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Sick of this shit?

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Covid-19 lays inequality in NZ bare

Covid-19 has laid bare our underlying systems of inequality. Victoria University of Wellington’s Dr Anna Matheson asks if will we learn from evidence this time.

Repeating the same actions over and over again and expecting the outcome to be different has long been considered the height of absurdity. And what is more absurd is doing this while equipped with knowledge showing us a better way.

This is how it has been with our collective societal response to addressing health inequities that the Covid-19 crisis is now exposing in very clear ways. Just as individuals with underlying conditions are more vulnerable to the pandemic, so too are many of our communities.

In Aotearoa New Zealand, we have known for more than 40 years that socioeconomic position determines how sick you will be and how long you will live. Put simply, if you are poor, your life expectancy is lower than someone with wealth – six years for men and five for women. If you are also Māori or of Pacific Island descent, you can expect to be sicker and die even sooner.

This pattern is mirrored globally, where the gap in life expectancy between richest and poorest countries is about 30 years. These starkly different outcomes for people are unfair and also avoidable.

The causes of differences in life expectancy are complex – but we know a lot about them. We know they are the result of systemic interactions, like institutional racism. Causes compound at both ends of the inequality spectrum – influencing both disadvantage and privilege. We also know inequality is relative, existing within countries as well as between countries, regardless of absolute material circumstances.

We know how inequality ‘gets under the skin’ through stress induced by a lack of control experienced more frequently by some social groups, and that it is a known risk factor for a number of chronic diseases. And while there are significant inequalities in access to, and people’s journey through, the healthcare system, the system has been estimated to account for only 30 percent of health outcomes. Social, commercial and political determinants of health, which play out unequally for different social groups, contribute to the rest.

For all this we know, Aotearoa has been unable so far to fix formative social malaise such as our intolerable numbers of children living in poverty. Similarly, the Waitangi Tribunal Health Inquiry last year found that, despite years of substantial intention and investment, Māori health inequalities remain almost unchanged.

Why has all we have learned not made an impact?

One answer lies in how we think about social intervention. Understanding health inequalities are reproduced through our social systems is important.

Currently, our systems flow away from the local – away from the intimacy that drives empathy and compels action. Part of this flow is determined by history and its impact on power, knowledge and resources. Part of it is about what is valued and what is not – such as workforces or local eco-systems. And part of it is that we are good at gathering data, evidence and information to define and understand problems, but less good at acting to implement effective solutions.

The Government has been lauded for its Wellbeing Budget, a welcome shift in focus away from predominantly economic growth. But if collective wellbeing is about the strength and flow of relationships with each other and the environment, solutions need to recognise this.

Power, resources and voice need to be returned to local communities and policies need to be developed that foster local self-determination and innovation. We haven’t seen the health and social gains from whole-of-government and intersectoral strategies we would have expected. This is likely because communities and policy makers also need to be more joined up.

It is against this background of inequality, inherent in our underlying systems, that the Covid-19 pandemic is happening. Despite the very necessary ‘first aid’ the Government is attempting to provide, we can predict which social groups will be most affected.

We know the consequences of the pandemic will be substantial and long-lasting, similar to those we saw through the 1980s and 1990s with economic restructuring. Profound health and social consequences will once again fall heavily on those in already difficult and precarious circumstances.

Reviews last year of the health and disability, mental health and primary health care systems all theorised that dominant western models of health are not entirely fit for purpose. This crisis shows, in no uncertain terms, that our underlying systems are not fit for purpose.

Let us learn from this moment and get more sophisticated and humane about addressing the large-scale outcomes of our social systems.

(Dr Anna Matheson is a Senior Lecturer in Health Policy in the School of Health at Te Herenga Waka—Victoria University of Wellington.)

Seems to me that no matter how much money they get, it will never be enough. An extra $50 million on top of what the rest of us get, to help fight this Chinese virus, will just go into the big hole that is Maori bureaucracy.

There will be fuck all to show for this extra $50 million, but it looks good to Cindy and Co.

Just another academic trying to place the blame on anyone else instead of putting it were it belongs.

11 COMMENTS

  1. What ethnicity is the virus that it so discriminates against races? For that matter, what do our stats look like by demographics?

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  2. Ironically, those who scream for equality of outcome will always choose the easiest path to try and achieve it.

    It’s much easier to tear down than to build up.

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    • Yes Toko. As I was reading it I thought , how do these people manage to use so many words and actually not say much at all. Maybe that’s what is required to get a PhD these days.

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  3. Some warning signs that the writer is a progressive

    – They use Te Reo terms to replace English words. For example, they replace the English word “Maori” with the synthetic word “Māori”. English has no macrons.
    – They use the word Aotearoa in front of the name “New Zealand” or replace it entirely.
    – They are a member of an organization that has “Aotearoa” at the end of its name. For example Peace Movement Aotearoa. You just know that this will be group that loves doublespeak.
    – They don’t believe in human agency. For example, “…socioeconomic position determines how sick you will be and how long you will live.”

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  4. I read it and could not see that the learned academic actually had any solutions or even one solution. Just another separatist and pointless rant probably from someone “working from home”.

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  5. FFS, is this what Newshub consider news, or a declaration of love from a smitten churnilist!

    Watch: Blushing Dr Ashley Bloomfield adorably reveals his favourite love song
    https://www.newshub.co.nz/home/entertainment/2020/04/watch-blushing-dr-ashley-bloomfield-adorably-reveals-his-favourite-love-song.html

    Dr Ashley Bloomfield’s place as a national treasure, healthcare hero and modest heartthrob has been well and truly staked as he guides Kiwis through the battle against the COVID-19 pandemic.

    The Director General of Health has been a sight for sore eyes for many worried New Zealanders as he takes his podium for the daily briefings alongside the Prime Minister. So much so that legions of fans, some of whom identify as “bloomers”, have taken to social media to profess their love.

    🤮🤮🤮

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