Obesity among the Maori population in New Zealand

This report assesses the prevalence, causes and health consequences of obesity among the Maori people in New Zealand, depicting health disparities among this indigenous population. It also evaluates the government's role in addressing obesity and implementing strategies to improve the overall health status of the Maori people.

Obesity among the Maori population in New Zealand
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Introduction
The health status of the indigenous persons continues to vary in terms of the historical
nature, social and political avenues due to their particular environments well as the incurring
interactions and existence of nonindigenous populations in their countries. The Maori of New
Zealand is such a group of indigenous persons who have continued to suffer immensely. This
has a significant effect on the overall deterioration of the health care issues of the Maori
which have deteriorated in the last decades (Sarfati et al., 2018). There are huge significant
differences in terms of various health parameters for these minority groups compared to the
non-Maori population in New Zealand. There are glaring significant health disparities among
this population. Contextual analysis of this aspect reflects a critical explanation of
inequalities. The nature of health care access to these indigenous populations has shown
varied associations compared to the non-Maori population (Came, McCreanor, Doole &
Rawson, 2016). Despite numerous studies undertaken, there still persist significant health
differences among the Maori population (Reid, Cormack & Paine, 2018). In this assessment,
obesity among the Maori people will be assessed with its prevalence, causes and health
consequences depicting health disparities among this indigenous population. This report
assesses the overall governance issues with regard to Maori health status and management of
health care across the board and current government strategies and policies to address the
situation.
Obesity issues among the Maori population
Despite progress in review reports and peer review studies describing the health status
of the Maori Indigenous community, there is still significant persistence on the issue. The life
expectancy of the Maori people for both males and females stood at 73.3 and 77.6 years
respectively in 2011 vis-a-vis 79.9 and 84.4 of the general population (AlBusaid, Huria,
Pitama & Lacey, 2018). Further, they do not only have shorter life expectancy and life span
but also they have a few years of good health. The leading causes of the disease affecting the
Maori people are diabetes and vascular diseases which are related to obesity rates where they
experience a health loss of 2.5 times higher compared to a nonindigenous person. Obesity is
crucial nonmodifiable factors which contribute significantly to these diseases and other
various types of cancers and reduced life span. The increase of weight loss management
programs illustrated the challenges and difficulties facing this population in managing

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meaning full weight loss (Johnstone et al., 2014).
Obesity state among the Maori people has shown various general consequences on the
overall health state and disparities in health care outcomes. Across New Zealand, there are
high overweight issues affecting the larger country. Maori population encounter
disproportionate health outcome and attributable high occurrence of overweight and obesity
among the entire population (Ng et al., 2014). There have been significant high BMI indices
among Maori adults with body mass index greater than >30 kg/m2.
In the 2016/2017 ministry of the health survey, 34% of the adults above 15 years of
age were overweight with BMI range of 25.0 and 29.9 with more than 1.2 million or 32%
among the general population. Out of about 4.3 million in the year 2008, rough estimates
indicate that 1.13 million adults in New Zealand were overweight (Theodore, Mclean &
Temorenga, 2015).
In a report published in 2008, Maori adults and other indigenous population had a
higher rate of obesity compared to the general population (Ministry of Health 2012). In the
year 2016/2017, an estimate of 50% of the Maori adults and 18% of children were obese. The
rates of obesity among these population is continually increasing from 41% to 42.7% among
men while women elevated from 40.4% to 48.3%, with significant changes being observed
among women. A survey undertaken has shown that Maori have significant rates of obesity-
related conditions such as diabetes, high blood pressure, and even heart attacks compared to
none indigenous populations (Ministry of Health, 2017).
Moreover, The New Zealnd Health Survey of 20172018 showed that 1 in 3 adults
above 15 years were obese representing 32% of the general population. 47% of the Maori
population were obese, a lower figure compared to the previous year. 65% of the Pacific
adults were obese. Among the children 1 in 8 are obese signifying a 12% prevalence. Among
the Maori children, 17% were obese while the Pacific children were 30% obese Ministry of
Health, 2018).
Maori have a high proportion of being to have a diet high in total and saturated fat and
reduced state of fiber, vitamin C and calcium signifying poor diet outcome and quality. The
dietary patterns have shown to reflect the lower socioeconomic outcomes of these indigenous
populations and decreased intake of healthier foods such as fruits, dietary fiber, calcium and
vitamin C. The association and linkage of poverty and obesity has been at times been viewed

