Tūtakarerewa-Indigenous Advocacy and Structural Racism in Bowel Cancer Screening in Aotearoa New Zealand
Date
Authors
Scott, N
Kidd, Jacquie
Arnet, H
Dargaville, C
Goza, M
Crengle, S
Jones, R
Kerrison, C
McKree Jansen, R
Supervisor
Item type
Journal Article
Degree name
Journal Title
Journal ISSN
Volume Title
Publisher
Pasifika Medical Association Group
Abstract
Aotearoa New Zealand has one of the highest bowel cancer rates in the world. Bowel cancer incidence is increasing for Māori (the Indigenous people of Aotearoa), while trending downwards for non-Māori. Over half of Māori who get bowel cancer are diagnosed before the age of 60 years and are more likely than non-Māori to die within 2 years. Pacific people also experience bowel cancer inequities. In 2016, a national bowel screening programme for Aotearoa was announced, with an age range of 60-74 years. However, equity modelling showed that the proposed programme would disproportionately benefit non-Māori and that lowering the screening age for Māori and Pacific peoples to 50 years could achieve equal health gains. Over subsequent years, Māori cancer leaders advocated for policy change to lower the bowel screening age by 10 years for Māori. They used academic publications, presentations, letters, position statements, media stories and meetings with government leaders. Despite this advocacy, in 2020, the Government announced it was not going to lower the bowel screening age for Māori and Pacific peoples. The advocates persevered. They were supported in their efforts by new data that further confirmed the increasing bowel cancer incidence for Māori. In 2022, the Government committed to lowering the bowel cancer screening age to 50 for Māori and Pacific peoples. However, what followed was a tardy, phased rollout in only three regions. A year on, a new government embarked on a politically motivated agenda to reject ethnically targeted policies, with further significant equity changes to the programme announced. This paper summarises the lobbying efforts of cancer leaders and the government response, revealing structural and institutional racism, represented by inaction and active rejection of evidence-based advice. We describe the perseverance required to advocate for equity in the face of structural racism and the cost to Māori lives while inaction and racism persist.Description
Keywords
4206 Public Health, 42 Health Sciences, Health Services, Clinical Research, Cancer, Health Disparities, Women's Health, Minority Health, Cancer, 11 Medical and Health Sciences, General & Internal Medicine, 32 Biomedical and clinical sciences, 42 Health sciences
Source
New Zealand Medical Journal, ISSN: 0028-8446 (Print); 1175-8716 (Online), Pasifika Medical Association Group, 138(1627), 79-89. doi: 10.26635/6965.7186
Rights statement
Open Access. The New Zealand Medical Journal is fully available to individual subscribers and does not incur a subscription fee. This applies to both New Zealand and international subscribers.