This review aims to analyse the effect of several key factors such as socio-economic status in connection with health care access of people. The literature study of this topic is important to us as health care providers in order to promote the rights and equality among Maori and non-Maori clients.
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Factors such as education, employment status, and housing may greatly affect one’s health. Like for instance, if a home is located in a community where health care facilities are immediate, then, services can be easily accessible to the public. However, if a person lives in a remote community where access to hospitals are limited, it will of course be difficult for him to manage certain illnesses and emergency cases since doctors and nurses are far from the place. Some people may also feel lazy to pay visits to clinics for some check-ups if it will be far from their homes. Poor quality houses may also cause deterioration of one’s health if it is not properly insulated as exposure to extreme cold climate may be a precursor for illnesses such as flu and fever. Mold build-ups in low quality shelters is also a risk factor in diseases. Pneumonia and other respiratory illnesses commonly affect indviduals, particularly young children, in poorly insulated and moldy homes in New Zealand. For this reason, th e New Zealand government is taking its actions to prevent health deterioration affected by housing. According to a report, Housing new Zealand(2013) is responsible for providing warm, dry homes for people in need, and ensuring those homes are the right size and where we need them (Housing New Zealand, 2013). Education plays an important role in using nursing services. A person can receive efficient nursing services from a health care provider if he is equipped with adequate knowledge of his or her rights and responsibilities. A certain client can be proactive with his treatment routine because he knows he has the right to decline or suggest any alternative medications which may be beneficial for him. Say for example, if he wishes to consume any medicinal herbs as a substitute or supplement, then he may do suggest it to his physician for approval. Employment status can also be associated with nursing services in terms of economic state. Salaries of employees affect their access to services because of affordability. Workers with higher salaries tend to have more funds for their health check-ups and medications than those who are within the minimum wages. But still, the government subsidised hospitalisations and medication for New Zealand citizens and residents. Victims of road accidents are also given with free medical assistance and hospitalisation as well. According to Pollock,
Under the Social Security Act 1938, public hospitals became free in 1939 and prescription medicines in 1941.  (Pollock, K., 2013)
The Accident Compensation Corporation (ACC)states that:
Everyone in New Zealand is eligible for comprehensive injury cover:
- no matter what you’re doing or where you are when you’re injured – driving, playing sport, at home, at work
- no matter how the injury happened, even if you did something yourself to contribute to it
- no matter what age you are or whether you’re working – you might be retired, a child, on a benefit or studying.
What injuries am I covered for?
Wounds, lacerations, sprains, strains, fractures, dislocations and work-related injuries such as hearing loss may all be covered. Most physical injuries are covered if they’re caused by:
- an accident
- a condition that comes on gradually because of your work (gradual process)
- medical treatment
- sexual assault or abuse. (The Accident Compensation Corporation, 2014).
However, there are some considerations that must be taken prior to approval of these benefits. That is,the ACC must be satisfied with the present conditions of the clients taking their claims. An accident victim must be physically injured, obtained mental injury as a result of physical injury. Injuries related to work or any traumatic accidents, damages of prosthesis, and death because of the accident.
There is a specific definition of ‘injury’ in the Accident Compensation (AC) Act 2001, which is the law that ACC must apply when considering applications for claims and assistance.
Gender is also an element that affects health because generally, women are the ones who bear children and this situation puts their lives at risk. Cook stated that before European contact to New Zealand, “Rates of maternal mortality in 19th- and early 20th-century MÄori communities are unknown, as the first figures were not collected until 1920. In that year nearly 23 MÄori women died for every 1,000 live births. (The rate amongstPÄkehÄwomen was 6.5 per 1,000 live births.) This figure, high as it is, was probably an underestimate: MÄori deaths were not reliably reported until after the Second World War. MÄori women’s access to medical help was limited by a number of factors:
- the loss oftohungaand traditional medical knowledge through population decline
- the scarcity of hospitals and doctors in the rural areas where most MÄori lived
- the refusal of some hospitals to admit MÄori
- the reluctance of some doctors to treat MÄori
- MÄori women’s reluctance to be examined by male doctors (almost invariably PÄkehÄ).” ( Cook, M.,2012).
Women also play a big role in the health care industry. Most health care providers and nurses are female as more women prefer such job roles than males. According to The Nursing Council of New Zealand, “The nursing workforce is overwhelmingly female, with only 7.4% of nurses being male (essentially unchanged from 2010 report figures of 7.2%). The male workforce is younger than the female workforce, with 38% aged under 40 compared with 31% of female nurses. The average age of the nursing workforce is 45.6, with the average age of male nurses being 43.4 and the average age of female nurses being 45.7.” (The Nursing Council of New Zealand, 2011).
