Contents 2 Introduction: a fair go for all? 5



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Common elements: Promising responses to structural discrimination


In examining promising initiatives to addressing structural discrimination there are several common elements that emerge as successful strategies and approaches:

  • collaboration between and amongst government agencies in the design and implementation of policies and programmes. Where an issue impacts on outcomes throughout a system or across systems, initiatives are more effective where there is a consistent approach and partnership by government agencies

  • cultivating an understanding of what structural discrimination is, an organisational and individual awareness of how it can manifest, and a commitment to developing initiatives to address it. Initiatives are most effective where these exist at all levels, from leadership to front-line staff. It is particularly effective to have both a “top down” and “bottom up” commitment from within agency/organisational leadership

  • willingness to have honest conversations within an organisational structure (e.g. office, department or agency) about the underlying causes of structural discrimination and what policies exist that may unintentionally sustain systemic barriers to equality

  • meaningful partnership and consultation with Māori, Pacific and ethnic communities to develop and sustain effective interventions to address disparities and ethnic inequalities in all sectors

  • targeted programmes with clear objectives that specifically address the needs of Māori, Pacific and ethnic communities – as opposed to programmes developed for “all New Zealanders” – are most effective

  • developing and sustaining evaluation processes to measure the impact of initiatives. Developing an evidence base is critical to justify ongoing expenditure. Evaluation should identify areas for improvement and effective practice

  • adequate resources – both financial and in terms of staff with relevant expertise (e.g. language skills or cultural knowledge) – training, and support

materials are vital.

The Commission also supports the recommendation made by the UN Committee Economic, Social and Cultural Rights to address structural discrimination that the government set specific equality targets by year and closely monitor their achievement.

Final comments


In the Commission’s research and interviews, there is strong, consistent evidence that structural discrimination is a real and ongoing issue in New Zealand. During workshops, the Commission heard people movingly describe the negative impact of receiving inadequate services. In health, education, criminal justice, and in public services, Māori, Pacific peoples and ethnic communities are disproportionately disadvantaged by a “one size fits all” model of provision. The formal equality of universal provision does not result in the substantive equality of significantly improved outcomes for everyone. Put simply, Māori, Pacific peoples and ethnic communities are not getting a fair go.

Addressing structural discrimination within a system or particular organisation will mean interrogating the ways things have always been done. This could involve returning to first principles and broadening the conceptual basis of what is understood by justice, health, and education, as the Waitangi Tribunal has recommended in Ko Aotearoa Tēnei. The statistics show that a monocultural approach in these areas is continuing to fail Māori, Pacific, and ethnic communities, so what do we have to lose by thinking differently?

Focusing more specifically within systems, studies continue to show that specific targeted programmes have the greatest impact on improving unequal outcomes. Yet negative political opinion can quickly be used to erode fragile gains: programmes are shut down after only a few years’ implementation; targeted funding is cut; and a refusal to see inequality in terms of ethnicity, despite evidence to the contrary, drives policy development. This is how structural discrimination persists. It is imperative that political backlash does not become the driver for policy formation at the expense of the rights and needs of all of New Zealand’s communities. The future success of New Zealand society – for everyone – depends on it.

A fair go for all is possible.


Contact the Human Rights Commission


Human Rights Commission InfoLine

If you have a human rights enquiry or discrimination complaint, call: 0800 496 877 (toll free) TXT 0210 236 4253 Fax 09 377 3593 (attn: InfoLine) Email infoline@hrc.co.nz Language Line and New Zealand Sign Language interpreter available www.hrc.co.nz



Tāmaki Makaurau – Auckland

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Level 1 Vector Building, 44-52 The Terrace PO Box 12411, Thorndon, Te Whanganui ä Tara Wellington 6144 Waea/telephone 04 473 9981 Waea whakaahua/fax 04 471 6759



Ōtautahi – Christchurch

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Office of Human Rights Proceedings

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ISBN: 978-0-478-35635-9 (PDF)

ISBN: 978-0-478-35633-5 (Print)

Published July 2012 Aotearoa New Zealand



Cover image: © Fairfax media

1 Committee on Economic, Social and Cultural Rights (2012), Consideration of reports submitted by States parties under articles 16 and 17 of the Covenant. Concluding observations of the Committee on Economic, Social and Cultural Rights, para 12 p 2, Accessed online at - http://www2.ohchr.org/english/bodies/cescr/docs/co/E.C.12.NZL.CO.3_en.doc on 24 May 2012.

