Māori, New Zealand's indigenous people, make up approximately 15.4 per cent of the country's population, with nearly a quarter living in the greater Auckland area. The relationship between the Māori and the New Zealand government is grounded in the Treaty of Waitangi, which contains a powerful expression of the Crown's moral obligations to act honourably in its dealings with Māori.

There are also more than 22 different Pacific communities in New Zealand – each with its own distinctive culture, language, history and health status. Collectively known as Pasifika, the biggest Pacific groups in New Zealand are the Samoan, Cook Islander, Tongan, Niuean, Fijian, Tokelauan, and Tuvaluan communities. To date, the majority of the Pacific communities in New Zealand originate from Polynesian states, however migration to New Zealand from Melanesian states has also increased, and predictions indicate that New Zealand can expect much larger numbers of migrants from Melanesia in the coming decades.

It is also important to note that there has been a rapid increase in the last decade of the number of Asians in New Zealand. By 2001, Asians had displaced the Pasifika communities as the third most populous ethnic group, with the 2006 Census data estimating the Asian population of New Zealand at around 9.2 per cent, with predicted growth to up to 16 per cent of the national population by 2016. Chinese (46 per cent) and Indian (29 per cent) are the majority groups, with populations from other Asian communities including Koreans, Filipinos, Japanese, Sri Lankans, Cambodians and Thais.

Despite significant gains in recent years, Māori continue to have the poorest health of any New Zealand group. Māori have a higher mortality rate than non-Māori, as well as higher rates of illness. Māori infants die more frequently from SIDS (sudden infant death syndrome), have lower birth weight than non-Māori and also experience higher rates of illness. Māori are 2.3 times more likely to experience and die from cardiovascular disease than non-Māori and Māori life expectancy is also significantly lower than the life expectancy for non-Māori.

Other minority groups in New Zealand also experience poorer health than the majority New Zealand European population. In particular, Pasifika still experience poorer health outcomes than the majority population. For example, Māori and Pacific communities have higher rates of diabetes. Māori and Pacific communities experience consistently higher infant mortality rates than the total New Zealand population, although this appears to be decreasing.[17] Moreover, the obesity rates are greater for Māori and Pasifika.

Māori health

The New Zealand government has taken some important strides to address Māori health disparity. He Korowai Oranga: Māori Health Strategy sets the direction for Māori health development in the health and disability sector. The vision of He Korowai Oranga is the achievement of whānau ora (healthy families), and recognizes the desire of Māori to have control over their future, and to seek their own solutions and to manage their own services.

The New Zealand government has developed targeted action plans that set objectives for Māori health. Whakatātaka – the Māori Health Action Plan – was implemented in 2002, and was built upon by the second Māori Health Action Plan, Whakatātaka Tuarua 2006-2011.

As part of Whakatātaka Tuarua, the Ministry of Health has identified the following areas for priority: building quality data and monitoring Māori health; developing whānau-ora-based models; ensuring Māori participation; and improving primary health care.

Under the 2000 New Zealand Public Health and Disability Act, health services require community participation and have been decentralized. The Act created 21 district health boards (DHBs), which provide services that meet local needs. This system is important for Māori health as every board is legally required to have at least 2 Māori members out of its 11, and Māori membership of the board must also be proportional to the number of Māori in the district's resident population. Moreover, DHBs must include Māori health and whānau ora as priority criteria in resource allocation and disincentives decisions, and should set funding targets for investment in Māori health and disability, and report on targets for their regions to increase funding for Māori initiatives. However, in the 2012 assessment the auditor general found that DHBs have not always performed adequately and noted a lack of monitoring and reporting.[18]

Another important initiative for Māori health is the fact that each DHB must develop a Māori Health Plan (MHP), which aims to improve Māori health and reduce the disparities between Māori and non-Māori. As key planning and monitoring documents, the MHPs provide a summary of a DHB's Māori population and their health needs. The plan then documents and details the interventions and actions the DHB plans to undertake to address health issues in order to achieve indicator targets set nationally, regionally and at district level.

The New Zealand Ministry of Health has also been working together with Māori traditional healing practitioners. Rongoā Māori, the traditional healing, is formulated in a Māori cultural context; it encompasses the understanding of events leading to ill health and its impacts are addressed through a range of culturally bounded responses. These responses include rakau rongoā (native fauna herbal preparations), mirimiri (massage) and karakia (prayer). In December 2011, a new national Rongoā governance body – Te Kāhui Rongoā Trust – was established to protect, nurture and promote Rongoā Māori, and aimed to become fully operational by June 2012.

Although it is too early to measure the success of the initiative, it remains significant, in particular in light of old repressive laws which banned traditional Maori healers (Tohunga) and outlawed Rongoā Māori. Although the law was repealed in 1962, the new Trust is one of the first initiatives to formally promote Rongoā Māori on the national level.

Health of Asian New Zealanders

It appears that many Asian migrants who arrive in New Zealand are relatively healthy, however this has been attributed to the 'healthy immigrant effect', which requires most migrants to be in good health in order to be allowed to immigrate to a new host country. However, this positive effect on health is reported to gradually diminish with increased length of residency.

In particular, data has demonstrated low use of primary health care, emergency health care and cancer screening for Asian people in New Zealand, particularly for Chinese New Zealanders. For youth this is particularly worrying, and 15 per cent of young Chinese New Zealanders reported accessing no health services at all, which was over three times the rate reported by other New Zealanders.

Another key issue is cardiovascular disease and diabetes for South Asian people. Indian people show the highest rates of self-reported diabetes of any ethnic group in New Zealand and they also show high levels of cardiovascular disease, similar to Māori.

Some of these challenges appear to arise from underlying structural obstacles for Asian New Zealanders as a minority group: these include a lack of knowledge of the New Zealand health system, cultural beliefs and approaches to health care that differ from the New Zealand system, and linguistic barriers. Mental health also remains a challenging area because of the degree of stigma attached to such illness in many Asian cultures, resulting in potential treatment delay and possible worsening of prognosis.

Notes

17. New Zealand Government, Third periodic report to the CESCR, E/C.12/ NZL/3, para. 472, available at: http://www2.ohchr.org/english/bodies/cescr/cescrs48.htm.

18. See: Controller and Auditor-General NZ, 'Part 5: Reducing health disparities for Māori', in Health Sector: Results of the 2010/11 Audits, retrieved July 2013, http://www.oag.govt.nz/2012/health-sector/part5.htm.

Disclaimer: © Minority Rights Group International. All rights reserved.

This is not a UNHCR publication. UNHCR is not responsible for, nor does it necessarily endorse, its content. Any views expressed are solely those of the author or publisher and do not necessarily reflect those of UNHCR, the United Nations or its Member States.