Understanding Māori health disparities
Understanding pathophysiology is an international textbook used for training health professionals in the disease processes that interfere with the proper functioning of the human body. When the first Australasian edition was produced it included a chapter on Australian indigenous health but nothing about Māori. Associate Professor Karole Hogarth, who had already written two chapters for the book, pointed out this omission to the publisher, who responded by inviting her to contribute a new chapter on Māori health.
Karole worked with a colleague at Otago Polytechnic School of Nursing, Mereana Rapata-Hanning. They agreed that it would be necessary to provide background to any discussion of the health disparities suffered by Māori. Breaches of the Treaty of Waitangi have contributed to those disparities but the Treaty is now also part of the solutions. Background information about Māori culture also had to be included, to help health practitioners treat people in their cultural context. For example if one ill child presents with an infection, a holistic approach is needed to look not just at the child's whole health but also the wider whānau.
It is important to consider the social determinants of health, both to understand the causes of health disparities and to address obstacles to successful treatment. But there are also genetic factors influencing Māori health, for example a gastric cancer gene. The two factors can compound, for example both genetic and environmental factors contribute to poor oral health in Māori.
The chapter on Māori health was included in the second Australasian edition, published in 2015. The third edition came out in 2018. It is being used here in teaching the Bachelor of Nursing and also the Competency Assessment Programme for internationally qualified nurses coming to practise in New Zealand. It has helped ensure these graduates enter nursing practice with an improved understanding of Māori health issues.