2 Human Rights Commission (2011) Tūi Tūi Tuituiā: Race Relations in 2010. Pp 48-49. Accessed online at http://www.hrc.co.nz/wp-content/uploads/2011/03/RaceRelationsReport_2011_final.pdf 28 May 2012.

3 Statistics New Zealand (2012). Household Labour Force Survey: March 2012 Quarter.P.15. Excel tables provided using ‘total response’ method to define ethnicity. Accessed online at http://www.stats.govt.nz/browse_for_stats/income-and-work/employment_and_unemployment/HouseholdLabourForceSurvey_HOTPMar12qtr/Commentary.aspx on 16 May 2012.

4 Johnson A., Salvation Army Social Policy and Parliamentary Unit (2010) A Road to Recovery.P.19. Accessed online at http://salvationarmy.org.nz/uploads/ARoadtoRecovery.pdf on 16 May 2012.

5 Statistics New Zealand National Population projections accessed June 2011 at http://www.statistics.govt.nz/tools_and_services/tools/TableBuilder/population-projections-tables.aspx

6 The Loss of Māori Potential Model was demonstrated in Julia Carr and Harry Tam (2012) Changing the Lens, Te Puni Kōkiri presentation to the Human Rights Commission, 9 May 2012.

7 Human Rights Commission (2011) Tūi Tūi Tuituiā: Race Relations in 2010, P.4. Accessed online at http://www.hrc.co.nz/wp-content/uploads/2011/03/RaceRelationsReport_2011_final.pdf.

8 State Services Commission (1997). EEO Policy to 2010: Future Directions of EEO in the New Zealand Public Service. Retrieved from http://www.ssc.govt.nz/eeo-policy-to-2010. (http://www.ssc.govt.nz/node/5282 for direct link).

9 The Aspen Institute Roundtable on Community Change, Structural Racism and Community Building (June 2004). P.11. Accessed online at http://www.kintera.com/atf/cf/%7BDEB6F227-659B-4EC8-8F84-8DF23CA704F5%7D/aspen_structural_racism2.pdf on 2 May 2012.

10 Structural discrimination impacts groups based on a variety of social dimensions (including physical ability, ethnicity and sexual orientation). In this paper, however, we focus specifically on the impacts of structural discrimination on the basis of ethnicity.

11 The Report of the Ministerial Advisory Committee on a Maori Perspective for the Department Of Social Welfare Puao-te-atu-tu (Daybreak), section 46, p. 18. Accessed online at http://www.msd.govt.nz/documents/about-msd-and-our-work/publications-resources/archive/1988-puaoteatatu.pdf on 2 May 2012.

12 Human Rights Commission (2011) Tūi Tūi Tuituiā: Race Relations in 2011, p. 5. Accessed online at http://www.hrc.co.nz/wp-content/uploads/2012/03/Race-relations-report-2011-for-web.pdf (29 May 2012).

13 Robert Slayton, ‘Institutional Racism’, The Huffington Post, 9 December 2009. Accessed online at http://www.huffingtonpost.com/robert-slayton/institutional-racism_b_384359.htmlhttp://www.huffingtonpost.com/robert-slayton/institutional-racism_b_384359.html on 2 May 2012.

14 Liu and August draw on the work of Kirkwood, Liu, & Weatherall, 2005; Sibley, Liu, Duckitt, & Khan, 2008) for this analysis. James H. Liu and Caren August (2012), ‘The Medium shapes the Message: Marshall McLuhan and Grice Revisited in Race Talk On-line’, unpublished paper, presented at the New Zealand Diversity Forum, August 2011, p. 10.

15 See, for example, Marie Gee Wilson, Priyanka Gahlout, Lucia Liu and Suchitra Mouly ‘A Rose By Any Other Name: the effect of ethnicity and name on access to employment’ The University of Auckland Business Review (2005), volume 7 no 2. Accessed online at http://www.uabr.auckland.ac.nz/files/articles/Volume11/v11i2-a-rose-by-any-other-name.pdf on 2 May 2012.

16 Section 21, Human Rights Act 1993. See also the definition of indirect discrimination given by the United Nations Committee on Economic, Social and Cultural Rights, General Comment 20: Non-discrimination in economic, social and cultural rights (2009, 42nd session:E/C.12?AC/20), para 8

17 See Human Rights Commission, “Statement on Tribunal decision’ 20 October 2011 for a summary. Accessed online at http://www.hrc.co.nz/newsletters/whitiwhiti-korero/english/2011/10/statement-on-tribunal-decision/ on 16 May 2012.

