He Mate Huango: an update on Maori asthma.
In 1990, a Ministerial Review to consider asthma among Maori people was undertaken following concern over disproportionate mortality and morbidity rates from asthma in Maori compared with non-Maori. Findings from the Maori Asthma Review included: a need for a reduction in cost of health care; increased patient education; use of asthma management plans; and greater Maori participation in the planning and delivery of asthma services and asthma education. Alongside this, a significant and complex situation was highlighted regarding Maori not accessing asthma services and asthma resources, the result of which was reflected in more severe asthma and higher hospital admission rates and death rates. The Review made a number of recommendations focussed on a need for substantial improvements in asthma management and asthma education, with the significant involvement of Maori people. This paper reviews the work and conclusions of the Maori Asthma Review and considers what developments have been made in research and policy since the Review's publication in 1991. A literature review was undertaken examining asthma prevalence studies and asthma mortality and morbidity data among Maori since the Maori Asthma Review was completed. Health policies and relevant government health initiatives were examined to assess the policy outcomes resulting from the findings and recommendations of the Review. The findings indicate that asthma prevalence remains similar between Maori and non-Maori children but asthma severity is greater in Maori children. Both prevalence and severity of asthma are greater in Maori than in non-Maori adults. Funding of health services in New Zealand have undergone dramatic changes since the introduction of the health reforms in 1993. These changes have affected the development and implementation of asthma services to Maori at both local and national levels. Effective planning and development of asthma services will continue to be hindered by a lack of dedicated and ongoing funding which is necessary to ensure long term planning and implementation of asthma services to Maori can take place.
Ellison-Loschmann
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Department of Public Health, Wellington School of Medicine, P.O. Box 7343, Wellington, New Zealand.
Pearce
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N
D001249:Asthma / Q000453:epidemiology / Q000208:ethnology* / Q000401:mortality; D006291:Health Policy; D006297:Health Services Accessibility; D006303:Health Services, Indigenous; D006801:Humans; D009520:New Zealand / Q000453:epidemiology; D010353:Patient Education as Topic; D015995:Prevalence; D012720:Severity of Illness Index