The Daily Bork

June 20, 2005

Institutional racism, maybe, maybe not.

Yet another fuzzy article concerning supposed racism,

Maori cancer data 'shaming' to doctors

The presented numbers...

Research showing Maori people are more likely to die from the most common cancers is "shaming" to doctors, says a leading Christchurch cancer expert.

Christchurch Hospital's clinical director of oncology, Chris Atkinson, was commenting on data presented to a public meeting yesterday by Massey University epidemiologist Dr Mona Jeffreys.

Jeffreys' study compared lengths of time from diagnosis to death for 20 main cancers. Maori had not only higher incidences of cancer than non-Maori, but were also more likely to die from it, she said.

For example, Maori women had a 30 per cent higher risk of getting breast cancer than non-Maori women, but were at twice the risk of dying from it.

Averaged survival rates at five years for the most common cancers, including lung, colon, prostate and cervical cancer, were 38% for Maori and 53% for non-Maori.

"There's no cancer for which Maori have a better survival than non-Maori non-Pacific people," Jeffreys said.

OK. Take it all at face value.

Now the claims...

Jeffreys said the disparities pointed to problems within the health system.

She said the term "institutional racism" was not helpful, but there were clearly barriers to diagnosing and treating Maori.

"I'm not saying this is doctors not offering proper treatment to everybody...But for people who need more time and family involvement in making choices, the pressure that's on them to make choices may not be conducive to making the best decision," she said.

Atkinson, who was last month named deputy chairman of the new Cancer Control Council, said the data should not lead to a "beat-up".

"My perception is not that we're not addressing (Maori) properly in the clinic," he said.

Apparently messages aren't getting through...

Linwood GP David Kerr said recent research had shown Maori and Pacific Islanders' knowledge of the national breast screening programme was much lower than that of non-Maori.

"Maybe those messages just aren't getting across," he said.

Fiona Pimm, chief executive of He Oranga Pounamu - a Ngai Tahu-mandated organisation that co-ordinates Maori health and social services - agreed more research was needed.

Why aren't they getting through?

Atkinson, who was last month named deputy chairman of the new Cancer Control Council, said the data should not lead to a "beat-up".

"My perception is not that we're not addressing (Maori) properly in the clinic," he said.

"We use a Maori whanau oral model with options and time set aside and we encourage family to be there."

So messaging is targetted in a "culturally sensitive" manner. But not getting through. Ergo... ?

But then we move on to other cultural aspects...

She was concerned about the possibility Maori were not offered some treatments but said the problem could also be due to Maori refusing treatments such as radiotherapy.

"As a kaumatua said to me, Maori aren't afraid to die.

"If they feel they've lived their life, they're not afraid to go."

(kaumatua = "elder")

Thus, even if they get the message they really just don't care because they "aren't afraid to die". So if "they" aren't afraid to die, why are you worried? Let them truck on as the please. Or are you getting all oppressive on them by imposing your values and forcing radiotherapy on them?

But they just can't avoid one last dig...

Pimm said institutional racism was "probably very real" in cancer care but she could not say so with certainty as no-one had investigated it.

The message is not getting through, despite culturally/racially "appropriate" targetting. Apparently Maori don't mind dying young anyway if they think they've had a good life. They might be not offered treatment but are known to refuse the same treatment. But in the end we think it is "probably" racism because no-one has studied it. Can anyone make any sense out of it?

Absent is the identification of what constitutes "Maoriness" in the study, but there is no defined measure for obvious reasons and is usually self-ascribed.

Curiously, if it is acutally "institutional racism", why does it not apparently afflict races other than Pacific Islanders/polynesians? I'd have thought Asians would have been in for a bit of rough treatment as well if it were the case.


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