18 In 1994, North Health (a Regional Health Authority responsible for purchasing health services from doctors in the Auckland region) sought to limit the number of doctors who were eligible for subsidies and benefits, to discourage the over-supply of doctors in the region. Accordingly, it issued a notice restricting eligibility to its subsidies to “general practitioners holding New Zealand undergraduate medical qualifications”.

This policy appeared neutral but had a disproportionate, adverse effect on doctors who had trained in other countries, and had come to New Zealand specifically to seek a career in medicine.


A doctor trained in the UK, for example, complained that she was discrimination on the hiring stage may not be enough to ensure unable to obtain permanent full-time work “solely on the fact that my medical degree is not from a New Zealand university”. Another doctor complained that he was prevented from working as a GP but went on to train medical students as a senior lecturer in a New Zealand medical school.

The Court considered it was not enough that the policy could be justified as economically sound. Justice Cartwright held that this policy was unlawful as it indirectly discriminated on the ground of national origin.

Summary on the Ministry of Justice website. Available online at http://www.justice.govt.nz/publications/publications­archived/2000/the-human-rights-act-1993-guidelines-for­government-policy-advisers-june-2000/indirect-discrimination on 26 July 2012


19 For example, Claire Haupini’s case against her employer who asked her to cover her moko. See Human Rights Commission, “Statement on Tribunal decision’ 20 October 2011 for a summary. Accessed online at http://www.hrc.co.nz/newsletters/whitiwhiti-korero/english/2011/10/statement-on-tribunal-decision/on 16 May 2012

20 Summary of Griggs v Duke Power Co drawn from Wikipedia, ‘Griggs v Duke Power Co.’. Accessed online at http://en.wikipedia.org/wiki/Griggs_v._Duke_Power_Co on 11 May 2012 and Cornell University Law School Legal Information Institute, ‘Griggs v Duke Power Co.,’. Accessed online at

  http://www.law.cornell.edu/supct/html/historics/USSC_CR_0401_0424_ZO.html on 11 May 2012.



21 Indigenous Human Rights Network Australia, ‘Special Measures’. Accessed online at http://www.ihrna.info/race-discrimination/special-measures - Indigenous Human Rights Network Australia on 8 May 2012.

22 Summarised from New Zealand Human Rights Commission (2010), Guidelines on Measures to Ensure Equality. Accessed online at http://www.hrc.co.nz/hrc_new/hrc/cms/files/documents/03-Mar-2010_16-12-18_Special_Measures_Feb_10.pdf on 8 May 2012.

23 Liu and August draw on the work of Augoustinos, Tuffin & Sale, 1999; Liu & Mills, 2005; Reeves, 1983; Wetherell & Potter, 1992, in Liu and August (2012) ‘The Medium Shapes the Message’ p 9

24 EU Charter of Fundamental Rights, Equality > Art 20. Equality before the law > JUSTICE commentary - Accessed online at http://www.eucharter.org/home.php?page_id=95 on 8 May 2012. An example relating to gender is cited: Unequal distribution of childcare responsibilities between women and men may make it more difficult for women with children to undertake jobs with long working hours without additional support or accommodation. Accordingly, merely eliminating sex that female workers have the same employment opportunities as male workers. It suggests that it may be necessary to take further steps to accommodate or assist female workers with children so that they may compete on equal terms with their male counterparts.

25 Equal Opportunity Commission of Western Australia, ‘Substantive Equality Policy Framework’. Accessed online at http://www.eoc.wa.gov.au/Substantiveequality/AboutSubstantiveEquality.aspx on 8 May 2012

26 New Zealand Human Rights Commission (2010), Guidelines on Measures to Ensure Equality. Accessed online at http://www.hrc.co.nz/hrc_new/hrc/cms/files/documents/18-Mar-2007_18-54-53_Special_Measures_A4_Final_PDF.pdf on 8 May 2012.

27 Committee on the Elimination of Discrimination against Women (2007). Concluding comments of the Committee on the Elimination of Discrimination against Women: New Zealand. (CEDAW/C/NZL/CO/6). Accessed online at http://www.iwraw-ap. org/committee/pdf/39_concluding_observations/new_zealand.pdf (29 May 2012).

