Ngā Karere

We are pleased to present Volume Two of the Iwi-Māori Partnership Board Health Profiles. Together with Volume One, completed in late 2023, these two reports represent the most up-to-date snapshot of Māori health for the health sector.

We acknowledge the legacy of work associated with Māori-led health data reporting to date, from the seminal Hauora series to Tatau Kahukura and the 2015 District Health Board Māori Health Profiles, this volume continues the commitment to excellence that Māori communities and whānau both need and deserve.

Volume One includes key demographic information, mauri ora (overall health status), whānau ora (healthy families) and wai ora (healthy environments) indicators specific to each Iwi-Māori Partnership Board.

Volume Two presents additional indicators focused on Te Aka Whai Ora-identified health priority areas including kahu taurima (early years), māuiuitanga taumaha (long-term conditions), mate pukupuku (cancer), oranga hinengaro (mental health and addictions) and ko ētahi atu tohu pūnaha (other system indicators) specific to each Iwi-Māori Partnership Board.

The data presented within these profiles are a dimension of ‘whānau voice’. They represent Māori stories and Māori lived experience and should be valued as a taonga for the health system to use and respond to as part of the broader commitment to Te Tiriti o Waitangi and equity.

The data presented in these profiles also require contextualisation – they are a starting point for Iwi-Māori Partnership Boards to interpret, together with other sources of information, and decide how best to respond to the needs (and rights) of the whānau within their rohe.

As the health sector transforms itself, Iwi-Māori Partnership Boards will play a pivotal role in understanding how the health sector is performing to meet the needs and aspirations of whānau in their area. This profile completes a commitment from Te Aka Whai Ora and Health New Zealand – Te Whatu Ora to provide Iwi-Māori Partnership Boards with data analysed from a Kaupapa Māori epidemiology positioning.

As Te Aka Whai Ora as an entity is disestablished, the commitment from Health New Zealand – Te Whatu Ora to continue this important work remains.

• In 2023, Te Tiratū IMPB was home to an estimate of 114,900 Māori, comprising approximately 25% of
  the IMPB’s total population.
• The Māori population of Te Tiratū is youthful, with 48% of the Māori population under the age of 25
  years (compared to only 27% of the non-Māori population in the area) in 2023.
• Over the next two decades, the Māori population is expected to grow to an estimated 156,770 (29% of
  the total IMPB population) and to be older – 10% of the Māori population with be 65 and over, compared
  to 7% in 2023. The non-Māori population of Te Tiratū will decrease its share of the total population,
  from an estimated 75% to 61% by 2043.
• Most Māori in Waikato DHB (62%) live in urban areas, with 38% living in rural areas, compared to 66%
  and 34% of non-Māori, respectively.

Life expectancy

• Life expectancy at birth for Māori born in Te Tiratū between 2018-22 is 76.8 years for females and 72.8 years for males.
• Life expectancy is 7.9 years shorter for Māori females and 8.3 years shorter for Māori males, compared to non-Māori.
• In Te Manawa Taki in 2018-20, the region in which Te Tiratū are situated, life expectancy for Māori was 75.0 years, 8.1 years lower than the non-Māori/non-Pacific population (83.1 years).
• Among Māori in Te Manawa Taki, 2.7 years of the 8.1-year gap can be attributed to conditions that are considered both amenable (through access to high quality health care) and preventable (through public health interventions), followed by 1.4 years from conditions considered preventable only and 0.9 years from conditions considered amenable only. An additional 2.0 years can be attributed to conditions that are considered non avoidable.
• The leading avoidable causes of death that contribute to the life expectancy gap among Māori in Te
  Manawa Taki are lung cancer, coronary disease and diabetes.

Self-assessed health

• In 2018, 78.3% of Māori aged 15 years and over reported their own health status as good, very good or excellent, similar to the percentage to Māori nationally (82.3%). A total of 21.7% of Māori in Te Tiratū reported their health status as fair or poor.

