16 Oct 2020

New Zealand health professionals criticise international diabetes research

9:05 pm on 16 October 2020

By Lillian Hanly

Health professionals in Aotearoa have criticised new research regarding disparities in health outcomes for patients with Type 2 diabetes.

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Photo: 123RF

The Global Burden of Disease Study found Māori have the highest mortality rates in comparison with people of European heritage.

Lead researcher Professor David Simmons said the issues facing Māori are exacerbated by inequities in access to modern medications.

However, Public Health Scientist Dr Geoff Kira from Massey University said the value of this research is diminished given the plethora of work available highlighting these disparities over time.

Dr Kira believes more work needs to be done now on how to address those disparities.

"What we really need to do is to be able to translate all this data that we have saying that there are problems into something actionable at the national and regional levels. We keep talking about disparities but what are we actually doing about it."

Dr Kira wants more focus on the unconscious bias that is happening at the health-care level which Māori witness on a daily basis. He wants Māori to have better access to health-care services, and to look further at social determinants of health.

"Social determinants such as employment, income and education need to be addressed. We're talking about health in all policies."

Dr Kira said people know the disparities are there, but what is missing is the transferring of that data to government policy that will make change.

Dr Rhys Jones of the University of Auckland was also concerned at the research, pointing to the inconsistency in the language used to identify patients. He found it difficult to interpret the findings given the authors used different concepts regarding ancestry and ethnicity to define those groups that were studied.

Dr Jones would have preferred to see a clear articulation of what the issues were that were being investigated.

"If the study was about looking at genetic differences, then it would be appropriate to use ancestry, to look at patients according to whether they have Māori or Pacific or European ancestry, or some combination. But if it's looking at social, structural and economic and other factors, then we really need to focus on looking at those groups by ethnicity."

In addition to this, Dr Jones wanted to see a study that would specifically look at those potential factors that might be driving the inequities.

"For example, looking at healthcare and whether Māori in that group tended to receive poorer quality care, or less likely to be prescribed the appropriate medication. Those sorts of things would give us some insights into what the actual mechanisms are and that would allow us to define what the problems are and then identify solutions to address them."

Furthermore, Dr Jones raised the concern about overseas-based researchers studying Māori health without a critical understanding of the social context in Aotearoa.

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