Lecture 5 Health 112.pdf

Māori Health Lecture 5 Associate Professor Damian Scarf  Māori Health Colonisation Determinants of Health Strategies to improve Māori health  Leading Up to Te Tiriti Māori existed as an independent society for >300 yrs before Pākehā arrived...

Māori Health Lecture 5 Associate Professor Damian Scarf  Māori Health Colonisation Determinants of Health Strategies to improve Māori health  Leading Up to Te Tiriti Māori existed as an independent society for >300 yrs before Pākehā arrived Early contact was on terms that recognised Māori as a sovereign people Te Whakaminenga He Whakaputanga o te Rangatira o Niu Tireni Te Tiriti o Waitangi signed by 43 chiefs on 6 February 1840 Deliberate mistranslation and subversion of Māori sovereignty Breaches After Te Tiriti 1852 New Zealand Constitution Act 1862 Native Land Act 1863 New Zealand Settlements Act 1864 Public Works Land Act 1867 Native Schools Act 1907 Tohunga Suppression Act  Determinants of Health ENVIRONMENT RACISM & & EPIGENETICS PRIVILEGE UNEQUAL TREATMENT BY SOCIETAL THE IMPORTANCE OF INSTITUTIONS WORLDVIEWS/POSITIONINGS COLONISATION Strategies to Improve Māori Health Kaupapa Māori Mātauranga Theory Māori Indigenous Māori Health Psychology Models Māori Models of Health Te Whare Tapa Whā Whiti Te Rā Meihana Model  Te Whare Tapa Whā Motivation Overemphasis on the physical aspects of health and biological constructs. Relationship with health professionals and health system was strained. Good health could not be gauged by simple measures (e.g. weight), spiritual and emotional factors viewed as equally important. Te Whare Tapa Whā Development Rahui Tane Hostel 1982 Kaumatua Tupana te Hira Professor Mason Durie  Te Whare Tapa Whā TAHA TINANA Physical TAHA HINENGARO Mental & Emotional TAHA WAIRUA TAHA WHĀNAU Spiritual Family & Social Sir Mason Durie Whiti Te Rā Development Phase 1 Mauri ora & Identity Phase 2 Literature Review Phase 3 Expert Wānanga  Identified Themes Reo Māori (Māori language) Taiao (Connection with the environment) Wairua (Māori spiritual beliefs and practices) Mahi-a-toi (Māori expressive art forms) Whānau (Māori relational values) Whakapapa (Intergenerational relationships) W Whiti Te Rā HONO MAHURU H REO MĀORI I WHAKAPAPA TAIAO T I T E R WHANAU WAIRUA Ā MAHI-A-TOI  Meihana Model Phase 1 Review and Development Phase 2 Taiao & Iwi Katoa Phase 3 Tested (+MBVEs)  HAUORA TINANA HINENGARO WAIRUA TAIAO IWI KATOA Patient Whanau  WAKA HOURUA WHANAU (SUPPORT NETWORKS) TINANA (PHYSICAL HEALTH) HINENGARO (PSYCHOLOGICAL WELL-BEING) WAIRUA (CONNECTEDNESS AND SPIRITUALITY) TAIO (EXTERNAL PHYSICAL ENVIRONMENT) IWI KATOA (SERVICES AND SYSTEMS)  HAUORA TINANA HINENGARO WAIRUA TAIAO IWI KATOA Patient Whanau NGA HAU E WHA (FOUR WINDS) COLONISATION RACISM MIGRATION MARGINALISATION  HAUORA TINANA HINENGARO IWI WAIRUA KATOA WAIRUA TAIAO IWITALAO KATOA Patient Whanau Whenua Whanau Ahua Tikanga Nga Roma Moana  NGA ROMA MOANA (CURRENTS) AHUA (Personal indicators of Te Ao TIKANGA Māori that are important to the (Māori cultural principles) patient/whanau) WHĀNAU WHENUA (The relationships, roles and (Genealogical or spiritual responsibilities of the patient connection between patient within Te Ao Māori) and/or whanau and land) Dr. Suzanne Pitama Health & Wellbeing Te Whare Meihana Whiti Te Rā Tapa Wha Model Wairua ✓ ✓ ✓ Whānau ✓ ✓ ✓ Hinengaro ✓ Tinana ✓ ✓ Connection & Expression Te Whare Meihana Whiti Te Rā Tapa Wha Model Whakapapa ✓ Whenua ✓ ✓ Whanaungatanga ✓ Reo Māori ✓ Expressive Arts ✓ Socio-Political Context Te Whare Meihana Whiti Te Rā Tapa Wha Model Colonisation ✓ Migration ✓ Racism ✓ Marginalisation ✓  Māori Health Colonisation Determinants of Health Strategies to improve Māori health