28 Human Rights Council (2009). Universal Periodic Review Report of the Working Group on the Universal Periodic Review New Zealand. (A/HRC/12/8). Accessed online at http://www.unhcr.org/refworld/country,,UNHRC,,NZL,45b632e02,4a9cdb95d,0.html(29 May 2012).

29 Human Rights Committee (2010). Concluding observations of the Human Rights Committee. Consideration of reports submitted by States parties under article 40 of the Covenant (CCPR/C/NZL/CO/5). Accessed online at http://www2.ohchr.org/english/bodies/hrc/docs/CCPR.C.NZL.CO.5_E.pdf (29 May 2012).

30 Anaya J. (2011). Report of the Special Rapporteur on the situation of human rights and fundamental freedoms of indigenous people – Mission to New Zealand (A/HRC/15/37/Add.9). Accessed online at http://www2.ohchr.org/english/bodies/hrcouncil/docs/15session/A.HRC.15.37.Add.9_en.pdf (29 May 2012).

31 Committee on the Rights of the Child (2011). Consideration of Reports Submitted by States Parties Under Article 44 of the Convention. Concluding Observations: New Zealand. Accessed online at http://www2.ohchr.org/english/bodies/crc/docs/CRC.C.NZL.CO.3-4_en.pdf (29 May 2012).

32 Committee on Economic, Social and Cultural Rights (2012), Consideration of reports submitted by States parties under articles 16 and 17 of the Covenant. Concluding observations of the Committee on Economic, Social and Cultural Rights, para 12 p 2, Accessed online at - http://www2.ohchr.org/english/bodies/cescr/docs/co/E.C.12.NZL.CO.3_en.doc

on 24 May 2012.



33 Ministerial Advisory Committee on a Māori Perspective for the Department of Social Welfare (1988). Pūao-te-ata-tū (Daybreak), pp.9, 19. Accessed online at http://www.msd.govt. nz/documents/about-msd-and-our-work/publications-resources/ archive/1988-puaoteatatu.pdf on 30 May 2012.

34 Barnes. & Harris P. (2011). ‘Still Kicking? The Royal Commission on Social Policy, 20 Years On’. In Social Policy Journal of New Zealand Issue 37, p10. Accessed online at http://www.msd.govt. nz/about-msd-and-our-work/publications-resources/journals­and-magazines/social-policy-journal/spj37/37-still-kicking-the­royal-commission-on-social-policy-20-years-on.html on 30 May 2012.

35 The Waitangi Tribunal. (1998), Te Whanau o Waipareira GP Publications, pp.207-38. Accessed online at http:// www.waitangi-tribunal.govt.nz/reports/summary. asp?reportid=%7B1C99EEB3-27C4-4E47-8A37­C64B1A7F0E52%7D on 30 May 2012.

36 New Zealand First Party (2000). Better Economics But Socially ‘Racial Apartheid’”, Press release, 15 June 2000. Accessed online at http://www.scoop.co.nz/stories/PA0006/S00307.htm on 30 May 2012

37 Te Puni Kōkiri (2007). New report shows Māori as New Zealand’s future makers. Press release, 18 October 2007. Accessed online at http://www.tpk.govt.nz/en/newsevents/news/archive/2007/10/18/new-report-shows-maori-as-new-zealands-future-makers--/on 30 May 2012.

38 Office of the Minister for Social Development and Employment (2004). Reducing Inequalities: Next Steps, p.3. Accessed online at http://www.msd.govt.nz/documents/about-msd-and-our-work/work-programmes/policy-development/reducing-inequalities/reducing-inequalities-next-steps.pdf on 30 May 2012.

39 Don Brash ‘Orewa Speech’ cited in TVNZ, (2004) ‘Brash pushes to dump Mäori seats’, News item, 27 January 2004. Accessed online at http://tvnz.co.nz/content/251436/425825/article.html on 30 May 2012.

40 State Services Commission (2004). Terms of Reference: Ministerial Review Unit to oversee review of targeted policy and programmes Accessed online at http://www.ssc.govt.nz/ tor-targeted-policy-review on 13 June 2012.

41 Callister P. (2007). Special Measures to Reduce Ethnic Disadvantage in New Zealand: an Examination of their Role. Institute of Policy Studies, Victoria University of Wellington, Wellington.

42 State Services Commission (2005). Guidance for developing needs based policies and programmes. Accessed online at http://www.ssc.govt.nz/needs-based-programmes on 13 June 2012.

