Role of Crown Health Policy in Entrenched Health Inequities in Aotearoa, New Zealand

Abstract

In Aotearoa (New Zealand), health disparities between Pākehā (non-Māori settler) and Māori (Indigenous person/s in Aotearoa) are deep, long-standing, and an indictment of decades of neglect, abuse, and racism despite the commitments of te Tiriti o Waitangi (te Tiriti) and ideological claims to a just and egalitarian social order. In this chapter we focus on the key health policy frameworks operated by the Crown and scrutinize the adequacy of their orientation to the provisions of te Tiriti and the effects they have in terms of health disparities. We undertake an analysis framed around the holistic Māori model of health promotion, Te Pae Māhutonga (Durie, Health Promot Forum Newsl 49:2–5, 1999), that supports the pursuit of the aspiration of health equity for the nation. We begin with an outline of demography and health disparities, lay the foundation of critical analysis based on te Tiriti and Te Pae Mahutonga, introduce and critique three key health policies, and close with an argument for a transformational approach to health in Aotearoa.