‘Focus on your own backyard’: A call to action on racism and inequity to mend the heartbreak

Don’t wait for someone else to address inequities in health, start doing what you can in your own backyard, says clinical researcher and Auckland GP Matire Harwood.

Dr Harwood (Ngāpuhi) used her Goodfellow Symposium address on racism and inequity as a call to action.

The Papakura Marae Medical Cen­tre GP referenced the Wai 2575 claim, part of the Waitangi Tribunal’s Health Services and Outcomes Kaupapa In­quiry. This is seeing Māori push back against the marginalisation created by a system set up to serve one group above another.

“There are now ethnic differences across the board,” says Dr Harwood, “and these inequities are heartbreak­ing for people who are losing whānau much, much too early, to diseases that could be better treated.

“There are inequities across all pathways, from risk factors to disease rates and how, we as a system, re­spond...You need to be doing more…a lot of us think it is to up to some­body else to sort out, whereas you can start by focusing on your own back­yards,” she says.

She pointed to several measures to bring about change, such as indige­nous leadership, a Māori Health Authority, calling out racism, and the living wage.

She says Papakura Marae saw im­mediate effects from increasing pay rates.

“I have had whānau come and say this has been the biggest change…‘We can buy school bags, we can pay for lunches, there is a sense of pride to determine for ourselves how we spend that money and not struggle from week to week.’

“So, go to your workplace and see how you can support that as well.”

Her Goodfellow talk highlighted statistics and research outing dispar­ities in health outcomes between Māori, Pacific peoples and European New Zealanders, and made the case that nothing will change until racism, privilege and systemic inequities are addressed.

While acknowledging health issues involving smoking-related cancer and heart disease, Dr Harwood says num­bers do not tell the full story. Ultimately, it is the social determi­nants of health that make such diseases more likely.

Advocating smoking cessation is only part of the answer to lung can­cer; there are also upstream factors, such as stress, “and stress comes from poverty”, says Dr Harwood.

“This is also about the fact that there are differences when people are valued, the idea that your social status can change depending on your socio­economic standing or ethnicity.

“Then those upstream factors – racism and privilege – lead to downstream effects like heart disease and, until these are ad­dressed, we won’t achieve equity.”

Referring to the connection between her Northland home, Tautoro, and Ngāpuhi chief Hōne Heke, she says: “It’s not good enough to just chop down flag poles or pres­ent the data, it’s also important to think about what we can do better.

“How can we mend the heartbreak? How can we be more responsive?”