home > Research Centre > Current Projects

Unequal Treatment: the role of health services.
A recent US publication has compiled compelling and comprehensive evidence of unequal treatment by ethnicity across diverse parts of their health system. This project will explore the role of unequal treatment in the New Zealand health system and how it contributes to disparities in: cervical cancer; obstetric procedures and adverse birth outcomes for mothers and babies; and ischaemic heart disease. This work will engage with health systems and health service providers to assist them to understand how they can contribute to the elimination of health inequalities. Routinely collected data on hospital admissions, deaths and cancer registrations will be analysed, and focus groups will be held with clinicians and other health workers to discuss the quantitative results and consider potential interventions. The project is funded by the HRC.

Oral Health Research Priorities for Māori
There have been very few investigations of hospital oral health service utilisation in New Zealand. Substantial oral health inequalities have been identified between Māori and non-Māori with Māori reported as having a lower level of oral health than non- Māori. This research will explore the use of hospital oral health services for Māori and non-Māori using a retrospective analysis of clinician daybooks held within Capital Coast DHB. It will contribute towards oral health policy and service development for Māori and non- Māori groups. The project is funded by the HRC.

Mauri Tangata: Long term health effects of involuntary job loss on mortality and morbidity
This factory closure study aims to investigate the long-term effects of involuntary job loss on mortality and morbidity. It will compare deaths, cancer registrations and hospital admissions among freezing workers made redundant in 1986 (Whakatu) and 1994 (Tomoana), with control workers from four Hawkes Bay freezing works that remained open. Follow-up will be continued to December 2004. The new control works include Pacific in Hastings, Wairoa, Takapau and Oringi. This study is unique in the world and provides an opportunity to establish the causal effects of unemployment, free from accusations of reverse causality. Māori have been disproportionately affected by involuntary job loss during the last two decades. The study aims to influence policies concerning economic, social and health inequalities and equitable access to health care. It is a partnership with Ngati Kahungunu Iwi Inc and funded by the HRC.

The study design enables a comparison of the closures over two different time periods. The labour conditions of the 1980s when Whakatu closed were quite different to the conditions endured by the Tomoana workers when it closed in the 1990s. The data analysis may therefore show different health effects for these two time periods.

This study is one of the largest in the world and provides an opportunity to establish the causal effects of unemployment, free from questions of reverse causality. Māori have been disproportionately affected by involuntary job loss during the last two decades, and the current economic recession will increase the number of job redundancies. This study aims to influence policies concerning economic, social and health inequalities and equitable access to health care.

In late July 2009, three community hui will be conducted throughout the Ngati Kahungunu region to disseminate the findings amongst the communities. This research project is a partnership with Ngati Kahungunu Iwi Inc (www.kahungunu.iwi.nz) and funded by the Health Research Council of New Zealand.

A community report was published at the end of the 1st stage of the study in 2001. Please click the following links for a copy.

1. Mauri Mahi (The Full Report - 7MB)

Māori Monitoring Services for Breastscreen Aotearoa (BSA)
This contract is for the design and implementation of independent Māori-appropriate analysis of Breast Screen Aotearoa monitoring data. The contract is with the National Screening Unit of the Ministry of Health.

Unequal Impact: Māori and non-Māori cancer statistics
This project involves extensive analyses of Māori and non-Māori cancer incidence, mortality, stage at diagnosis and survival. It aims to establish a baseline from which to evaluate the effectiveness and equitable impact of the cancer control strategy. Two comprehensive cancer chartbooks including analyses of cancer outcomes for Māori and non-Māori by rurality and deprivation will be produced. The first of these chartbooks was released in May 2006. The Chartbooks are funded by the Ministry of the Health.

Ethnicity data project: brief overview
There is an ongoing need for high quality, standardised ethnicity data in the health sector. This data is essential for measuring, monitoring, and addressing health inequalities in Aotearoa/New Zealand. It is also important in developing policies and programmes that are responsive, relevant to, and in line with Maori priorities.

The Ministry of Health has developed protocols to facilitate consistency, standardisation, and appropriate ethnicity data practices across the health sector (Ethnicity Data Protocols for the Health and Disability Sector). However, there have recently been a number of changes within the broader ethnicity data collection and classification context that have the potential to impact on health sector data.

Donna Cormack is currently leading a project funded by Te Kete Hauora to identify ethnicity data issues (current and future), and to examine the potential implications on the Maori health sector of changes within the broader context of ethnicity data policies and practices in Aotearoa/New Zealand. As part of the project, a series of collaborative discussion papers are being produced, and two fora will be held to discuss relevant issues and disseminate findings.

The discussion papers will cover the following topic areas:

• Official ethnicity data in Aotearoa/New Zealand
• Issues with monitoring Maori health over time
• The classification and output of multiple ethnicities
• National identity and ethnicity: ‘New Zealanders’ as an ethnic group
• Improving and maintaining quality in ethnicity data collections
• Genetic explanations for ethnic disparities in health

Further information:
If you have any questions or would like further information, please contact:
Donna Cormack
Email: donna.cormack@otago.ac.nz

Racism fellowship: brief overview
Dr Ricci Harris and Dr Donna Cormack are currently jointly undertaking a 2-year fellowship funded by Te Kete Hauora and based with Te Ropu Rangahau Hauora a Eru Pomare, University of Otago, Wellington. The fellowship will be used to develop Maori research capability and expertise in the area of Maori health and inequalities. More specifically, the fellowship applicants will focus on developing research capability and expertise in the area of racism, health and inequalities.

Within New Zealand and internationally, racism is recognised as an important determinant of health and fundamental driver of ethnic inequalities (Harris et al 2006, Krieger 2003, Nazroo 2003, Williams 1997, Ministry of Health 2002). However, the investigation of racism as a cause of ill health is still an emerging field of scholarship both in New Zealand and internationally. Some important gains have been made in beginning to assess the prevalence and impact of racism on Maori health and inequalities, such as measures included in the New Zealand Health Survey. However, these are highly specific in that they focus on interpersonal racism in certain domains. A comprehensive approach to measuring and monitoring the different types of racism and its effects is needed, including systemic, interpersonal and internalized racism (Paradies et al 2008). In addition, evidence on effective interventions to combat the negative health effects is required. This fellowship will contribute to our further understanding of racism and its impact on Maori health and inequalities and investigate options for more comprehensive monitoring, and potential interventions.

The fellowship funding will support work in several areas and will be undertaken in two main components that each of the fellowship applicants will lead. These include an analytical component, led by Ricci Harris, and a theoretical and methodological component led by Donna Cormack.

Current Projects & Recent Publications
Current Projects
Recent Publications