Journal Articles

Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915

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Author: search.filters.author.McCreanor TSubject: search.filters.subject.Maori

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    Survival disparities in indigenous and non-indigenous New Zealanders with colon cancer: The role of patient comorbidity, treatment and health service factors
    (BMJ Publishing Group Ltd, 2010) Hill S; Sarfati D; Blakely T; Robson B; Purdie G; Chen J; Dennett E; Cormack D; Cunningham R; Dew K; McCreanor T; Kawachi I
    Background Ethnic disparities in cancer survival have been documented in many populations and cancer types. The causes of these inequalities are not well understood but may include disease and patient characteristics, treatment differences and health service factors. Survival was compared in a cohort of Maori (Indigenous) and non-Maori New Zealanders with colon cancer, and the contribution of demographics, disease characteristics, patient comorbidity, treatment and healthcare factors to survival disparities was assessed. Methods Maori patients diagnosed as having colon cancer between 1996 and 2003 were identified from the New Zealand Cancer Registry and compared with a randomly selected sample of non-Maori patients. Clinical and outcome data were obtained from medical records, pathology reports and the national mortality database. Cancer-specific survival was examined using Kaplan�Meier survival curves and Cox hazards modelling with multivariable adjustment. Results 301 Maori and 328 non-Maori patients with colon cancer were compared. Maori had a significantly poorer cancer survival than non-Maori (hazard ratio (HR)=1.33, 95% CI 1.03 to 1.71) that was not explained by demographic or disease characteristics. The most important factors contributing to poorer survival in Maori were patient comorbidity and markers of healthcare access, each of which accounted for around a third of the survival disparity. The final model accounted for almost all the survival disparity between Maori and non-Maori patients (HR=1.07, 95% CI 0.77 to 1.47).
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    Colonisation, hauora and whenua in Aotearoa
    (Taylor and Francis Group for The Royal Society of New Zealand, 7/10/2019) Moewaka Barnes H; McCreanor T
    Colonisation has deeply harmed Maori communities, seriously and consistently undermining their vitality, aspirations and potentials, particularly since the 1860s, at inestimable cost to the entire nation. The British arrival in Aotearoa commenced a relationship between two very different peoples that has profoundly influenced their distinct and collective fortunes ever since. Despite manifest breaches of te Tiriti o Waitangi, this relationship has centred settler interests ensuring that Maori sovereignty has been displaced in favour of colonial hegemony, entrenching longstanding, preventable inequities in health and other important domains of social life. In this paper we trace some broad indicators of relational health and wellbeing in Aotearoa and consider how Maori thinking about whenua, health and wellbeing might lead healing opportunities for people and whenua. We outline ways in which a unified, dynamic, relational Maori concept based on whenua as the determinant of health could contribute. We believe this could expand, strengthen and revitalise prevention, protection and promotion approaches, to counter the injustices of colonisation, contribute toward health equity and move toward just, sustainable shared futures for the benefit of all New Zealanders.