One’s social status is relevant in the promotion of well-being. That is, if a person has a good standing in the community where he or she dwells, there is a higher chance of self-esteem and optimum mental health may be achieved at this point. It is because how a person feels from the inside radiates towards his personality and how he reacts with people around him. A good social status may also result from a decent employment status. In addition, a supportive community can also promote each other’s well-being. Those who are socially isolated are at higher risk of health deterioration because of lack of social support from the neighbourhood. For example, people with disabilities may cope better in a disable friendly places, such as presence of handrails and ramps, which are supported by the government and its people. A good relationship with the community and family also creates a friendly atmosphere and happiness in each other. These positive vibes are also key factors in promoting healthy individuals. As what Griffiths mentioned,
- “People with strong family, cultural and community ties have better health than people who are socially isolated.
- Social cohesion or ‘connectedness’ is related to the health of individuals and communities.
- Single parent families, people with mental illness, people with disabilities, people
living alone and older people are particularly vulnerable to social isolation.
- There are generally high levels of access to telephones and motor vehicles in New
Zealand but access for some groups is poor.
- Features of New Zealand society that may tend to reduce social connectedness are
unemployment, frequent change of residence (high mobility), and an increase in
single parent and one person households over the past decade.” ( Griffiths, 1998)
Summing it up, good communication is a relavant factor in health improvemnt because interaction with other people limits the bounadries, and creates a channel to divert any confusions or uncertainties in life. In adddttion, reaching out benefits everyone especially in times of needs and other unexpected life circumstances. This concept is similar to the saying that “No man is an island.” or “No man can live alone by himself.”
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Maori people’s access to health care is different from that of non-Maoris. This is because of several factors such as inaccessibility to health care facilities of the indigineous native people. Cultural safety is also an element because some individuals may prefer utilizing the tradional way of treating illnesses rather than seeing a general physician for consultation. And in line with this idea, it will be difficult to contest them in their beliefs because doing so will result to violation their right to self-determination or them beig in-charge of their own well-being. Non-Maoris, on the other hand, are well accustomed to modern lifestyle as compared with Maori group. This is the reason why more non-Maori people regularly pay visit to clinics and other health care facilities if they have some concerns regarding their health issues. Moreover, non-Maori, especially the Kiwi people are the ones who introduced the modern health care system in New Zealand. So, most likely, they are the ones who will patronize more that particular type of system.
The legitimacy of differences in culture and respect for the rights of others can be materialized or be actualized in the priniciple of Tino rangatiratanga. As mentioned before, the principle of Tino rangatiratanga focuses on a Maori’s right to self-determination. It means that despite the introduction of new government and health care delivery system in New Zealand, these indigenous people can still have the right to choose their preference especially in health care, and whatever culture or values they possess or believe in to can still be preserved. In this context, equality among each individal can be evident.
Power relationship can be defined as ann unequal quality of relationship between a client and a health care provider. This is comprised of a higher authority, or the health care provider who is much superior to the client. This is due to the fact that health care professionals tend to possess more knowledge than his or her client in the sense of giving care or treatment. However, instances that there may be biases in this scenario if a client is submissive to whatever the health care professional tells him. Like if the client is not given the privilege to speak out what is on his mind and the choices or preferences he or she wishes to have.
In my belief, imbalances in health care relationships can be resolved if proper education is provided to every individual especially to Maori people. Since they have diverse cultural beliefs and that is, very different from the modern approach, it is very important to orient them properly prior to imposing new treatments and medical interventions to them. An equitable, efficient and efffective health service delivery can be achieved as well if every health care professional can be compassionate and understading of each client’s needs and cultur. One must always keep in mind that health services is not just about the physical aspect, but, rather, it must be hollistically done. Emotional and cultural aspects must be identified and given importance as well.
To summarize this review, there is still some inequalities in health service with Maori and non-Maori people as evident in several readings published. As members of one community, it is important that each must take part in improving this issue in the society. Especially as part of the health care team, it is my responsiblity to materialize whatever learnings I gained in reviewing this literature. Through this task, I was also able to identify the markers that affects the well-being and access of every individual to health care. And the knowledge of these factors can help us in our roles in the community. Yet, despite of the issues present, it is still evident that New Zealand is indeed one of the coutries to have ann excellent health care system in the world because it took an effort to provide subsidy for medical and hospitalistion for its citizens.
 Housing New Zealand. (2013). 2012-2013 Annual Report (Focused. Homes for people, reshaping our houses). Wellington. Retrieved from http://www.hnzc.co.nz/our-publications/annual-report/2012-13-annual-report/annual-report-2012-13
 Pollock, K. (2013) ‘Health and society – Health services’, Te Ara – the Encyclopedia of New Zealand. Retrieved from http://www.TeAra.govt.nz/en/health-and-society/page-4
 The Accident Compensation Corporation. (2014). Am I covered?. Retrieved from http://www.acc.co.nz/making-a-claim/am-i-covered/index.htm
 National Health Committee. (1998). The Social, Cultural and Economic Determinants of Health in New Zealand: Action to Improve Health (A Report from the National Advisory Committee on Health and Disability). Wellington: Griffiths, G. Retrieved from http://nhc.health.govt.nz/system/files/documents/publications/det-health.pdf
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