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Massey Magazine Issue 13 November 2002

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Ages and stages in Maori health

Child health, mental health and the health of older Maori will be key areas of focus for the Te Pumanawa Hauora research group's HRC-funded programme.

Professor Mason Durie, Assistant Vice-Chancellor and Professor of Maori Research and Development, says most of the group’s health research to date has focused on service delivery, health promotion, and Maori public health.  New funding of $1.6 million from the Health Research Council will allow the team to pursue two new projects, as well as take an existing project to a new level.

One new project, Oranga Kaumatua, will investigate the health needs of two cohorts of Maori, one a traditionally conservative group of 'Kaumatua', the other a group of 'older Maori' who do not necessarily have close links with conventional Mäori networks.  Professor Durie says that the demographic profile of Maori is changing, and the number of Maori elderly will increase quite dramatically over the next 25 years, from about 4% to around 9%.

" It is going to be important to know what planning needs to be done in order to be ready for quite a major shift in Maori demography," he says.  "We think that the stresses and the lifestyles of the two groups are significantly different and that different health needs might be experienced, requiring a range of health interventions."

The other new project involves the validation of the Hua Oranga, a Maori measure of mental health outcome.  Unlike many conventional outcome measures that focus on clinical symptoms Hua Oranga is largely a measure of well-being. “It is more concerned with function rather than residual illness and depends on three perspectives.  It actually asks a clinician, a patient and a patient's family member for their opinions about the results of treatment or care.  Many outcome measures rely entirely on what the doctor thinks, but patients and their families sometimes have quite different views about how successful an intervention has been.”

Professor Durie says that although Hua Oranga is designed for use in mental health settings it canvasses gains in mental health, physical health, spiritual health, and social health.

Te Pumanawa Hauora's existing project involves formally validating another outcome measure, Te Ahuatanga o Te Waiora Tamariki - a picture of child health.  Trailed initially with women after childbirth the set of questionnaires have been developed to assess the health status of Maori children in terminology, contexts and constructs relevant to Maori.

Professor Durie says that the shift to measuring outcome is likely to be increasingly important in New Zealand.  "Those outcome measures that are available focus very much on the reduction or removal of symptoms, but symptoms are a narrow way of measuring well-being. What our two outcome measurement projects have in common is the shift in focus from a sickness model to a wellness model.

" The point about validation is that before any of the measures can be useful, they've really got to be tested so that they can be portable and used in a range of settings by different people, with reliable results."

The research programme will involve researchers at the Palmerston North and Wellington campuses, including a number of HRC Maori postdoctoral fellows.


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