No abstract

Objectives. We investigated whether reported experience of racial discrimination in health care and in other domains was associated with cancer screening and negative health care experiences. Methods. We used 2006/07 New Zealand Health Survey data (n = 12 488 adults). We used logistic regression to examine the relationship of reported experience of racial discrimination in health care (unfair treatment by a health professional) and in other domains (personal attack, unfair treatment in work and when gaining housing) to breast and cervical cancer screening and negative patient experiences adjusted for other variables. Results. Racial discrimination by a health professional was associated with lower odds of breast (odds ratio [OR] = 0.37; 95% confidence interval [CI] = 0.14, 0.996) and cervical cancer (OR = 0.51; 95% CI = 0.30, 0.87) screening among Maori women. Racial discrimination by a health professional (OR = 1.57; 95% CI = 1.15, 2.14) and racial discrimination more widely (OR = 1.55; 95% CI = 1.35, 1.79) were associated with negative patient experiences for all participants. Conclusions. Experience of racial discrimination in both health care and other settings may influence health care use and experiences of care and is a potential pathway to poor health.

Racism is firmly established as a determinant of health and an underlying cause of ethnic health inequities. As an organised system, racism operates at multiple levels (including structurally and interpersonally). Racism and its many manifestations are breaches of international human rights obligations and, in the Aotearoa New Zealand context, te Tiriti o Waitangi. This article considers approaches to anti-racism in health and disability policy in the 30 years following the foundational publication Pūao-te-Ata-Tū (Ministerial Advisory Committee on a Māori Perspective for the Department of Social Welfare, 1988), which was one of the first government publications to name and call out the harmful impacts of institutional racism. The article then examines the ways in which government health and disability sector organisations have talked about and responded to racism at a national level since 1980. The results of this research urge a stronger organisational-level approach to antiracism in the health and disability system for more tangible results, requiring multi-level solutions, and transforming what is considered ‘business as usual’ in health and disability sector institutions.

INTRODUCTION: Spurred by critical reviews of Oranga Tamariki–Ministry for Children, Aotearoa New Zealand’s statutory child protection agency, and growing calls for services delivered “by Māori, for Māori, with Māori”, the New Zealand government is taking significant steps toward devolving responsibility for supporting the wellbeing of tamariki, rangatahi, and whanau Māori from the Crown to Iwi and Māori social service providers. Frequently overlooked in discussions of Crown–Māori partnerships are community-based Māta Waka (pan-tribal) organisations, which provide a range of much-needed services to tamariki, rangatahi and whānau Māori who are not mana whenua. The purpose of this Kaupapa Māori research was to examine the expectations that kaimahi working for a Māta Waka Kaupapa Māori service provider have of other organisations that: 1) partner with tamariki, rangatahi and whānau Māori; and, 2) partner with Māta Waka. APPROACH: Drawing on findings from wānanga with kaimahi, this article illuminates the principles and values that guide their practice, using these as a foundation for exploring the complexities, challenges, and opportunities inherent in building effective partnerships with statutory child protection services on behalf of tamariki, rangatahi and whānau Māori across differences in mandate, power, world views, and guiding frameworks or tikanga Māori. IMPLICATIONS: The study findings have implications for current Crown–Māori partnership efforts and, by extension, for the wellbeing of tamariki, rangatahi, and whānau Māori.