Inequalities in health affecting Mäori and Pacific
peoples

Evidence that the health experience of New Zealanders is sharply divided along ethnic lines has been steadily accruing over the last 20 years. A clear pattern has emerged demonstrating poorer health among Mäori compared with non-Mäori (Pomare et al 1995). More recently, research has shown that Pacific peoples also experience poorer health than European/Other New Zealanders (Ministry of Health 1999a).
The unequal position of Mäori health results from a combination of factors (National Health Committee 1998), including poorer social and economic status; the impact of discrimination (including institutional and personal racism (Jones 2000)); higher levels of behavioural risk
factors, such as smoking; and lower access to or effectiveness of some health services (Pomare and de Boer 1988). Significant interrelationships exist among these factors, and a fuller understanding of the determinants of Mäori health continues to evolve.
Factors impacting on the health of Pacific peoples are less well studied but are likely to be similar to those affecting Mäori. Poorer social and economic circumstances are likely to account for a substantial proportion of excess ill health affecting Pacific peoples (Ministry of Health 1997b).
In a paper developed for the National Health Committee, Woodward and Kawachi identified four major arguments in favour of reducing health inequalities due to social, cultural and economic factors (Woodward and Kawachi 1998):

• Inequalities in health are inherently unfair, especially in circumstances where personal responsibility is least relevant. The Treaty of Waitangi places further emphasis on the health of Mäori (Durie 1998).

• Reduction in health inequalities benefits everyone, largely because the conditions that lead to health inequalities are detrimental to all society, but also because some consequences of health inequalities have obvious spill-over effects (for example, infectious diseases).

• Health inequalities are largely avoidable.

• Interventions to reduce health inequalities may be cost-effective (although further information on this issue is required).

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