A recently published paper argues that more self-determination and frank discussions about structural racism could help improve access to health care for indigenous populations.
The paper addresses the parallels between Indigenous populations in New Zealand and the United States. The paper was published by Elsevier Science and Health.
The paper called for more in-depth conversations about socioeconomic factors such as employment and housing that would affect how hard it could be for an Indigenous person to access healthcare. Marshall Chin is a co-author on the paper and an expert in health care disparities at the University of Chicago Medicine. He is also Director of Finding Answers: Solving Disparities Through Payment and Delivery Reform, a program of the Robert Wood Johnson Foundation. He said non-Native communities also need to recognize that these factors aren’t as much of a problem for them.
Chin said it’s time to handle issues about health and economic challenges for Native populations more directly.
“It’s important to have honest discussions in this country about history, about colonialism,” said Chin. “About why we are in this situation now where tribes have significant health challenges and economic challenges. Because the solutions do then require us to address some of the factors that have driven them where we are today.”
The paper also said healthcare equity is a problem in both New Zealand and the United States. In 11 other western countries, the Commonwealth Fund found in 2017 that New Zealand ranked eighth while the United States ranked eleventh in health equity.
Co-author and Maori Tribal Member Ngāti Kahungunu Bryn Jones said that health disparities are greatly reduced if Indigenous communities are given more control over their health care systems.
“The more authentically indigenous communities were afforded the ability to determine how services were run the more successful those initiatives were,” said Jones. “And too often we are operating under the constraints of the mainstream system, how it should be delivered and it doesn’t necessarily work very well for the communities they are working for.”
Jones said the people making the decisions about indigenous health care are often not the indigenous themselves and that the decision makers can sometimes be out of touch with the day to day needs of Indigenous communities.
“This is common to the United States and to New Zealand, Aotearoa. We do find ourselves where we are often making decisions which work really well for our dominant culture, for our white culture. And those decisions are generally made by educated affluent healthcare professionals, often doctors making decisions that work really well for their people, and those decisions really fail indigenous population groups.”
Both Chin and Jones hope the paper sheds light on the issue of health care inequity for Indigenous people around the globe. The title of the article is “Lessons for Achieving Health Equity Comparing Aotearoa/New Zealand and the United States.”