Yesterday David Seymour made headlines when he posted to his Twitter followers a priority vaccine code for Māori and railed against Māori ‘jumping the queue’. Instead of irresponsible race trolling, the Act leader should look at the evidence, writes Dr Rawiri Jansen, clinical director of the National Hauora Coalition.
Aotearoa needs the best vaccination programme possible. We will all be better off if and when we can achieve vaccination rates of 90% or 95% of the eligible population. The cost of failure would be immense – in terms of hospitalisations and deaths, in terms of health services delayed, deferred and impacted by outbreaks. We are literally all in this together, and we have done a world-class job of protecting our communities this far.
But positive though that path has been, it is nevertheless lumpy and uneven. The pandemic does not exist in a vacuum; it occurs in the context of a racialised society, in the context of long-standing historical inequities. The evidence is unequivocal and stable over decades – Māori and Pacific communities experience worse health outcomes. This arises from factors within the health system and differential access to the determinants of health, such as education, employment, income and housing. More immediately, missing health services in cancer screening (such as cervical smears or colonoscopies for bowel cancer) exacts an unequal impact on the most vulnerable communities in New Zealand.
The Covid-19 vaccination programme is no different. Regrettably, it has not been designed for equity from the outset. Despite evidence that Māori and Pacific are exposed to much greater risk from Covid-19, and at much younger ages, the government decided against being guided by that science. The messages and the messengers have delivered a compelling motivation to part of the community to get vaccinated, but the choice of messages and messengers and indeed the media channels have privileged the least vulnerable communities.
Providing vaccines to Māori and Pacific communities has not yet delivered the result that we all collectively need. Some Ministry of Health commentary has obscured the yawning inequity by asserting that a given rate of vaccinations for Māori over the age of 65 years (78.8% as of last week) is nearly equal to the European rate (87%). An eight percentage point gap is not acceptable. And, for the sake of clarity, even equality of vaccination rates would not provide equitable protection for Māori communities. The evidence is unequivocal: Māori and Pacific peoples are at risk of bearing a disproportionate health burden from Covid-19.
So we are organising immense efforts to remediate the inequitable vaccination programme. This includes efforts to improve availability for Māori and Pacific whanau to be able to access vaccinations, addressing barriers to access for Māori and Pacific, and addressing information needs for Māori and Pacific whānau. Sensibly and necessarily this has entailed promoting a dedicated code for Māori and Pacific whānau to book at a vaccination centre, and inviting Māori and Pacific whanau to attend vaccination centres unbooked. Both of these approaches have formed part of the vaccination programme that has worked so well for European New Zealanders.
In the decisions he took yesterday, David Seymour has sought to sabotage these efforts. It is no exaggeration to say that in doing so he has created a direct risk for Māori and Pacific communities, and by extension a risk for all New Zealanders. It is small-minded and harmful. The message to Mr Seymour is as simple as this: Don’t be racist.
Dr Rawiri McKree Jansen is clinical director, National Hauora Coalition, and co-leader, Te Rōpū Whakakaupapa Urutā, National Māori Pandemic Coordination Group.
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