of suicide, especially among youth

• Lower educational achievement

• High rates of imprisonment (50% of prison population)

• Higher rates of cardiovascular disease yet lower rates of interventions

• Poor access to services

AIDS in New ZealandSource: AIDS New Zealand – www.moh.govt.nz


Number of people diagnosed with HIV in New Zealand through antibody testing by year of diagnosis and means of infection

2004 157 diagnosed through antibody testing

28 reported through viral load testing

High numbers of new diagnoses among msm and heterosexual men and women (as in 2003) has been sustained



Place of infection of MSM diagnosed by antibody test by year of diagnosis

73 msm diagnosed with HIV

51 (70%) infected in New Zealand

9 (12%) infected in Australia

Of the 51, average age = 38

82% = European

10% = Māori

2% = Pacific

AIDS and Māori


Of the 46 MSM diagnosed in 200314 were infected in last 5 years, 7 of these in last 12 monthsAverage age = 3952% aged between 30 and 3913% under 3070% Pakehā17% Māori11% Pacific Island

AIDS in New Zealand – Key Points


The high number of new diagnoses of HIV that occurred in 2003 was sustained in 2004.

The number of men who have sex with men (MSM) diagnosed with HIV, infected in New Zealand, increased slightly in 2004.

The number of MSM known to be infected in New Zealand in the previous 12 months, also increased.

The number of people diagnosed with HIV who were heterosexually infected overseas increased in 2004.

On the positive side, Māori, like

other indigenous people, have…


• Survived more than two hundred years of colonisation• Shown remarkable resiliency in the face of extreme

adversity and dispossession of land• Made significant contributions to the societies and

cultures of which they are a part• Shown that there are viable alternatives to the dominant

Western paradigm that prevails today

For example…


Ngā Pae o te MāramatangaHorizons of Insight


One of seven centres of research excellence established by the New Zealand Government in 2002

VISIONTransformation of New Zealand society such that Māori

participate fully in all aspects of society and the economyMISSION

To provide excellent research, training and knowledge transfer

Strategic focus of Ngā Pae o te

Māramatanga


3 key research programme themes

1. Building sustainable and healthy communities2. Social and educational transformation3. New frontiers of knowledge

Achieved through research activities, knowledge transfer and research training.

The first three years… An organisation in development Research capacity building involving research

organisation, entities and communities Māori doctoral programme Research training opportunities – workshops,

writing retreat, attendance at conferences MAI programme Inaugural international conference Innovative research

The National Institute of Research Excellence for Development and Advancement

Thank you Merci

Clive AspinNga Pae o te Maramatanga

University of AucklandAuckland

New [email protected]


M ā ori Health Today: Strategies for Improving M ā ori Health and Well-being Dr Clive Aspin...

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