Maori suffer roughly seven to eight years lower life expectancy than non-Maori along with disparities observed in a wide array of morbidity indicators such as chronic diseases, infectious diseases and injuries. Maori are more likely than non-Maori to be younger when diagnosed with an illness and be seriously unwell before they seek help. These statistics just goes to highlight the intolerable disparities in health that prevail in the current New Zealand population and have been evident for all throughout the colonial history of New Zealand. Possible explanations for the inequity include historical influences such as colonisation, alienation and dispossession as well as current influences such as socioeconomic deprivation which, together are symptomatic of racial prejudice and discrimination. The effects of racism have had a detrimental effect on the status of Maori hauora and portrayed the failure of the New Zealand healthcare system to provide equally effective care to all citizens. The operation of racism has run the whole gamut in terms of differential access and quality of healthcare to Maori and more direct effects of racism such as trauma and stress.
When considering the inherent health disadvantage of the Maori with regards to the ethnic disparities, the problem is said to lie within the inferior genetic mix or different biology. Although genes do have a significant input to the risk factors and status of Maori health, it has been found in more recent times that the social environment interaction also plays a major role in shaping our body. The role of social hierarchy and systemic bias, coined as ‘the biological expression of racism’ is often not taken into consideration and rather explanations are focussed on cultural stereotypes. (resource book) Jones clarifies and differentiates the term, racism into three parts. Firstly, Jones defines institutionalised racism as differential access to goods, services and opportunities in the society on the basis of race and Came adds that this advantages one sector of the population while disadvantaging another. This apparent form of racism that presents itself within the public health sector extends into public health policy making as well as funding practices. The second form of racism, interpersonal racism is the differential assumption about the abilities and intentions of others as well as differential treatment towards others according to their ethnicity, which is often experienced by many Maori when they seek professional medical advice. Lastly, internalised racism is the acceptance of negative ideologies about their own abilities and intrinsic worth due to their identification within an ethnic group. This occurs as a result of mass propaganda and brainwash making a lot of the Maori believe that the problem is indeed located within them. [1,14,15]
Institutionalised racism accounts for the significant ill-health of the Maori and contributes to the disparities in health through many ways. Most importantly, differential access to health care is noted, whereby the Maori have significantly lower access to both primary and secondary health care services. As a result, the Maori were 1.5 times as likely to have had unmet medical needs as compared to the non-Maori counterparts. This includes not being to be able to visit the local GP, not being able to obtain full access to early detection, prevention services and referral to specialist care. This is further reflected in the longer waiting times throughout the care pathway along with disproportionately lower hospitalisation rates where Maori have higher mortality rates. Differential access to health care centres is partially explained by the socioeconomic deprivation. Maori adults were 1.6 as likely to have been unable to visit a GP as a result of the high costs