43 For example article 2 states that “States Parties shall, when the circumstances so warrant, take, in the social, economic, cultural and other fields, special and concrete measures to ensure the adequate development and protection of certain racial groups or individuals belonging to them, for the purpose of guaranteeing them the full and equal enjoyment of human rights and fundamental freedoms.”

44 See, for example, TVNZ, ‘Fallout over Whanau Ora’, 15 February 2010,. Accessed online at http://tvnz.co.nz/politics-news/fallout-over-whanau-ora-3365703 on 16 May 2012.

45 Whānau Ora is still in its early stages and its success is dependent on building leadership capability. At present, there is risk that a small pool of community leaders will become over-burdened with commitments and responsibilities. Its success also depends on being able to maintain progress long term, despite the changeability of the policy cycle. Budget 2011 invested $30 million in Whānau Ora over the next four years, in addition to the $30 million invested in the 2010 budget. The additional funding will allow at least eight new providers to join Whānau Ora, in new locations across New Zealand.

46 The Taskforce conducted a literature review and submissions process including 22 hui around New Zealand. A governance group was established in 2010 comprised of community representatives and senior government officials.
Whānau Ora consists of two funding streams. The Whānau Ora fund is for providers or provider collective to develop a programme of action and business case to transform their current service provision to a whānau-centred model of practice. The Whānau Integration, Innovation and Engagement Fund provides funding to whānau via Whānau Ora providers (who have been engaged by whānau) to develop a whānau plan. Whānau plans include short, medium and long term aspirations. An example of such aspirations are to learn about whānau land and create leadership development for teenagers in the whānau. The first 25 Whānau Ora service providers and provider collectives were selected, consisting of 158 individual providers. Those providers include Māori and Pacific social service groups and refugee/migrant focussed providers

Regional Leadership Groups have also been established, comprising community leaders, officials from the Ministry of Social Development, District Health Boards and Te Puni Kōkiri The Regional Leadership Groups meet frequently with the community, on the marae and at providers’ offices. We have heard through interviews that the regional meetings are inclusive and for the large part constructive. Decisions are most often reached through consensus.



47 Taskforce on Whānau-Centred Initiatives (2010). Whānau Ora: Report of the Taskforce on Whānau-Centred Initiatives to Hon Tariana Turia, Minister for the Community and Voluntary Sector. Accessed online at http://www.msd.govt.nz/about-msd-and-our-work/work-programmes/initiatives/whanau-ora/index.html on 13 June 2012.

48 The New Zealand Medical Association describes the Whānau Ora concept as “help[ing] in breaking down much of the current siloed thinking around the provision of healthy development and wellbeing Blakely T., Simmers D. & Sharpe N. (2011) ‘Inequities in health and the Marmot Symposia: time for a stocktake’. In The New Zealand Medical Journal. Vol. 124 No. 1338. Accessed online at http://journal.nzma.org.nz/journal/124-1338/4754/ on 13 June 2012.

49 A fuller discussion of rights and responsibilities under Article 2 of the Treaty can be found in the Commission’s chapter on‘Human Rights and the Treaty of Waitangi’ in Human Rights in New Zealand 2010. Accessed online at http://www.hrc.co.nz/hrc_new/hrc/cms/files/documents/Human_Rights_Review_2010_Summary.pdf, pp38-55 on 26 July 2012.

50 Human Rights Commission (2010), Te Mana i Waitangi: Human Rights and the Treaty of Waitangi, p.18. Accessed online at http://www.hrc.co.nz/human-rights-and-the-treaty-of-waitangi/human-rights-and-the-treaty on 13 June 2012.

51 In 2003, the Commission began its Te Mana i Waitangi programme to assist communities understand the human rights dimensions of the Treaty. Between 2003 and 2007, the Commission conducted over 400 community dialogue sessions and 30 regional symposia to identify key issues, followed by approximately 40 workshops to develop a Treaty framework.

52 Human Rights Commission (2011), Treaty of Waitangi Obligations and the Human Rights Commission, pp.1-2 Unpublished paper.

53 See Crown-Tangata Whenua case studies online at http://www. hrc.co.nz/home/hrc/humanrightsandthetreatyofwaitangi/crown­tangatawhenuaengagement/crown-tangatawhenuaengagement.php

54 Waitangi Tribunal (2011). Ko Aotearoa Tēnei A Report into Claims Concerning New Zealand Laws and Policies Affecting Māori Culture and Identity. Te Taumata Tuatahi, Accessed online at http://www.waitangi-tribunal.govt.nz/scripts/reports/reports/262/52823D9E-6BD4-465E-86EE-8A917BAE12D1.pdf on 16 May 2012.

