Landmark Report Released into Maori Aging and Disabilities “Manaaki Pakeke” – New Zealand Maori Council calls for a policy shift and greater focus

The New Zealand Maori Council has released a comprehensive policy statement challenging the Government and policy makers to do more when it comes to Maori elders, the aging and those living with a disability. Called “Manaaki Pakeke” the statement outlines confronting data of Maori who reach retirement with a plethora of undiagnosed conditions, lower than average life expectancy and more. Matthew Tukaki, Executive Director of Council, has said that this is the first time a national Maori organisation has shed light on what is often hidden away:

“The reality is we are dealing with forgotten Maori, forgotten New Zealanders. We are dealing with a group of people who are often impoverished in retirement relying solely on the State for a pension, we are dealing with people who have preventive disease that undiagnosed lowers their life expectancy, we are dealing with people who are often caring for their grandchildren but who, themselves, can’t afford the dentist, prescriptions or food for themselves. Then we have our Maori people living with a physical or intellectual disability.” Tukaki said

“Our people have a lower life expectancy compared to non-Maori, more likely to have higher rates of disability, more likely to contract certain forms of cancer and more likely not to be able to afford to live into retirement. And then we have a low degree of infrastructure investment in the regions, Iwi and Hapu Health services literally running on the smell of an oily rag as well as the challenge of having a workforce to meet demand.” Tukaki said

“We see the increase prevalence of elder abuse, people becoming socially isolated and so on. By releasing this position statement for discussion the New Zealand Maori Council wanted to both shed a light on what is happening but also offer up some ideas and solutions around how we might go about addressing them – lets not shy away from the challenge of problem solving even though the task at hand may be arduous and confronting Tukaki said.

Mr Tukaki has said the next step will be to build more “meat” into the detail of the policy statement with everything coming together at the National Hui of the Council in November:

“I can tell you that this is one of the key things keeping our people awake at night and in order to really address the challenge of aging we need to develop an approach that is by Maori for Maori. The same in terms of the disability sector – and nothing is off the table”

Some of the solutions being suggested include:

• Investing more in Kaumata Housing and Housing attached to Marae
• Increased investment in mobile health units
• Additional health promotion campaigns around preventive health checks
• Development of care support networks within communities for health and welfare checks
• Investing in additional supplementary allowances and financial support for elders looking after mokopuna
• Dedicated support for Maori with a disability or intellectual disability as they age
• More investment support for Marae and Iwi Health and Social Service around infrastructure in rural and regional areas
Some key health and financial facts impacting Maori:

• Māori had a higher disability rate than non-Māori, regardless of age, in 2013. Older people had higher disability rates generally.
• The heart failure mortality rate among Māori was more than twice as high as that of non-Māori), and Māori were about 4 times as likely as non-Māori to be hospitalized for heart failure. The disparity was greater for females: the heart failure hospitalization rate among Māori females was about 4.5 times as high as that among non-Māori females
• the most common cancers registered for Māori females over this time period were breast cancer, lung cancer, colorectal cancer, uterine cancer and cervical cancer. Figure 9 shows that the leading causes of cancer death for Māori females were lung cancer, breast cancer, colorectal cancer, stomach cancer and uterine cancer.
• The most common cancer registration sites for Māori males were prostate cancer, lung cancer, colorectal cancer, liver cancer and stomach cancer (Figure 10). The leading causes of cancer mortality for Māori males were lung cancer, colorectal cancer, prostate cancer, liver cancer and stomach cancer.
• The chronic obstructive pulmonary disease (COPD) mortality rate among Māori aged 45 and over in 2010–12 was almost 3 times that of non-Māori in the same age group
• The disparity was greater for females: Māori females had a COPD mortality rate almost 3.5 times that of non-Māori females
• Data from the Ministry of Health shows that the self-reported prevalence of diabetes among Māori was about twice that of non-Māori in 2013/14.It also shows that there are much higher disparities between Māori and non-Māori for diabetes complications.
• Renal failure is one of the complications of diabetes. Rates of renal failure with concurrent diabetes for Māori aged 15 and over were more than 5 times that of non-Māori at the same age group in 2012–14. While some of this difference can be attributed to the higher prevalence of diabetes among Māori, the disproportionately higher rate suggests that Māori with diabetes are more likely to have renal failure than non-Māori with diabetes. The extent of the disparity can be estimated by dividing the relative risk of renal failure by the relative risk of prevalence (i.e., 5.55 ÷ 1.99), which suggests that among people with diabetes, Māori are 2.8 times as likely as non-Māori to have renal failure.
• Lower limb amputation is another complication of diabetes. Similarly, rates of lower limb amputation with concurrent diabetes for Māori were over 3 times that of non-Māori in 2012–14. Therefore, among people with diabetes, lower limb amputations among Māori can be estimated as 1.7 times that of non-Māori (i.e., 3.44 ÷ 1.99).
• Maori are four times more likely than non-Maori to have little or no financial savings heading into retirement / more likely to be reliant on national super
• Maori are more likely to not own their own home in retirement – instead the asset is owned by a central or local Government authority (such as Housing New Zealand) although there is an increase in the supply of Iwi provided and supported housing for Kaumatua and Kuia
• Maori are five times more likely than non-Maori to head into retirement with a higher debt to savings ratio
• Maori are more likely to look after their Mokopuna on a full time or more than part time basis into retirement – where the child or children will be living with them

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