Module two: Te Tiriti o Waitangi, colonisation and racism

Summary

This module delves into ethnic bias, particularly against Māori, examining the impact of colonization, racism, and the Te Tiriti o Waitangi on Māori health. It reveals disparities in healthcare accessibility and outcomes between Māori and non-Māori. Personal narratives underscore the systemic bias and the need for cultural safety over competence. The discussion advocates for Māori leadership in health decisions and practical strategies to combat implicit bias, urging healthcare professionals to engage with Māori patients with genuine respect and understanding.

Takeaways

• 📜 The module focuses on ethnic bias, particularly against Māori, and its impact on health.
• 🏥 Racism is a systemic issue that manifests in societal structures, institutions, and individual beliefs and practices.
• 📊 A 2019 report by the Health Quality & Safety Commission highlights health inequities between Māori and non-Māori populations.
• 🚑 Health services are less accessible and beneficial for Māori, and efforts to improve quality do not always translate to equity.
• 📝 The report identifies colonization, failure to meet Te Tiriti o Waitangi requirements, and institutional racism as factors perpetuating health disparities.
• 👨‍⚕️ Personal experiences reveal that Māori patients often face patronizing attitudes and assumptions about their socio-economic status in healthcare settings.
• 👥 There is a difference in treatment between Māori and non-Māori patients, with Māori receiving fewer interventions and experiencing worse outcomes.
• 🌐 The transition from cultural competence to cultural safety in healthcare aims to address power imbalances and biases in medical practice.
• 🤔 Clinicians are encouraged to reflect on their biases and engage with Māori patients in a more meaningful and equitable manner.
• 📚 Strategies to combat bias include providing data on disparities, promoting a racism-free environment, and supporting staff in learning about Māori culture and language.

Q & A

What is the focus of the second module on bias?

The focus of the second module is on ethnic bias, particularly bias against Māori.

What is the role of Te Tiriti o Waitangi in the context of Māori health?

Te Tiriti o Waitangi is a treaty that has established requirements for the relationship between the Māori people and the government. The module suggests that failure to meet these requirements has contributed to the disadvantages faced by Māori in terms of health equity.

How does the Health Quality & Safety Commission's report from July 2019 highlight the disparities in health care between Māori and non-Māori?

The report shows a pattern of inequities over the lifetimes of Māori and non-Māori, with health services being less accessible and providing fewer benefits for Māori compared to non-Māori.

What is the impact of societal racism on ethnic bias in health care according to the module?

Societal racism leads to bias against certain ethnicities, which is reflected in the health care system through less accessible services and unequal treatment for Māori patients.

What personal experiences do Māori parents face when accessing health care for their children with disabilities?

Māori parents often encounter patronizing attitudes and assumptions of poverty or social deprivation from health care staff, which they perceive as a form of racism.

How does the concept of cultural safety differ from cultural competence in health care?

Cultural safety involves considering the power dynamics between the health care professional and the patient, focusing on the professional's own biases and how they might affect patient outcomes, rather than just learning about the patient's culture.

What is the significance of colonisation in the context of Māori health as discussed in the module?

Colonisation has been both insidious and explicit in disadvantaging Māori and creating a health system that does not adequately serve their needs, leading to unequal treatment and poorer health outcomes.

What are some of the strategies that can be implemented to address implicit and unconscious bias in health care?

Strategies include providing data on different treatment outcomes for various groups, committing to a racism-free environment, actively upholding the Treaty of Waitangi, and supporting staff to learn about cultural safety.

What does the 2019 amendment to the Health Practitioners Competence Assurance Act 2003 require of health practitioners?

The amendment requires health practitioners to respond effectively and respectfully to Māori, addressing the need for improved cultural competence and safety in health care.

How can clinicians improve their engagement with Māori patients to enhance their well-being?

Clinicians can reflect on their biases, engage with patients in a mindful and loving manner, and consider involving community support or other Māori clinicians to better support the health journey of Māori patients.