Access to health is a fundamental right of all human beings (WHO; 2004). If all people had access to health care then no disparities would be found between different groups. However, according to Giddings (2005) the health status of groups in various countries is not similar and have widened between groups since some groups are marginalised and others are privileged by their social identities. This may also be the case in New Zealand. Statistics by the Waikato District Health Board (2012) indicate that Maori as a group is more prone to ill health than any other ethnic groups in the region. Similar results were obtained by Howden, Chapman & Tobias (2000) who state that Maori have lesser health standing at levels such as all learning opportunities, job status and income than non-Maori. The general conclusion from these studies is therefore that there does seem to be a discrepancy with Maori health care. In order to address this, it is necessary to identify and address the relevant factors that can create a barrier to a level playing field for Maori as far as health is concerned and through this process give effect to the WHO’s “right to health” outcomes for all. Howden, Chapman & Tobias (2000) see the barriers to efficient Maori health care as being institutional racism, ongoing effects of colonization on Maori through tapering the Maori monetary base and reducing Maori political influence. Theunissen (2011) agrees in principal with this by concluding that the disparities in Maori health exist mainly due to an inconsistent consideration of Maori culture and social policies. Factors such as institutional discrimination (leading to interpersonal racism which is seen as breaches of human and indigenous rights), lack of respect and lack of cultural safe practises are seen as barriers to the provision of efficient health services. According to the Ministry of Health (2012) health is viewed within a framework of values, priorities, collective experience, customs, beliefs and place in society of which all is influenced by social policy. To improve Maori health and address inequalities within the social policy framework, one must therefore consult with Maori as to their health priorities and the manner in which it should be rendered. Maori’s perspectives on health are reflected in various models such as Te Whare Tapa Wha, Te Wheke and Te Pae Mahutonga with all of these models emphasising a holistic approach. In this paper the Te Pae Mahutonga model is used (Durie, 2003) to explain Maori health. The model identifies six cornerstones of wellness namely Mauriora, Waiora, Toiora, Te Oranga, Te Mana Whakahaere and Nga Manukura. 1. Mauriora is associated with a secure cultural identity. Urbanisation broke the link between Maori and the land which caused insecure access to the Marae, Maori language issues and reduced opportunities for cultural expression in society. 2. Waiora is associated with environmental protection and linked to Maori’s spiritual world. It connects physical with mental wellness due to the interaction between the people and the environment (water, earth and cosmic) 3. Toiora is associated with a person’s lifestyle and relates to the willingness to engage in high risk experiences such as substance abuse, gambling, sedentary lifestyles and low moral values. The statistics for Maori in a Hawkes Bay study indicated that Maori was overrepresented as a group when compared to non-Maori (Ngati Kahungunu Iwi, 2003). 4. Te Oranga is dependent on a person’s participation in society which is determined by social position. This in turn is a function of income, job status, choice of school and access to good health services. 5. Nga Manukura (leadership) refers to the ability of local leaders to assist health professionals with the health promotional effort. The formation of alliances between these different groups to enable and combine diverse perspectives will increase the effectiveness of health programs to...
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