The definition of health equity by Health New Zealand | Te Whatu Ora is as follows:
“In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes.”
The concept acknowledges that not only are differences in health status unfair and unjust, but they are also the result of differential access to the resources necessary for people to lead healthy lives.
Put simply:
equality is treating people the same
equity is treating people fairly.
equity is about being prepared to work differently to help people achieve the same outcomes.
In this illustration the first picture shows what happens when everyone gets the same. In the second picture we can see that each person gets the support they need to see the game. The third picture shows everyone being able to watch the game without additional supports because the systemic structures and biases that cause the inequity have been removed.
Video: Addressing inequity in primary care
In this video Susan Reid of Health Literacy NZ talks about addressing inequity in primary care using treatment of gout as an example:
(Health Literacy NZ and Health Navigator NZ, 2020)
Addressing health inequity for tāne Māori PHARMAC seminar held on 29 April 2019.
1. PHARMAC seminar: Addressing health inequity for tāne Māori 1 of 5, overview of the issues (28 minutes)
(PHARMAC, NZ, 2019)
Video: PHARMAC seminar: Addressing health inequity for tāne Māori, 1b of 5, overview of the issues (33 minutes)
(PHARMAC, NZ, 2019)
2. Video: PHARMAC seminar: Addressing health inequity for tāne Māori, 2a of 5, cultural significance (30 minutes)
(PHARMAC, NZ, 2019)
Video: PHARMAC seminar: Addressing health inequity for tāne Māori, 2b of 5, cultural significance
(PHARMAC, NZ, 2019)
3. PHARMAC seminar: Health inequity for tāne Māori 3 of 5, collaboration, what does this mean? (30 minutes)
(PHARMAC seminars, 2019)
There are many examples of affirmative action towards improving equity in healthcare across Aotearoa New Zealand. Here are some of the initiatives that organisations and individuals are doing.
The National Science Challenges examples
He Pikinga Waiora – Making health interventions work for Māori communities
This project focussed on ways to address implementation of health-related programmes and initiatives to reduce health inequalities and achieve health equity for Māori.
Video: What is Mana Tū – Taria Tane | LTC Forum 2020: A whānau ora approach to long term conditions
The study examined the impact of Mana Tū, a programme co-designed with whānau, clinicians, health service planners and whānau ora providers, on clinical and lifestyle interventions for whānau living with pre-diabetes and people with poorly controlled diabetes.
In this video, Dr Ryan talks about some of the findings in the report:
(Health Literacy, NZ & Healthify He Puna Waiora, NZ, 2020)
Video: Delivering culturally competent care – a Pacific perspective
In this video Dr Api Talemaitoga talks about some of the determinants of health inequity in Pacific peoples and provides some ideas for things you can do in your everyday practice.
(Health Literacy, NZ & Healthify He Puna Waiora, NZ, 2020)
Video: What's your advice about getting a flu vaccination?
Also see Talanoa with Dr Api, a series of videos providing a Pacific perspective on topics such as COVID-19 and vaccinations:
(Prepare Pacific, NZ, 2020)
Video: HCH MoC Strengthening Equity, Consumer leadership & honouring Te Tiriti o Waitangi – Health Care Home's Enhanced model of care
The Health Care Home collaborative have recently launched the enhanced model of care. This webinar describes the need for the enhanced model of care, what has been enhanced and some information on how to support practical implementation:
(Health Care Home Collaborative, NZ, 2020)
Video: Mauri Ora Window – The art of breathing life into other's experiences
In this webinar, Hemaima Reihana-Tait describes the Mauri ora window, a toolkit of principles and practice that supports equitable healthcare practices.
(Health Care Home Collaborative, NZ, 2020)
Video: Equity perspectives – Keriana Brooking and John Whaanga
(Ministry of Health, NZ, 2019)
Video: Equity perspectives – Ashley Bloomfield
(Ministry of Health, NZ, 2019)
Video: Kiri Rikihana (HQSC) on health equity
(Ministry of Health, NZ, 2019)
Video: Ministry of Health work programme – Achieving equity
(Ministry of Health, NZ, 2018)
Video: Jill Clendon on improving health equity
(Ministry of Health, NZ, 2019)
This video talks about the importance of speaking up for patient safety. Telling anyone you think they missed something or got something wrong can be daunting, especially a superior. But being vocal is necessary because many times, our patients can't speak for themselves. Communicating observations or concerns, requesting clarification or challenging another person's decision or action, are at the core of speaking up.
(HQSC, NZ, 2019)
Improving access to GPs through telehealth
The following information is taken from the Health New Zealand | Te Whatu Ora website. It’s a great example of Māori health providers, the community and others working together to provide more accessible healthcare and address some of the known barriers in achieving greater equity in health outcomes.
Residents of Matakana Island in the Bay of Plenty have improved access to healthcare thanks to a new telehealth service on the island.
The service, which the Bay of Plenty DHB started trialing 2 years ago, enables GP consultations to take place in remote areas through the use of video conferencing.
Matakana is a small island situated in Tauranga Harbour, with a population of around 300. Formerly, a GP would travel from the mainland to the island every fortnight. This was often only to see a handful of patients. Now the GP is accessible by video appointment every weekday at Te Akau Hauora, a Māori health provider clinic in Papamoa.
Staff from Te Awanui Hauora Trust on Matakana Island are trained to provide support to both the patient and the GP during the video conference. The GP continues to visit in person every 3 to 4 weeks.
David Spear, a GP at Te Akau Hauora clinic, says the advantage for routine consultations is that people don’t have to spend half a day travelling by ferry to and from Tauranga. "You can start things and follow up locally."