55 Waitangi Tribunal, (2011) Ko Aotearoa Tēnei: pp.205-5, 227-8

56 Waitangi Tribunal, (2011) Ko Aotearoa Tēnei: Sheet on Key Themes, p.2. Accessed online at http://www.waitangitribunal.govt.nz/doclibrary/public/reports/generic/Wai0262/Wai262Factsheet1KeyThemes.pdf on 13 June 2012.

57 Human Rights Commission (2012), Tūi Tūi Tuituiā: Race Relations in 2011, p.5. Accessed online at http://www.hrc.co.nz/wp%1fcontent/uploads/2012/03/Race-relations-report-2011-for-web.pdf on 13 June 2012.

58 Guerin B. (2003). ‘Combating Prejudice and Racism: New Interventions from a Functional Analysis of Racist Language’ Journal of Community and Applied Social Psychology, pp.29-30. Accessed online at http://onlinelibrary.wiley.com/doi/10.1002/%20casp.699/abstract on 13 June 2012.

59 Lyons C. A, Madden H., Chamberlain K. & Carr S. (2011). “‘It’s not really us discriminating against immigrants, it’s more telling people how to fit in’: Constructing the nation in immigration talk in New Zealand”. In Journal of Community and Applied Social Psychology Volume 21, Issue 1, p.5. Accessed online at http://onlinelibrary.wiley.com/doi/10.1002/casp.1051/abstract on 13 June 2012

60 Callister, P. (2008). ‘Skin Colour: Does it Matter in New Zealand? In Policy Quarterly Volume 4, Number 1 2008. Accessed online at http://ips.ac.nz/publications/files/096ec48fb3a.pdf on 13 June 2012.

61 Reed, W. (2009). Framing the Discussion of Racism. In Williams, Z. (Ed). African Cultures and Policy Studies: Scholarship and the Transformation of Public Policy. New York: Palgrave MacMillan, p.59.

62 Valencia, R. (1997). The Evolution of Deficit Thinking: Educational Thought and Practice. RoutledgeFalmer. New York.

63 William Ryan (1971), Blaming the Victim, cited in M. Brinton Lykes (1996), Myths About the Powerless: Contesting Social Inequalities. Philadelphia: Temple University Press, p.7. Accessed online on 13 June 2012.

64 Child Poverty Action Group (2011). Hunger for Learning: Nutritional barriers to children’s education, pp.17-8. Accessed online at http://www.cpag.org.nz/assets/Publications/2-0%2025804%20Hunger%20for%20Learning%20Brochure.pdf on 17 May 2012

65 Human Rights Commission (2011). Tūi Tūi Tuituiā: Race Relations in 2010, p.47.

66 Robson B., Cormack D. & Cram F. (2007) ‘Social and Economic Indicators’. Chapter in Hauora Māori Standards of Health IV: A Study of the Years 2000 – 2005. School of Medical and Health Sciences, University of Otago, Wellington. Accessed online at http://www.hauora.maori.nz/downloads/hauora_chapter03_web.pdf on 13 June 2012.

67 Human Rights Commission (2011). Tūi Tūi Tuituiā: Race Relations in 2010, p.47.

68 A section on a fifth system – the economic system – appeared in an earlier draft of this paper. This analysis focussed on unemployment and barriers to economic participation. It will now appear on the Commission’s forthcoming web resource on structural discrimination,, along with the final version of this report.

69 Page A, Tobias M, Glover J, Wright C, Hetzel D, Fisher E. (2006) Australian and New Zealand Atlas of Avoidable Mortality. Adelaide: PHIDU, University of Adelaide. Accessed online at http://www.publichealth.gov.au/pdf/atlases/avoid_mortality_aust_2006/avoid_mortality_ch1_intro.pdf on 13 June 2012.

70 Medical Council of New Zealand. (2008). Best health outcomes for Māori: Practice implications. See also Ministry of Health Tatau Kahukura: Māori Helath Chart Book 2010. 2nd edition, p 35. Accessed online at http://www.health.govt.nz/publication/tatau-kahukura-maori-health-chart-book-2010-2nd-edition on 24 May 2010, p 26.

