Māori Men and the Indirect Procurement and Sharing of Prescription Medications

Māori men have higher rates of many diseases and lower life expectancy than other population groups in New Zealand. The general consensus is that these health inequalities are due to the inequitable distribution of the social determinants of health; for example, education, employment, income and housing, and were largely driven by colonization and the social and economic marginalization of Māori. Health care factors, including reluctance to consult doctors or late presentation, are part of this equation, but do not fully explain the disparities in health between Māori men and other population groups. As part of our ongoing work in this area, we draw on a focus group discussion with seven Māori community health workers to provide a preliminary analysis of how some Māori people access and use medications. Particular attention is given to the emergent practice of Māori women presenting to general practitioners (GPs) with proxy symptoms to obtain medications for their male partners. This practice exemplifies a range of strategies that some whānau (family) have developed to navigate the health system and overcome the reluctance of some men to engage with the medical profession. The practice raises issues relating to the nature of “primary” and “whānau” care, accessibility of medical services and medications, adherence to medication regimes and the dynamics of doctor–patient relations.

[1]  N. Pearce,et al.  Improving access to health care among New Zealand's Maori population. , 2006, American journal of public health.

[2]  Holly Elsse Primary health care the New Zealand way. , 2008, Bulletin of the World Health Organization.

[3]  R. Lawrence Health and Social Justice: Politics, Ideology, and Inequity in the Distribution of Disease , 2005 .

[4]  F. Cram,et al.  Mapping the themes of Maori talk about health. , 2003, The New Zealand medical journal.

[5]  Pauline Norris,et al.  Emplacement and everyday use of medications in domestic dwellings. , 2011, Health & place.

[6]  B. Delahunt,et al.  Analysis of the prevalence of voiding symptoms in Maori, Pacific Island, and Caucasian New Zealand men. , 1995, Urology.

[7]  D. Clarke,et al.  Maori Identification, Drinking Motivation and Mental Health , 2010, International Journal of Mental Health and Addiction.

[8]  R. Kearns,et al.  Exploring the 'fit' between people and providers: refugee health needs and health care services in Mt Roskill, Auckland, New Zealand. , 2005, Health & social care in the community.

[9]  S. Crengle,et al.  A comparison of Maori and Non-Maori patient visits to doctors: the National Primary Medical Care Survey (NatMedCa) 2001/02. Report 6. , 2005 .

[10]  P. Crampton,et al.  Ethnic differences in access to prescription medication because of cost in New Zealand , 2010, Journal of Epidemiology & Community Health.

[11]  Darrin Hodgetts,et al.  Social Psychology and Everyday Life , 2020 .

[12]  I. Winship,et al.  Cultural enhancement of a clinical service to meet the needs of indigenous people; genetic service development in response to issues for New Zealand Maori , 2007, Clinical genetics.

[13]  P. Zed,et al.  Drug-Related Visits to the Emergency Department , 2005 .

[14]  R. Wilkinson,et al.  The Spirit Level: Why More Equal Societies Almost Always Do Better , 2009 .

[15]  I. Kowanko,et al.  Improving Indigenous health through better medication management: an overview , 2005 .

[16]  K. Chamberlain,et al.  ‘The Problem with Men’: Working-class Men Making Sense of Men’s Health on Television , 2002, Journal of health psychology.

[17]  T. Riddell,et al.  Access and society as determinants of ischaemic heart disease in indigenous populations. , 2010, Heart, lung & circulation.

[18]  T. Blakely,et al.  Ethnic inequalities in mortality among the elderly in New Zealand , 2008, Australian and New Zealand journal of public health.