More affirmative action is needed for Māori and Pasifika health outcomes to improve, a new study says.
University of Otago public health professor Peter Crampton and University of Auckland acting dean Prof Warwick Bagg’s research was published in the British Medical Journal Open yesterday.
The pair’s study found although the representation of Māori and Pasifika was improving, it still lagged far behind the representation in wider society.
The study recommended several measures to address the issue, including having universities commit and act to indigenise institutional ways of knowing and being; reviewing selection policies to ensure that communities in greatest need of doctors are prioritised for enrolment into medicine; and government funding to pay for more New Zealanders to study medicine.
"To have the greatest positive impact on health outcomes, the population of doctors as a whole should mirror the society which they take an oath to serve.
"To achieve this, those who are enrolled in medical school should broadly mirror the demographics of the people they will ultimately work for."
The research said the under-representation of Māori and Pacific doctors had contributed to profoundly negative health outcomes for those populations. For example, Māori life expectancy was seven years less than non-Māori.
"It is essential to contextualise this study within New Zealand’s colonial history."
The authors acknowledged the indigenous rights of Māori and that those rights had been systematically breached.
"These breaches preceded the signing of Te Tiriti o Waitangi in 1840 and continued unabated after the signing.
"These actions have, and continue to, privilege New Zealand Europeans and exclude Māori."
The research argued while exclusion was not limited to Māori and Pacific peoples, they deserved "specific attention given the indigenous rights and high health needs of Māori and the historical relationship (at times fraught) and high health needs of Pacific peoples in New Zealand society".
The research also noted the cohort was heavily skewed by pupils from schools serving high socioeconomic communities irrespective of school type.
"Similarly, the impact of socioeconomic privilege was seen across all ethnicities with a nearly linear negative relationship with increasing small area deprivation."
About 59% of all medical students were female, and the study anticipated women would finally outnumber men in the medical workforce by 2025.
"Although for nearly 30 years there have been similar numbers of men and women admitted to Australasian medical schools, women remain under-represented in the medical workforce, particularly in some specialties, and in senior medical leadership roles and earn less than their male counterparts."
The findings arrived at a potentially fraught time for affirmative action pathways at universities.
The National-led government’s coalition agreement included a clause to "examine the Māori and Pacific admission scheme and its Otago equivalent to determine if they are delivering the desired outcomes".
Act New Zealand party leader David Seymour has previously expressed doubt about the effectiveness of the schemes.