71 Blakely, T., Simmers, D. (2011). Fact and Action Sheets on Health Inequities. University of Otago and New Zealand Medical Association. See also Ministry of Health (2010), Tatau Kahukura, p 49

72 Ministry of Health (2010), Tatau Kahukura, p 35.

73 Ministry of Health (2010), Tatau Kahukura, p 40

74 Blakely, T., Tobias M., Atkinson J., Yeh L-C., Huang K.,(2007) ‘Tracking Disparity: trends in ethnic and socioeconomic inequalities in mortality, 1981–2004’ Public Health Intelligence occasional bulletin 38, Ministry of Health. Accessed online at http://www.otago.ac.nz/wellington/otago024504.pdf on 13 June 2012.

75 Medical Council of New Zealand. (2010). Best health outcomes for Pacific Peoples: Practice implications, p 7. Accessed online at http://www.mcnz.org.nz/assets/News-and-Publications/Statements/Best-health-outcomes-for-Pacific-Peoples.pdf on 13 June 2012.

76 Medical Council of New Zealand (2010). Best health outcomes for Pacific Peoples, p 9

77 New Zealand Ministry of Health (2012). ‘Rheumatic Fever Programme Expanded’, Accessed online at http://www.moh.govt.nz/moh.nsf/indexmh/rheumatic-fever on 13 June 2012.

78 Sharpe, N (2011). “Rheumatic fever in New Zealand: from perennial failure to successful eradication”. The New Zealand Medical Journal. Vol 24 No 1343. Accessed online at http://journal.nzma.org.nz/journal/124-1343/4887/ on 13 June 2012.. September 2011.

79 New Zealand Government (2012), The 10 public service results set for the next three to five years. Accessed online at http://beehive.govt.nz/sites/all/files/PublicServiceResults.pdf on 12 June 2012.

80 DeSouza, R. (2007). “Walking a tightrope: Asian health research in New Zealand”. Diversity in Health and Social Care. 4:9-20, p.11.

81 Ministry of Health. 2006. Asian Health Chart Book 2006. Wellington: Ministry of

Health. Accessed online at http://www.health.govt.nz/publication/asian-health-chart-book-2006 on 13 June 2012.



82 Scragg, R, 2010. Asian Health in Aotearoa in 2006 - 2007: trends since 2002-2003. Auckland: Northern DHB Support Agency, p 52. Accessed online at http://www.asianhealth.govt.nz/Publications/Asian%20Health%20Trends%20Scragg%202010.pdf on 6 June 2012.

83 Harris R., Tobias M., Jeffreys M., Waldegrave K., Karlsen S., & Nazroo J. (2006). Effects of self-reported racial discrimination and deprivation on Māori health and inequalities in New Zealand: cross-sectional study. The Lancet, Volume 367 (Issue 9527), pp, 2005-2009

84 Harris R., Tobias M., Jeffreys M., Waldegrave K., Karlsen S., & Nazroo J. (2006). Racism and Health: The relationship between experience of racial discrimination and health in New Zealand. Social Science & Medicine, Issue 63, pp 1428-1441.

85 See Ministry of Health and University of Otago (2006), Decades of Disparity III: Ethnic and Socioeconomic Inequalities in Mortality, New Zealand 1981–1999, Wellington. Ministry of Health. Accessed online at http://www.otago.ac.nz/wellington/otago024509.pdf on 24 May 2012.

86 University of Otago (2009), ‘Ethnic Minorities Likely to Suffer in Troubled New Zealand Economy’, Accessed online at http://www.otago.ac.nz/news/news/otago006367.html on 24 May 2012.

87 Ricci Harris, Donna Cormack, Martin Tobias, Li-Chia Yea, Natalie Talamaivao, Joanna Minster, Raimata Timutimu, (2012) ‘The pervasive effects of racism: Experiences of racial discrimination in New Zealand over time and associations with multiple health domains’. Social Science & Medicine, 74 (3), pp 408-415.

88 Ricci Harris, Donna Cormack, Martin Tobias, Lia-Chia Yeh, Natalie Talamaivao, Joanna Minster, Roimata Timutimu, (2012), ‘Self-reported experience of racial discrimination and health care use in New Zealand: results from the 2006/07 New Zealand Health Survey’, American Journal of Public Health. Accessed online at http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2011.300626 on 31 May 2012.