Mortality – deaths

• From 2014 to 2018, the leading causes of death for Māori in Waikato DHB were ischaemic heart disease, lung cancer, diabetes, chronic obstructive pulmonary disease (COPD) and cerebrovascular disease. These are the same five leading causes of death for Māori nationally. This pattern differs to the leading causes of death for non-Māori in Waikato DHB, which were ischaemic heart disease, dementia, cerebrovascular disease and lung cancer in 2014-2018.
• In 2014 to 2018, leading causes of death for Māori females were lung cancer, ischaemic heart disease, COPD, diabetes and cerebrovascular disease; and for Māori males, were ischaemic heart disease, lung cancer, diabetes, COPD and cerebrovascular disease.
• The all-cause mortality rate for Māori in Waikato DHB (336 deaths each year per 100,000 people) was 2.1 time higher than that of non-Māori in 2014 to 2018. This equates to an average of 213 Māori females and 248 Māori males dying each year in Waikato DHB.
• Potentially avoidable death (those deaths considered preventable through high quality health care or public health interventions, or both) was 2.45 times higher for Māori aged 0 to 74 years compared to non-Māori in Waikato DHB in 2014 to 2018.
• In 2014 to 2018, the leading causes of potentially avoidable death for Māori in Waikato DHB were ischaemic heart disease, lung cancer, diabetes, COPD and cerebrovascular disease. These are similar to Māori nationally. For Māori females in the region, leading causes were lung cancer, COPD, ischaemic heart disease, breast cancer and diabetes and for males, leading causes were ischaemic heart disease, lung cancer, diabetes, suicide, and motor vehicle accidents.
• Potentially avoidable death from diabetes was 6.5 times higher for Māori aged 0 to 74 years compared to non-Māori in 2014-18 in Waikato DHB.
• Potentially avoidable death from lung cancer was 4.0 times higher for Māori aged 0 to 74 years compared to non-Māori in 2014-18 in Waikato DHB.
• Potentially avoidable death from COPD was 3.9 times higher for Māori aged 0 to 74 years compared to non-Māori in 2014-18 in Waikato DHB.
• Potentially avoidable death from ischaemic heart disease was 3.0 times higher for Māori aged 0 to 74 years compared to non-Māori in 2014-18 in Waikato DHB.
• On average, there were 38 potentially avoidable Māori deaths under age 75 years each year from lung cancer, and 38 from ischaemic heart disease in Waikato DHB.

• In 2018, most Māori (67.3%) in Te Tiratū reported their whānau was doing well compared to 73.6%
  nationally. About a third (32.6%) reported that their whānau was not doing well.
• 76.9% of Māori in Te Tiratū reported it was easy/very easy to get support in times of need compared
  to 78.1% of Māori nationally.
• Being involved in culture was important (very or quite) 47.8% of Māori in Te Tiratū in 2018 and
  spirituality was very important (very or quite) to 50.4%.
• A quarter of Māori (25%) aged 15 years or over in Te Tiratū reported using te reo Māori regularly in the
  home in 2018.
• Almost all Māori (97%) in Te Tiratū had been to a marae at some time. 84.1% had been to an ancestral
  marae at some time, 46.2% had been in the last 12 months, and 64% reported that they would like to
  go more often.
• In 2018, 14.2% of Māori in Te Tiratū had taken part in traditional healing or massage in the last 12
  months.

Education

In 2018, 62.9% of Māori in Waikato DHB aged 20 years and over had at least a Level 2 Certificate. The proportion of non-Māori with this level of qualification was 77.1%.

Work

• In 2018, 46.6% of Māori adults aged 15 years and over were employed full time and 15.1% were employed part-time.
• In 2018, 9.7% of Māori in Waikato DHB were unemployed, twice the rate of non-Māori, and Māori were 1.2 times more likely than non-Māori to not be in the labour force.
• Most Māori adults were involved in unpaid work (89.1%).
• In 2018, Māori in Waikato DHB were significantly more likely than non-Māori to participate in unpaid work looking after a disabled or ill household (2.0 times) or non-household (1.5 times) member.

Income and Standard of Living

• Using the NZDep 2018 index of neighbourhood deprivation, 48% of Māori in Waikato DHB lived in the two most deprived deciles in 2018, compared to 21% for non Māori. A total of 5% of Māori in Waikato DHB lived in the two least deprived deciles in 2018, compared to 15% of non-Māori in Waikato DHB.
• In 2018, 11.4% of Māori adults reported often postponing or putting off a doctor’s visit, 7.2% often went without fresh fruit and vegetables, and 11.7% often put up with feeling cold, because of cost.
• Māori in Waikato DHB are significantly more likely than non-Māori to receive an income of $20,000 or less. This equated to 37.7% of Māori aged 20 years and over (21,384 people) living on an income of $20,000 or less compared to 27.8% of non-Māori in 2018.
• In 2018, Māori in Waikato DHB were 3 times more likely to be without access to a motor vehicle and 2.2 times more likely to have no access to telecommunications, compared to non-Māori.

Housing

• Māori in Waikato DHB are less likely that non-Māori to own their own home. In 2018, 68.9% of Māori aged 20 years and over lived in a home they did not own/partly own or hold in a family trust compared to 51.1% of non-Māori.
• Living in an overcrowded home (requiring at least one more bedroom) was 2.7 times more common for Māori (23.6%) than non-Māori (8.8%) in 2018.
• In 2018, 45.0% of Māori reported living in a home that was sometimes or always damp, and 37.2% reported living in a house with mould. Māori in Waikato DHB were 1.8 times more likely than non-Māori to live in a damp and mouldy home.
• Māori in Waikato DHB were 1.5 times as likely as non-Māori to live in homes without any source of heating in 2018.
• Primary Care Enrolment
• In October 2023, an estimated 82.5% of Māori in Waikato DHB were enrolled with primary care compared to 97.6% of non-Māori. This suggests 17.5% of Māori in Waikato DHB were not enrolled with primary health care compared to 2.4% for non-Māori.