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paradoxically in that, their poor populations are not the only extreme sufferers of obesity but
also those with access to low-cost foods. Further, individual and personal choices of food and
the physical activity state have been the greater disadvantaged aspect of the general health
outcomes of these populations (Ellison-Loschmann, L., & Pearce, 2006).
Obesity issue among the Maori population has called for urgent attention. The
occurrence of obesity-related illness remains to be a significant challenge and burden of
disease observed among the Maori people. Obesity has significant effects on the overall
individual ability to perform various community functions such as family and participation in
the overall community workforce. Hence obesity has demonstrated a significant challenge on
the overall advancement of the Maori Health aspiration (Warbrick, 2011). Further critical
recognition of the rights of the indigenous persons plays a fundamental role among the Maori
people. The fundamental role on the recognition of treaties such as the Waitangi treaty
entrenches the overall benefits to be guaranteed for all citizens. This offers and places the
Government of New Zealand in a better position to improve the standards of health among
the indigenous population (Ministry of health, 2014).
The role of the government in addressing obesity
The underlying factor determining the health outcome of the Maori people is
underpinned in colonial history (Mariott & Sim, 2015). Since the European settlement, the
emergence and signing of the Treaty of Waitangi in 1840 took place. The health outcomes
and access of the Maori people have been disadvantaged for a long period of time due to
colonization and recurrent breaches of the treaty leading to land confiscation, loss of
knowledge and resources and general disorientation of the social-political organizations and
discrimination across the Maori population (Finegood, Merth & Rutter, 2010). The
underlying loss of land, poverty and limited access to traditional foods have often favored
negatively the health outcome of this population. This experience in health care and health
status has mirrored consumption of cheap processed foods characterized by high fat and
sugar, lack of physical activity and increased rates of obesity and cardiovascular diseases.
The deliberate delineation and exclusion from the education system have worsened
the state of the Maori people. There has been little government attention to address the wider
gaps in accessing the basic fundamental of the health outcomes of the Maori people. The
structural reforms are undertaken by the government of New Zealand such as the

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privatization of the of major utilities and remodeling of the welfare state lead to increase the
state of unemployment and poverty increased among the Maori people among the working
class and decline of health outcomes (Tobias et al., 2009).
Research studies undertaken have demonstrated that there are significant differences
in the social, environmental, economic and political landscape determining the overall health
outcome among the Maori people (Smith, Humphreys & Wilson, 2008). Maori people, dis-
proportionality have adverse negative socioeconomic and dietary factors which have shown
to predispose them to obesity and illness. Census undertaken by the government in 2013
showed that about 16.4% of Maori professionals were employed compared to the national
average of 22.5% while being Maori increased the likely hood of not being employed
(Statistics New Zealand, 2013).
The government of New Zealand has a fundamental role in reversing these trends on
the obesity and promotion of public health approaches among the general population. These
advances should not be left to nongovernmental bodies and other stakeholders who have
limited power financial ability and general capacity to undertake comprehensive approaches
and policy alignment to address obesity (Gortmaker et al., 2011). Further, the government has
a fundamental role in implementing and discharging rights and responsibilities as per the
treaty of Waitangi for the people of Maori (Ministry of Health, 2014). The government needs
to prioritize this factors which underlie the health inequality and health disparity among the
people of the Maori with a greater address on the improvement related to socioeconomic
deprivation, improving education levels and increase access to food and enabling food
security across the population (Ministry of Health, 2014).
Government strategies and priorities
Since 3 decades ago, there has been an upward trends in terms of health services
intervention to meet the needs of the Maori community with greater autonomy in the overall
design and delivery of health care Currently there are entrenched Kaupapa Mori service care
embedded in policies and have formed part of the health sector (Boulton, Tamehana &
Brannelly, 2013).
Various research studies have been undertaken among the Maori community and trials
of various interventions to address and improve the health outcome of the Maori.
Implementation of the famous Ngati and Healthy diabetes program was able to yield

