Maori male death rates defy Government health action

By MARTIN JOHNSTON

The annual rate of deaths of Maori men remains more than twice the level of other New Zealand men, despite years of Government action to improve Maori health.

A study has found that among males aged 15 to 64, the annual rate of deaths from all causes is 2.4 times higher for Maori.

But when the researchers looked at deaths from a range of treatable ailments - such as bronchitis, asthma, appendicitis and high blood pressure - the Maori rate shot up to 5.3 times the non-Maori figure.

This suggests failures in health services getting through to Maori, one of the researchers, Christchurch School of Medicine sociologist and epidemiologist Andrew Sporle, said yesterday.

The ethnic disparity in death rates mirrors health gaps.

A sample of adult health statistics shows that 46 per cent of Maori smoke compared with 23 per cent of Pakeha, 17 per cent of Maori have high blood pressure compared with 11 per cent of Pakeha and 8 per cent of Maori have diabetes compared with 3 per cent of Pakeha.

An Auckland Maori health service says the best hopes for a turnaround lie in devising separate health messages for Maori and in fostering Maori health organisations.

The 1996-97 death-rate study, paid for by the Health Research Council, is published in today's New Zealand Medical Journal.

"The high levels of Maori preventable death emphasise the need to make health policy and services more responsive to Maori health needs," conclude the researchers.

Mr Sporle highlighted Maori smoking, their over-representation in dangerous manual jobs, and doctors' attitudes as other possible reasons for the gap between the Maori and non-Maori death rates.

He said a death rates study published in the journal in 1993 had concluded that there was a small but gradual closing of the gap between Maori and others.

"While we can't compare between years [because of changed definitions of Maori ethnicity], we know that there is still a very large difference between Maori and non-Maori."

The Sporle study also found:

* The annual Maori death rate remained well above the non-Maori rate even allowing for Maori being more concentrated than others in lower socio-economic groups.

* The Maori death rate for men in the top occupational group was higher than for those in the bottom non-Maori group.

* Big Maori death rate variations between the highest and lowest occupational groups. The researchers believe this may be partly due to the negative effects of two decades of economic restructuring falling disproportionately on Maori in the lower groups.

The West Auckland Waipareira Trust delivers health services to about 7500 people a year, mainly Maori, through its Waipareira Health Centre.

The centre's general manager, Tereki Stewart, said the health of Maori had improved in the past decade, largely because of the creation of many organisations like his, in which Maori delivered health services to Maori.

But health services needed to become better at targeting health promotion messages at Maori.

The Director-General of Health, Karen Poutasi, said findings such as the Sporle study validated the Government's health spending plans.

Among the priorities for spending an extra $410 million for primary healthcare announced last week was targeting high health needs, she said, and that included Maori and Pacific Islanders who were poor.