M ā ori Health Today: Strategies for Improving M ā ori Health and Well-being

1. Māori Health Today: Strategies for Improving Māori Health and Well-being Dr Clive Aspin Executive Research Officer A presentation to Health Canada 21 March, 2005 The National Institute of Research Excellence for Māori Development and Advancement

2. Presentation outline • Some facts about New Zealand • Treaty of Waitangi (1840) • Post-Treaty • Māorihealth today • Strategies for improvement • Nga Pae o te Maramatanga The National Institute of Research Excellence for Māori Development and Advancement

3. 1st Capital and where TOW was signed Where I live Clive (Ngati Maru) Hobbiton Present Capital – 2nd home of B,R and I Where some of LOTR was filmed French settlement The National Institute of Research Excellence for Māori Development and Advancement

4. Our Neighbours The National Institute of Research Excellence for Māori Development and Advancement

5. Our Place in the World The National Institute of Research Excellence for Māori Development and Advancement

6. Aotearoa/New Zealand – some facts • Population: 4,000,000 • Prime Minister: Helen Clark • Head of State: HM Queen Elizabeth II • Governor-General: Dame Sylvia Cartwright • Speaker of the House: Margaret Wilson • 1 in 4 New Zealanders live outside New Zealand • Country in OECD with largest percentage of tertiary qualified citizens living outside New Zealand • 15% of population are Māori - arrived approx. 1000 years ago • Majority of European descent – began arriving approx. 200 year ago – people from UK continueto make up biggest percentage of migrants • Other ethnic groups include Pacific Islanders, people from Asian countries The National Institute of Research Excellence for Māori Development and Advancement

7. A little bit of history… • 1000 - Arrival of Kupe from Hawaiiki – multiple migrations • 1642 – Arrival of Abel Tasman • 1769 – Arrival of James Cook • 1835 – Declaration of Independence • 1840 – Signing of Treaty of Waitangi The National Institute of Research Excellence for Māori Development and Advancement

8. The National Institute of Research Excellence for Māori Development and Advancement

9. One of many copies… The National Institute of Research Excellence for Māori Development and Advancement

10. Promises of the Treaty of Waitangi (and basis on which chiefs agreed to sign) • Māori would retain possession of their lands and fishing areas. • At the same time, Māori would accept the new Colonial government's pre-emptive right to purchase land. All sale of land by either Māori or European would be transacted via the government. • Māori would accept the sovereignty of the Queen. • Māori would be guaranteed the same rights and privileges as those of all British subjects. The National Institute of Research Excellence for Māori Development and Advancement

11. Some interesting facts… • Treaty is a contract between two sovereign entities – in this case, Queen Victoria and 500+ chiefs of Aotearoa • Over 500 signatories • Many chiefs signed with a cross or a copy of their moko (facial tattoo) • Five women signed but women chiefs were subsequently prevented from signing • Many chiefs refused to sign • Signed by Governor Hobson on behalf of Queen Victoria – in his pyjamas The National Institute of Research Excellence for Māori Development and Advancement

12. The Treaty of Waitangi - 1840 The National Institute of Research Excellence for Māori Development and Advancement

13. Early representations of Māori The National Institute of Research Excellence for Māori Development and Advancement

14. Fascination and … The National Institute of Research Excellence for Māori Development and Advancement

15. …repulsion The National Institute of Research Excellence for Māori Development and Advancement

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18. Historically, Māori and other indigenous people • Have been scrutinised by non-indigenous people and researchers according to Western and colonialist paradigms • Have been marginalised within society • And, as a consequence, they have been excluded from research and this has contributed to their ongoing marginalisation The National Institute of Research Excellence for Māori Development and Advancement

19. Today, research with Māori must… • Reflect the genuine needs of Māori • Involve communities at all stages of the research process • Seek appropriate ethical approval • Lead to improvements in well-being • Contribute to the development of the Māoricommunity • Provide workforce development opportunities • Lead to outcomes that will make a difference The National Institute of Research Excellence for Māori Development and Advancement

20. Māorihealth and well-being today • Significant disparities continue to exist between Māoriand non- • Lower life expectancy than non-Māori • Higher rates of psychiatric illnesses • Higher rates of all cancers, leading cause of death and illness • Increasing rates of suicide, especially among youth • Lower educational achievement • High rates of imprisonment (50% of prison population) • Higher rates of cardiovascular disease yet lower rates of interventions • Poor access to services The National Institute of Research Excellence for Māori Development and Advancement

21. AIDS in New ZealandSource: AIDS New Zealand – www.moh.govt.nz Number of people diagnosed with HIV in New Zealand through antibody testing by year of diagnosis and means of infection 2004 157 diagnosed through antibody testing 28 reported through viral load testing High numbers of new diagnoses among msm and heterosexual men and women (as in 2003) has been sustained The National Institute of Research Excellence for Māori Development and Advancement

22. Place of infection of MSM diagnosed by antibody test by year of diagnosis Place of infection of MSM diagnosed by antibody test by year of diagnosis 73 msm diagnosed with HIV 51 (70%) infected in New Zealand 9 (12%) infected in Australia Of the 51, average age = 38 82% = European 10% = Māori 2% = Pacific The National Institute of Research Excellence for Māori Development and Advancement

23. AIDS and Māori Of the 46 MSM diagnosed in 2003 14 were infected in last 5 years, 7 of these in last 12 months Average age = 39 52% aged between 30 and 39 13% under 30 70% Pakehā 17% Māori 11% Pacific Island The National Institute of Research Excellence for Māori Development and Advancement

24. AIDS in New Zealand – Key Points The high number of new diagnoses of HIV that occurred in 2003 was sustained in 2004. The number of men who have sex with men (MSM) diagnosed with HIV, infected in New Zealand, increased slightly in 2004.The number of MSM known to be infected in New Zealand in the previous 12 months, also increased.The number of people diagnosed with HIV who were heterosexually infected overseas increased in 2004. The National Institute of Research Excellence for Māori Development and Advancement

25. On the positive side, Māori, like other indigenous people, have… • Survived more than two hundred years of colonisation • Shown remarkable resiliency in the face of extreme adversity and dispossession of land • Made significant contributions to the societies and cultures of which they are a part • Shown that there are viable alternatives to the dominant Western paradigm that prevails today The National Institute of Research Excellence for Māori Development and Advancement

26. For example… The National Institute of Research Excellence for Māori Development and Advancement

27. Ngā Pae o te MāramatangaHorizons of Insight One of seven centres of research excellence established by the New Zealand Government in 2002 VISION Transformation of New Zealand society such that Māori participate fully in all aspects of society and the economy MISSION To provide excellent research, training and knowledge transfer The National Institute of Research Excellence for Māori Development and Advancement

28. Strategic focus of Ngā Pae o te Māramatanga • 3 key research programme themes • Building sustainable and healthy communities • Social and educational transformation • New frontiers of knowledge • Achieved through research activities, knowledge transfer and research training. The National Institute of Research Excellence for Māori Development and Advancement

29. The first three years… • An organisation in development • Research capacity building involving research organisation, entities and communities • Māori doctoral programme • Research training opportunities – workshops, writing retreat, attendance at conferences • MAI programme • Inaugural international conference • Innovative research The National Institute of Research Excellence for Development and Advancement

30. Thank you Merci Clive AspinNga Pae o te MaramatangaUniversity of AucklandAuckland New Zealandc.aspin@auckland.ac.nz The National Institute of Research Excellence for Māori Development and Advancement