Cultural Issues in Diabetes 2

Maori Health
Maori health is an issue in New Zealand because Maori, as a group, tend to have the poorest health outcomes of any group within the NZ health system. Many complex factors lead to poor health status but the impact of those factors is particularly evident among Maori and Pacific peoples and has resulted in disparities in Maori and pacific peoples’ health status.
The availability of food to a family is one way socioeconomic status can impact on health outcomes and associated behaviours. Information from the 1997 National Nutrition Survey (NNS) indicates that Maori were more likely than Europeans to report that they lived in a household that ran out of food due to a lack of money. Over a quarter of Maori men (26%) and over a third of Maori women (36%) stated in the survey that their household ran out of food, sometimes or often, due to lack of money. This compares to 7% of European men and 11% of European women.

Smoking is a major factor in preventable blindness. In the NZHS, nearly half of all Maori adults reported that they were current smokers (46%), compared to 23% of non-Maori. Maori and non-Maori smoking rates by age also differ considerably. In particular, Màori aged 25–44 years are twice as likely to be current smokers as non-Maori of the same age.

The relevance of the Treaty of Waitangi is that it acknowledges Maori as the people that the British joined with in a system of partnership. In this partnership, Maori could reasonably expect their needs to be catered for equitably. It would be an easy thing for people to read up on the low status of Maori health and wellbeing and to make a commitment to ensuring that their own practice is able to address any particular needs of its Maori clients.

For optometrists in strongly Pacific Island communities it might be possible to have some of the practice information leaflets available in Tongan and Samoan.

Cultural competence self-test
Check off the things that you could do in your practice:

Display pictures, posters, notices etc that reflect the cultures and ethnic backgrounds of your clients.

Have available magazines and brochures in reception that are of interest to and reflect the cultures of individuals and families who come to see you.

Be aware of risk factors that are more frequent in particular groups and ensure these are considered within the consultation.

Recognise that your professional or moral viewpoints may differ from that of your patient(s) and accept that individuals and families are the ultimate decision makers for their own health and well-being.

Keep abreast of the major health concerns and issues for patient groups in your practice area.

Be aware that religion and other beliefs may influence how individuals respond to treatment plans or referrals.

Encourage reception staff to become culturally aware and to make your practice welcoming to all the cultural groups in your practice list.

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