Maori health and inequalities

Vad gör man om man mitt under värsta regnovädret ligger nerbäddad (nå väl, sitter vid köksbordet) med en livshotande förkylning? Man bloggar.
Tänkte berätta om Maoriernas hälsa, och för att inte uppfinna hjulet själv tar jag en artikel ur Cole's Medical practice in New Zealand 2011, där finns också källorna för de fakta som nämns (ifall någon will fördjupa sig i emnet).
Jag skulle uppskatta att 30 till 50 procent av våra patienter är Maori.

Maori, the indigenous poplation of NZ, make up approximately 15 percent of the NZ population, yet Maori have the poorest health of any NZ group. Maori have a higher mortality rate than non-Maori as well as higher rate of illness. Maori infants die more frequently from Sudden Infant Death Syndrome and have lower birth weight than non-Maori children.
Avoidable death rates are almost double for Maori than for other New Zealanders, and Maori die, on average, eight to ten years earlier.
New Zealand has a higher rate of death fram cancer than Australia, with Maori accounting for two thirds of the excess male cancer deaths and one quarter of the excess female cancer deaths. Maori women have rates of breast, cervical, and lung cancer that are several times those of non-Maori women.
There is a higher incidence of obesity in the Maori community (27 versus 16%), which contributes to the higher incidence of diabetes (8 versus 3 percent) and the younger age at diagnosis (43 versus 55 years). This is compounded by lower rates of diagnosis and lesser access to effective treatment.
In summery, Maori are sicker, for longer periods, but have less access to care and die earlier than Pakeha (New Zealanders of European decent).  These disparities in overall Maori health persist even when factors such as poverty, education and location are accounted for, demonstrating that culture in an independent determinant of health status. These lower standards of health lead to suboptimal outcomes for individual Maori and influence the Maori community's negative perceptions of the health system as a whole. These negative experiences can also reinforce stereotypes within the practicioner community if a provider does not understand a Maori patient's dissatisfaction and thus cannot prevent similar experiences with other patients.

Studies have consistently demonstrated that some doctors treat Maori differently from non-Maori. in one stuy it was observed that doctors spent 17 percent less time interviewing Maori than non-Maori patients.
Once age is taken into account, Maori turn up for GP appointments at the same rate as non-Maori, but obtain fewer diagnostic tests, less effective treatment plans and are referred for secondary or tertiary procedures at lower rates than non-Maori patients.
Analysis of the National Minimum Database over the period 1990-99 suggests bias against Maori receiving cardiac revascularisation procedures even though the clinical need is mucher greater. Similar evidence of bias is available for outcomes following stroke, obstetric interventions, heart failure, and asthma. These studies point to unconscious bias by providers rather than frank racism in health service delivery.
However the impact is that Maori patients are less likely to receive adequate care or adequate and understandable health information. This will in turn compromise the ability of Maori patients to adhere to treatment recommendations and the effectiveness of any treatment offered.
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Hälsning!
Florian