scholarly journals Derek A Dow, Maori health and government policy, 1840–1940, Wellington, New Zealand, Victoria University Press in association with the Historical Branch, Department of Internal Affairs, 1999, pp. 280, illus., NZ$39.95 (paperback 0-86473-366-6).

2002 ◽  
Vol 46 (4) ◽  
pp. 600-601
Author(s):  
Janet McCalman
2021 ◽  
pp. 0310057X2198971
Author(s):  
M Atif Mohd Slim ◽  
Hamish M Lala ◽  
Nicholas Barnes ◽  
Robert A Martynoga

Māori are the indigenous people of New Zealand, and suffer disparate health outcomes compared to non-Māori. Waikato District Health Board provides level III intensive care unit services to New Zealand’s Midland region. In 2016, our institution formalised a corporate strategy to eliminate health inequities for Māori. Our study aimed to describe Māori health outcomes in our intensive care unit and identify inequities. We performed a retrospective audit of prospectively entered data in the Australian and New Zealand Intensive Care Society database for all general intensive care unit admissions over 15 years of age to Waikato Hospital from 2014 to 2018 ( n = 3009). Primary outcomes were in–intensive care unit and in-hospital mortality. The secondary outcome was one-year mortality. In our study, Māori were over-represented relative to the general population. Compared to non-Māori, Māori patients were younger (51 versus 61 years, P < 0.001), and were more likely to reside outside of the Waikato region (37.2% versus 28.0%, P < 0.001) and in areas of higher deprivation ( P < 0.001). Māori had higher admission rates for trauma and sepsis ( P < 0.001 overall) and required more renal replacement therapy ( P < 0.001). There was no difference in crude and adjusted mortality in–intensive care unit (16.8% versus 16.5%, P = 0.853; adjusted odds ratio 0.98 (95% confidence interval 0.68 to 1.40)) or in-hospital (23.7% versus 25.7%, P = 0.269; adjusted odds ratio 0.84 (95% confidence interval 0.60 to 1.18)). One-year mortality was similar (26.1% versus 27.1%, P=0.6823). Our study found significant ethnic inequity in the intensive care unit for Māori, who require more renal replacement therapy and are over-represented in admissions, especially for trauma and sepsis. These findings suggest upstream factors increasing Māori risk for critical illness. There was no difference in mortality outcomes.


2021 ◽  
Author(s):  
◽  
Kezia Fairbrother

<p>In 2018, the government published the report of its inquiry into mental health and addiction in Aotearoa New Zealand, which called for a ‘paradigm shift’ in the country’s approach to mental wellbeing. This research portfolio explores the role architecture has to play in this shift, acknowledging the problematic historical associations of architecture and mental health. In doing so, the work aims to establish principles for a new architectural typology of mental health care, outside of conventional institutions. It explores contemporary approaches to wellness, and integrates research from several bodies of theoretical and evidence-based research into a new creative practice within architecture. Specifically, the research draws on theory around nonrepresentational therapeutic landscapes, third place and evidence based design. These inform creative explorations of the therapeutically affective qualities of naturally-sourced materials. The findings of this explorations are transferred to spatial design using a ‘multiplicity’ approach based on nonrepresentational theory and Māori health models, which is then applied to a specific site in Wellington, New Zealand. Finally, architectural applications for this research are proposed in the form of a community-based third place to support mental health and wellbeing.</p>


2021 ◽  
Author(s):  
◽  
Tessa Lynch

<p>Generally, one in five New Zealanders experience mental illness. Majority of lifelong mental illnesses begin before the age of 25, presenting a real problem for youth. In 2018, young people of New Zealand called for more help as they rallied outside parliament. The government responded by allocating more money towards student mental health. Yet, employing more counsellors, which is necessary, is not the only way to contribute to an urgent need for a new approach towards supporting mental health and wellbeing.   This research portfolio responded to this complex situation by developing ‘a guide’ for the design of tertiary spaces supportive of wellbeing. One of the most important goals of this work was to align the research closely with user needs and views, therefore research methods involved including students views in more than one phase of development. The work draws on evidence based design, geography, health and architectural theory and the existing wellbeing knowledge. Engagement with the users, observation, experiments and real life interventions were critical in refining a conceptual framework which kept the users at the centre of the process. The outcome of this research was a resource to guide the design of tertiary space for wellbeing, using five intervention points, which could have a positive effect on the student wellbeing if implemented as a system.  New Zealand must shift the current model of mental health care towards more holistic understandings of health, which better incorporates Māori health and wellbeing. Despite New Zealand’s bicultural values, Māori experience significantly higher rates of mental illness. This prompted to design with the same understandings of hauora (health). As a result, the conceptual framework presented a multi-dimensional, interconnected understanding of wellbeing through an integrated framework exploring physical, cultural, social, learning and spiritual environments.   While it is acknowledged that environments can affect our mental health, this is an under researched field requiring motivation to stimulate discussion and change. This research advocates wellbeing as a central focus in the design of our built environments and explores the opportunity for architecture to facilitate our student and national wellbeing goals.</p>


Author(s):  
Christine Cheyne

Since 2000 intergovernmental relations in New Zealand have been evolving rapidly as a result of a significant shift in government policy discourse towards a strong central-local government partnership. New statutory provisions empowering local government to promote social, economic, environmental and cultural wellbeing have significant implications for the range of activities in which local authorities are engaged. In turn, this has consequences for the relationship between local government and central government. The effectiveness of the new empowerment and the prospects for further strengthening of the role of local government are critically examined. Despite some on-going tensions, and an inevitable mismatch in the balance of power between central and local government, it is argued that there is a discernible rebalancing of intergovernmental relations as a result of new legislation and central government policy settings which reflect a ‘localist turn’. On the basis of developments since 2000 it may be argued that the New Zealand system of local government is evolving away from the recognised ‘Anglo’ model. However, further consolidation is needed in the transformation of intergovernmental relations and mechanisms that will cement a more genuine central-local government partnership.


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