Hauora tuwhena :kaupapa ta tataritanga hauora Maori, 1990-99 = Disproportionate health : a policy analysis of the health of Maori, 1990-99.

This thesis examines the effects of public sector restructuring on Maori health development during the 1990s, primarily through an analysis of health sector reform, changes to health policy direction, and the response of Government to Maori development issues. The relationship between health development and socioeconomic status is also examined in order to determine what the cost of the economic and political climate of the decade has been for Maori. A key focus is the partnership, and obligations thereof, established by the Treaty of Waitangi between Maori and the Crown. As Government has acknowledged the Treaty as the founding document of Aotearoa New Zealand, any discussion of Maori health must start with the Treaty as a basis. The theoretical framework adopted employs social policy and sector analysis in order to assess whether health outcomes for Maori have improved during the 1990s. Institutional influence on the policy process is also examined as part of this framework. The influence of these procedures on policy development and general health outcomes for Maori during the 1990s is assessed, while health outcomes for Maori women in particular are discussed as a case study. This thesis examines why disproportionate health development still occurs in terms of Maori and non-Maori health despite Maori health having been designated a health gain priority area since 1984, and Government requirements that mainstream accountability to Maori be improved. As part of this examination, health promotion and intervention strategies have been assessed as these are seen as an effective first point of contact for groups traditionally disadvantaged in terms of health outcomes. Moreover, areas have been highlighted where improvement to policy could enhance positive Maori development, as positive Maori development is seen as essential to improving health outcomes for Maori. Regional policy efforts for promoting Maori health gain are also examined