Section opening title fits within this text box which maintains the margins as defined by the box ed

1
(No Transcript)
2
Healthy Maori in the Ngai Tahu rohe NZCOSS
2006 ConferenceRaraka Korero Weaving Our
Stories 19th October 2006
3
He Oranga Pounamu

• Maori Development Organisation (MDO)
• Mandated by Te Runanga o Ngai Tahu
• Established June 2000
• Kaupapa to advance the Maori health and social
  services sector for all Maori in Ngai Tahu rohe

4
Affiliated Providers

• 30 affiliated Maori for Maori provider
  organisations
• Service delivery across health, social services,
  education, justice, employment and housing
• Kaikoura in the north, Bluff in the South, and
  across to Hokitika and Reefton in Te Tai Poutini
• Some structures are runaka based or mandated
  while others are Maori/Community NGO driven

5
(No Transcript)
6
18 Papatipu Runanga Ngai Tahu Whanui
Te Runanga o Ngai Tahu
TRIBAL GOVERNING BODY REPRESENTING THE 18
PAPATIPU RÜNANGA
Office of Te Runanga o Ngai Tahu
EXECUTIVE ARM OF TE RÜNANGA O NGÄI TAHU
Ngai Tahu Communications He Oranga Pounamu Te
Tapuae o Rehua
Ngai Tahu Holdings Corporation Ltd
DEVELOPMENT OF ECONOMIC BENEFITS
ASSOCIATED ENTITIES
7
Regional Maori Providers
8
He Oranga Pounamu Canterbury Maori Providers
Alis Home HelpOtautahi Social ServicesTe Aka
Umanga Ki WaitahaTe Ora Hou ki OtautahiTe Puna
OrangaTe Puna Whaihua Arowhenua Whanau Services
Te Rapana TrustTe Tai O MarokuraTe Mataariki
Whaioranga Trust Positive Directions Trust Te
Arawa Whanau ki Otautahi Maori Resource
Disability Centre He Waka Tapu Trust Otautahi
Maori Womens Welfare League Te Puawaitanga
9
He Oranga Pounamu Other Regional Maori
Providers Inangahua Manaaki mo te WhanauRata
Te Awhina Trust Arai Te Uru Whare HauoraKai
Tahu ki Otago TrustPikiake Te Rito TrustTe
Roopu Tautoko ki te Tonga Hokonui Runanga Health
Social Services TrustTe Whana o Hokonui Marae
Inc/ Pa HarakekeAwarua Social Health Services
Nga Kete Matauranga Pounmau Charitable Trust/
Oraka Aparima Health Social ServicesMurihiku
Iwi Social ServicesTe Huarahi ki te Oranga Pai
10
Maori Services

• Primary Care Maori PHO with GP and Practice
  Nurse Clinics
• Tamariki Ora Well Child Services delivered in
  the home
• Whanau Ora personal health focus on individual
  and whanau health plans a public health
  education and health promotion component
• Nutrition Physical Activity exercise activity
  programmes and nutrition education hui
• Mobile Nurse disease specific personal health
  nurse delivering home based disease management
  care eg diabetes, cardiac and respiratory disease
• Problem Gambling population approach for health
  promotion and health education and a treatment
  service approach for people with a gambling
  addiction

11
Maori Services

• Alcohol Drug Addiction day and residential
  treatment services
• Screening programmes population health approach
  to health promotion and health education for
  cervical screening and breast screening
  programmes
• Immunization population approach for health
  promotion alongside personal health approach for
  Outreach Immunization Nurse to immunize tamariki
  in their homes
• Service Co-ordination personal health service
  with a focus on organizing and coordinating
  access and delivery of health services for rural
  populations
• Strengthening Youth Well Being population focus
  on reducing youth suicide through increased youth
  well being
• Regional Social Services / I Resource
  Information Services
• Traditional Rongoa Services

12
Maori Health Inequalities
13
Maori Health Status

• On average Maori experience the worst health
  status of any population group in New Zealand.
• While there have been significant gains in health
  status for the entire population the gap between
  Maori and non-Maori has remained.
• Most significant overall gains have been related
  to public health initiatives that have focused on
  population approaches such as clean water,
  sewerage systems and immunization.
• Increasing number of Maori health providers
  especially in the primary care environment
• 1992 20 Maori health service providers
• 2006 240 Maori health service providers

14
Comparing Life Expectancy at Birth2000 - 2002
Prof Mason Durie, 2005
15
Contemporary Issues
1904 2004
Alcohol and Drug AIDS Heart Disease Cancer Asthma
Diabetes Obesity Motor Accidents Unsafe behaviors
16

• Ischaemic Heart Disease
• Maori gtx2.5 higher mortality
• Maori x1.5 higher likelihood of hospitalization
• Maori same rate of re-vascularisation
  procedures
• Diabetes
• Among people with diabetes Maori are x3.5 more
  likely to have renal failure
• Among people with diabetes Maori are x2 more
  likely to require lower limb amputation
• All Cancer
• Maori cancer registration rate is slightly higher
  than non-Maori
• Maori cancer mortality rate is x2 higher than
  non-Maori

17
Health Determinants
Life Expectancy Small Area Deprivation in New
Zealand, MoH 2001
18
Deprivation Profiles
Reducing Inequalities in Health, MoH 2002
19
Ethnicity, Deprivation Life Expectancy
Reducing Inequalities in Health, MoH 2002
20
Deprivation Profile Canterbury DHB
(Source data Census 2001 and Ministry of
Health)
21
Myths Ethnic Disparities

• Increasingly data is confirming that many of the
  past anecdotal explanations for ethnic
  disparities are in fact wrong. For example
• Maori dont go to the doctor until they are
  really sick.
• Maori across all age groups are accessing primary
  care services at the same or higher rates than
  non-Maori (Pegasus Health)
• Maori refuse treatment opportunities
• Maori take up surgical services at the same rate
  as non-Maori but are not referred to a surgeon at
  the same rate as non-Maori (ACC)
• Maori dont go to appointments when referred or
  avoid going to the hospital
• Maori hospital admission rates are greater than
  non-Maori but Maori are less likely to undergo an
  intervention or surgical procedure than non-Maori
  
• Maori have worse cancer outcomes because they
  present with more advanced disease
• Maori cancer deaths are disproportionately higher
  than non-Maori after adjusting for level of
  staging at registration

22
Access to Primary Care
Consultation rates for all patients submitted on
Pegasus Health Surgery patient registers, July
2004 - June 2005
23
Maori Population Growth
Maori population has grown by 57 from 1981 - 2001