New research shows it is unlikely New Zealand’s health needs, and the inequities that lie within, will be adequately addressed by the present cohort of health workforce students.
Training facilities across the country have already made changes to address the issue, but more needs to be done.
A new University of Otago-led study shows policy changes are urgently needed to ensure the country’s future health workforce reflects the diverse communities it will serve.
The collaborative research set out to provide the sociodemographic profile of students enrolled in their first year of a health professional programme in New Zealand, between 2016 and 2020.
Data from about 20,000 students, representing 10 of the 23 organisations in New Zealand that provide health professional programmes, was analysed.
Specifically, it looked at gender, citizenship, ethnicity, rural classification, socioeconomic deprivation, school type and school socioeconomic scores.
University of Otago Kōhatu Centre for Hauora Māori professor Peter Crampton said the study showed New Zealand’s health workforce students did not reflect the diverse communities they would serve in several different dimensions.
"There is a systematic under-representation of students who identify as Māori and Pacifica, and students who come from low socioeconomic and rural backgrounds."
The enrolment rate for Māori students was about 99 per 100,000 of eligible population, and 100 per 100,000 for Pacifica students, he said.
That is compared with 152 per 100,000 for New Zealand European students.
"Health professionals from different backgrounds bring their own various strengths and perspectives to the job of providing care, and these perspectives in turn influence their career decisions and professional practice, such as where they choose to work, how they relate to patients and their understanding of health priorities.
"We believe that the presence in the health system of health professionals from a range of backgrounds will help address biases in healthcare delivery that lead to inequities in health outcomes."
The under-representation of Māori students was of particular concern, given the health sector’s stated dedication to Te Tiriti o Waitangi and to growing the Māori health workforce, he said.
University of Auckland Faculty of Medical and Health Sciences professor Warwick Bagg said the results were concerning, but the fix was "eminently achievable".
"Our system for training health professionals can, and should, be much strengthened by ensuring that Māori and Pacific students, and students who come from low socioeconomic and rural backgrounds, participate in training programmes, at least in proportion to their populations in Aotearoa."
The study made three recommendations, largely directed at central government agencies responsible for health workforce policies.
It recommended a nationally co-ordinated system for collecting and reporting on the sociodemographic characteristics of the student health workforce; that mechanisms be developed to allow the agencies that fund tertiary education to base their funding decisions directly on the projected needs of the health system; and tertiary education funding decisions be based on Te Tiriti o Waitangi.
"In summary, we recommend that there be a clearer focus on ensuring wider and more representative participation in health professional training courses, and this can be achieved through greater co-ordination between the education system and the health system," Prof Bagg said.