89 Sue Crengle, Elizabeth Robinson, Shanthi Ameratunga, Terryann Clark and Deborah Raphael (2012), ‘Ethnic Discrimination prevalence and associations with health outcomes: data from a nationally representative cross-sectional survey of secondary school students in New Zealand’, BMC Public Health 12:45, pp 4, 8. Accessed online at http://www.biomedcentral.com/content/pdf/1471-2458-12-45.pdf on 31 May 2012.

90 Reid, P., Robson, B., Jones, C. P. (2000) Disparities in health: common myths and uncommon truths. Pacific Health Dialog. Vol. 7 No. 1., (38-47), p 46.

91 Blakely, T., Simmers, D., & Sharpe, N. (2011). ‘Inequities in health and the Marmot Symposia: time for a stocktake’. In The New Zealand Medical Journal Volume 124 Number 1338, p 4. Accessed online at http://www.otago.ac.nz/wellington/otago023744.pdf on 26 June 2012.

92 See, for example, Sobrun-Maharaj, A. and Wong, A. S. (2010), Building evidence for better practice in support of Asian mental wellbeing: An exploratory study. Accessed online at http://www.fmhs.auckland.ac.nz/soph/centres/cahre/_docs/Building%20Evidence%20for%20Better%20Practice%20in%20Support%20of%20Asian%20Mental%20Wellbeing.pdf on 26 June 2012; DeSouza (2007), ‘Walking a Tightrope’.

93 Arroll B., Goodyear-Smith F., Lloyd T. (2002), “Depression in patients in an Auckland general practice”, The New Zealand Medical Journal, Vol 115 No 1152, (176-9), cited in Medical Council of New Zealand (2006), Statement on best practices when providing care to Māori patients and their whānau, p 2. Accessed online at http://www.mcnz.org.nz/assets/News-and-Publications/Statements/Statement-on-best-practices-when-providing-care-to-Maori-patients-and-their-whanau.pdf 20 June 2012.

94Peter Jansen and David Jansen, (2011), ‘Māori and Health’, in Cole’s Medical Practice in New Zealand, Medical Council of New Zealand, pp 48-60 (p 53). Accessed online at http://www.mcnz.org.nz/assets/News-and-Publications/Coles/Chapter-5.pdf on 26 June 2012.. For further evidence of discrepancies between Māori and non-Māori in visits to GPs, see Crengle S., Lay-Yee R., Davis P., Pearson JA. (2006). “Comparison of Māori and non-Māori patient visits to doctors’. National Primary Medical Care Survey, Report 6. Accessed online at http://www.moh.govt.nz/notebook/nbbooks.nsf/0/D222772D6D01D0FACC25748C007D64D8/$file/NatMedCaReport6Dec2005.pdf on 26 June 2012.

95 Ministry of Health and Ministry of Pacific Island Affairs. (2004). Tupu Ola Moui: Pacific Health Chart Book 2004 cited in Medical Council of New Zealand, Best Health Outcomes for Pacific Peoples: Practice Implications (2010), p 10. Accessed online at http://www.mcnz.org.nz/assets/News-and-Publications/Statements/Best-health-outcomes-for-Pacific-Peoples.pdf on 26 June 2012.

96 Jansen and Jansen, “Māori and Health” (2011), p 53.

97 Davis P et al (2005). Pacific Patterns in Primary Health Care: A Comparison of Pacific and All Patient Visits to Doctors: The National Primary Medical Care Survey (NatMedCa): 2001/02. Report 7. Wellington: Ministry of Health, pp 91-2. Accessed online at http://www.health.govt.nz/system/.../natmedcareport7pacificdec2005.pdf on 26 June 2012.

98 See, for example, Gray M., & McPherson K. (2005). Cultural Safety and professional practice in occupational therapy: A New Zealand perspective. Australian Occupational Therapy Journal. Issue 52, 34-42.

99 Griffith, M. D., Mason, M., Yonas, M. Eng, E., Jeffries,V., Plihcik, S., and Parks, B. (2007) Dismantling institutional racism: theory and action. American Journal of Community Psychology. 39:381–392 (p 383)

100 Auckland City Council (2010). State of the City Report 2010. Accessed online at http://www.aucklandcity.govt.nz/council/documents/stateofcity/default.asp on 13 June 2012.

101 Auckland District Health Board Equal Employment Opportunities Programme (EEO) Maori and Pacific Employees. Accessed online at www.neon.org.
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