New vaccination data proof of Govt's broken promise to Māori
Friday, 8 October 2021
ANALYSIS: On Thursday, Jacinda Ardern met with a crowded room of Māori health providers. There were masks, but no physical distancing.
The trip to Rotorua came on the same day the Ministry of Health released its most detailed data yet on vaccination rates across the country.
What the suburb-by-suburb breakdown shows is wholly unsurprising.
It shows poorer and browner neighbourhoods are under-vaccinated. More affluent, whiter suburbs have higher rates of vaccination.
**READ MORE:
* Covid-19: The most detailed look yet at where vaccination rates are lagging
* Covid-19: Whānau Ora has been seeking better Māori vaccination approach since February
* Covid-19: Legal action launched in effort to boost Māori vaccination rates
* Covid-19: John Tamihere threatens court over Māori vaccination data
* Covid-19: The stark inequity of the vaccine rollout
**
Even neighbouring suburbs have staggeringly different protection rates.
In the Wellington Region, the traditionally wealthy suburb of Aotea has 92.7 per cent coverage for first dose, while neighbouring Waitangirua and Cannons Creek have some of the lowest rates in the region – between 63 and 65 per cent.
In south Auckland, 82 per cent of people in Māngere East had received their first dose, while across the motorway in Māngere West, which neighbours Auckland Airport, that rate was 66 per cent – a gap of 16 percentage points.
Many parts of Northland, inland Bay of Plenty and East Cape, and the West Coast, have lower than average rates.
The Government won’t be surprised by these stark disparities.
Since the beginning of the pandemic, it has promised to prioritise Māori and Pasifika groups, to ensure an equitable vaccine rollout.
That hasn't happened.
Years of inequitable health outcomes, and a Waitangi Tribunal case to prove it, meant those in power knew where the sticky spots would be. But they refused to step away from a mainstream approach in order to avoid what should never have been inevitable.
Early in the programme, the prime minister pointed to supply restrictions and then population age demographics to explain the gap. With ample supply, and all over 12s eligible to the vaccine, that will no longer wash.
High-level data that Stuff has been publishing every week has shown a gap steadily growing between Asian and Pākehā people, and those with Māori and Pasifika backgrounds.
The new, more detailed data, repeats this trend, with lower rates of vaccination in areas with larger Māori populations.
The new figures show a clear failure of policy and programme, by a government so keen to avoid race-based politics it’s ended up with another Māori pandemic.
Last time the Government announced a non-mainstream approach to addressing inequitable access and health outcomes for Māori, it was accused of apartheid medicine.
The political legacy of Don Brash, who was the leader of both the National Party and the ACT Party, means those in power feel forced into creating public health policy that focuses on all New Zealanders. We’re the Team of 5 Million after all.
But not everyone is at equal risk.
The lawyer who wants to come home from the UK for a summer beer on the beach and game of cricket won’t be affected in the same way as the family living cheek by jowl in south Auckland.
The Government was repeatedly warned taking a mainstream approach to the vaccine roll-out would see some communities fall behind, but it claimed it could capture those vulnerable groups by prioritising health conditions, not ethnicity.
As the Delta outbreak threatens to breach 50 cases a day, and spread throughout the country, it’s become clear the communities where Covid-19 will settle in. These are the same communities that are inequitably protected.
The indigenous health experts who spoke to Stuff say Māori were always going to be most at-risk from Covid-19.
On Wednesday night, Lucy Telfar-Barnard, a University of Otago health and housing researcher, wrote a detailed Twitter thread, fuelled by anger. She slept on it just in case she changed her mind; she didn’t.
The thread is a clear breakdown of what the Government was told every step of the way. Those in charge of the pandemic response had the opportunity to take a different approach in order to avoid the situation we’re now facing: inequitable protection against Covid-19.
When the country went into level 4 lockdown, and vaccine supply was no longer an issue, the Government should have changed tack, Telfar-Barnard says.
That didn’t happen. Instead, the gap has widened.
And the longer it takes to get to those communities, the more time conspiracy theorists have to push an anti-vax agenda.
There are now some good initiatives and events popping up around the country.
In some cases, Māori health providers have long been quietly steering the waka in a different direction.
One Hutt Valley provider has been vaccinating whole families it comes into contact with, regardless of who is officially eligible.
In Auckland, Waipareira Trust chief executive John Tamihere says the appointment-based system has worked well for Pākehā and Asian Kiwis, but not Māori.
There are a range of reasons: Historic distrust of government, and disconnection from the healthcare system due to systemic racism, a lack of health literacy, and tangible barriers like transport and inability to take time away from work and family.
That means vaccinations need to go to the people.
Mobile buses and teams provide the capacity, but first health providers need to find those unvaccinated groups or whānau.
Until now, granular data has not been publicly available.
In an effort to access the details of unvaccinated Māori, Tamihere has taken the Ministry of Health to court.
The chief executive of Whānau Ora Commissioning Agency says if he is armed with that information, his own Waipareira Trust and other Māori health providers can target Māori populations in the areas most in need.
Because as the general population moves towards 90 per cent full coverage, the country will open. “But that exposes us,” he says.
“I find it deeply frustrating and upsetting. It makes one very angry that the people holding all the resources and all the knowledge knew it.”
Meanwhile, the National Hauora Coalition has been able to gain access to Covid Immunisation Register data, and cross-match that with profiles of its 200,000 enrolled patients. From there, the coalition has contracted Māori entities to run a call centre, and track down those yet to be immunised.
Sometimes a more bespoke approach is needed, even if it might seem unconventional. And strategies that reach into vulnerable Māori and Pasifika communities are getting results.
This is the approach the Government should have taken from the start, like it promised. Not at the eleventh hour.