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significant decrease on the overall prevalence of pre-diabetes among the Maori people
through community-driven interventions which aimed at total reducing the overall weight and
increasing the exercise levels among the population. The Ngati and Healthy community
health promotion initiative were able to use health promotion, education and health aspects
and strategies in adapting the overall environment and to make healthy avenues and
improvements across the indigenous populations (Tipene-Leach et al., 2013).
Due to this initiative, there has been a significant increase in the overall obesity trends
across the population. Roll out of the Te Wai O Rona intervention program was initiated as a
four-year intervention study on diabetes prevention and was undertaken in the regions of the
urban setting of New Zealand. This study aimed at changing the behavioral aspects of the
Maori community. The intervention was undertaken through the usage of community health
workers trained on the facets of behavior change theory. This intervention employed
participatory approaches in addressing the local community issues and enabling support
towards lifestyle changes and improving access to healthier foods and motivating on physical
exercise. The program achieved significant improvement in on the overall health outcomes of
the population. However, due to the short and limited funding, the sustainability of the rollout
was impacted negatively (Hayes, 2016).
The most comprehensive national intervention strategy implemented entails the
Healthy Eating – Healthy action: Oranga Kai – Oranga Pumau (HEHA) launched in the year
2003. This aimed at improving the coordination of the policy framework across the
government and nongovernmental agencies. This focused on the environmental changes
especially in the education set up, workplace and also food distribution mechanisms in
schools. This strategy was embedded on the three key principles of the Treaty of Waitangi
thr4ogub partnerships with communities in developing effective strategies and protection
through special protection on Maori values and practices. With this regard, caucus under the
ministry of health was formed which focussed on the Maori was formed to guide on the
implementation of the Maori strategy. This strategy was essential in providing effective solid
foundation on the efforts undertaken by public health for the Maori and indigenous
communities towards the reduction of obesity and health inequalities, however the program
did not last long as it was terminated (Swinburn & Wood, 2013 & McLean et al., 2009;
HEHA strategy, 2009).
More recent approaches have turned to individualistic obesity prevention intervention.

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The government is aiming at increasing access to better health care outcomes and to better
health care outcomes among New Zealand. Further other approaches such as the “Whanāu
Ora” have been introduced as a new approach on improving the health care state of the Maori
people.
Recommendation and rationale for Maori health improvement
There is a need for adopting a long term multi-sectorial approach and policy action
towards improving the obesity state of the Maori and the general health status. These are
essential so as to ensure there is continued sustainability among the initiatives undertaken in
the community. Encouraging political goodwill among the political class is essential for the
Maori people. Strong leadership is necessary especially when implemented policies and
interventions are not effective enough to achieve the needed results. There is a need for
improved investment in approaches and interventions aligned with the health priorities of the
Maori people. Lack of adequate financial ability often hinders the effective implementation
of programs as observed from previously enrolled initiatives. Further, improved coordination
and engagement across all the stakeholders are needed for the Maori people. An effective
relationship is essential for building time and commitment.
Conclusion
Health outcomes of indigenous populations often vary based on various historical,
social and political factors which tend to sideline the indigenous persons form access to
health care equally compared to the nonindigenous population. Obesity rates among the
Maori and indigenous persons in New Zealand call for adequate attention across all the
sectors. The government role in implementing and taking the lead role in implementing these
strategies is essential in overall health care access. In addressing this significant gap and
addressing obesity trends, the government needs to show commitment, plan for resources,
addressing sociological factors and entrenching the goodwill is critical in addressing the
health outcomes of the indigenous population. The right to health as envisaged in universal
rights of people need to be respected and implemented for the indigenous persons of New
Zealand.

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