The death of Rotorua man Frank Walters from a heart attack has sparked anger in a Rotorua GP, who says New Zealand needs to do more about poverty.
Frank Tipene Walters died overnight on November 16 last year at his brother's Clinkard Ave home in Rotorua.
While a coroner has ruled Walters died from heart disease with diabetes as an underlying condition, Rotorua GP Harry Pert said in the coroner's finding unemployment, poverty, homelessness and difficulty accessing health services were also major contributors in his death.
Among other failures in social determinants, Pert describes New Zealand's access to dental care as "hideously unacceptable" and "worse than the third world".
Coroner Donna Llewell's finding into the death of Walters, a 53-year-old sickness beneficiary from Rotorua, has just been released to the Rotorua Daily Post.
The finding said Walters had been living with his brother, Anthony Walters snr, and had gone to bed with a cup of tea. He died overnight, and his body was discovered by his family the next morning.
A toxicology report showed he died due to a sudden cardiac event. There was no alcohol or cannabis in his blood but there was a presence of a high-potency synthetic cannabinoid in his system.
Pert, who was Walters' GP, said in his report to the coroner that Walters had poor dentition, which made it hard for him to have nutrition appropriate for his diabetes. The fact he hadn't been able to access dental services contributed to his poor diabetes control, Pert's report said.
The report noted Walters was often very motivated to improve his health but social challenges were overwhelming for him.
Pert's report noted "social determinants of health are also becoming more significant and perhaps less recognised and recorded".
Speaking to the Rotorua Daily Post, Pert said he was seeing the impacts of poverty more than any other time in his 45-year medical career.
"We talk about problems with obesity, nutrition, diabetes and so on but we don't talk enough about why that is."
Pert said too many people couldn't afford healthy food.
"New Zealand is a country that can produce food like hardly any other in the world yet we are not able to feed our own population adequately and I think that needs a bit of soul-searching to understand why that is.
"Why is it cheaper to buy Coca-Cola than milk and why can't people buy fresh fruit and vegetables?
"It's all very well saying eat healthily but if you haven't got any teeth it's really hard. We have hideously unacceptable standards of dental care and access to dental care in New Zealand. It's worse than the third world. It's completely unacceptable in a rich country like ours that people can't access basic dentistry properly."
Pert said housing was another factor.
"We can't house our population either, in a country that's got space and we grow building materials.
When asked if it made him angry, Pert said: "It makes me very angry, absolutely."
The Rotorua Daily Post talked to Anthony Walters snr, who said his brother started well not long after his diabetes diagnosis in 2015 but "got a bit slack".
"He didn't know he was dying. He started off very well but not towards the end. A bit of it was because of his own personal doing and his diet because if he didn't feel like eating he wouldn't."
Elmer Peiffer from Rotorua Whakaora, which distributes donated food to Rotorua's most in need, said poverty was becoming a major factor in life-or-death situations.
"You have to take into account the cost of a doctor's appointment and the cost of medication on top of that."
He said it wasn't just the homeless or those on benefits, as they saw working families struggling to access what should be basic rights like getting dental care.
"You can get infections from poor teeth that go into your bloodstream that can kill you. There's just not enough income to take care of yourself."
Peiffer said while people's priority should always be their health, he found it hard to believe they would focus on their health when they had other financial pressures to meet.
Peiffer said some of the people they dealt with couldn't face the cost of going to a doctor.
In one particular case, his organisation helped a homeless man with a serious health condition who wouldn't go to the doctor because he had debt with his local surgery.
Peiffer said they paid his debt, then set him up with payments of $5 a week direct to his medical centre to take care of future doctors' costs and prescriptions at a pharmacy.
Peiffer said it meant the man didn't get put off going to see the doctor for financial reasons when his health was in need.
Bay of Plenty homeless advocate Tommy Wilson said the coroner's finding proved that "poverty or pohara [poor] can kill you".
"It's sadly a true reflection of the growing gap between the haves and have nots and
land that has enough for all of us, especially kai and land, and where a warm safe house should be the priority for any Government no matter what political pōtae they are wearing."
Wilson said it all started with good healthy kai. He said initiatives of feeding children in schools was a great start and he hoped it would be rolled out to every child and every homeless and poor family.
He said this was the focus for Te Tuinga Whanau Support Services Trust, which had just this week taken possession of a commercial kitchen that would allow them to partner with Bay Venues to produce 500 healthy meals a day to those in need.