Kenyon College, Gambier, 43022, Ohio, USA.
University of North Carolina Gillings School of Global Public Health, Chapel Hill, 27599, North Carolina, USA.
Int J Equity Health. 2021 Jan 6;20(1):10. doi: 10.1186/s12939-020-01340-y.
The history of infant mortality inequities among Māori in New Zealand provides a remarkable case study for understanding the shortcomings of policy which fails to consider the differential risks associated with disadvantaged groups. Specifically, the failure of the initial 1991 reform in addressing Māori infant health, followed by the relative success of post-1994 policy, demonstrate that disadvantaged populations carry differential social risks which require adjusting policy accordingly. Literature on these policies show that differential risks may include disparities in representation, access to resources, socioeconomic status, and racism. The consideration of differential risks is important in analyzing the underlying causes of inequities and social policy deficiencies.
To describe and illustrate the need for policy addressing inequities to consider the differential risks associated with disadvantaged groups through an analysis of New Zealand's Māori infant mortality policy progression.
The article is a commentary on a series of policies aimed at reducing infant mortality in New Zealand. It analyses three policies and how their differences are linked to the corresponding trends in equity between Māori and non-Māori populations.
The progression of Māori infant mortality policy clearly demonstrates that equitable social policy must be culturally sensitive and inclusive towards disadvantaged groups, as well as willing to adapt to changing circumstances and shortcomings of current policy. Prior to 1994, health policy which did not account for the differential risks of Māori populations caused inequities in infant mortality to increase, despite infant mortality decreasing on a national level. After policy was adjusted to account for Māori-specific risks in 1994, infant mortality inequities significantly declined. A comprehensive analysis of these policies shows that the consideration of differential risks is highly related to a decrease in corresponding inequities.
As New Zealand, and other countries facing inequities such as the United States and Australia, move forward in constructing policy, they would do well to consider the lessons of how New Zealand policy changed the frequency of infant mortality in Māori populations. The study shows that the consideration of differential risks associated with disadvantaged groups is necessary for policy to successfully address inequities.
新西兰毛利人婴儿死亡率的不平等历史为理解政策的缺陷提供了一个很好的案例研究，这些政策未能考虑到与弱势群体相关的不同风险。具体来说，1991 年最初改革未能解决毛利人婴儿健康问题，随后 1994 年后的政策相对成功，这表明弱势群体承担着不同的社会风险，需要相应调整政策。这些政策的相关文献表明，不同的风险可能包括代表性、资源获取、社会经济地位和种族主义方面的差异。考虑到不同的风险对于分析不平等和社会政策缺陷的根本原因非常重要。
通过分析新西兰毛利人婴儿死亡率政策的发展，描述并说明需要制定政策来解决不平等问题，以考虑弱势群体所面临的不同风险。
本文是对一系列旨在降低新西兰婴儿死亡率的政策的评论，分析了三项政策及其差异如何与毛利人和非毛利人之间的公平趋势相关联。
毛利人婴儿死亡率政策的发展清楚地表明，公平的社会政策必须对弱势群体具有文化敏感性和包容性，并且愿意适应不断变化的情况和当前政策的缺陷。1994 年之前，没有考虑毛利人人口不同风险的卫生政策导致婴儿死亡率不平等现象加剧，尽管全国婴儿死亡率有所下降。1994 年政策调整以考虑毛利人特有的风险后，婴儿死亡率不平等现象显著下降。对这些政策的全面分析表明，考虑不同的风险与相应不平等现象的减少密切相关。
随着新西兰和其他面临不平等问题的国家（如美国和澳大利亚）在制定政策方面取得进展，它们最好考虑新西兰政策如何改变毛利人婴儿死亡率频率的经验教训。该研究表明，考虑弱势群体相关的不同风险是政策成功解决不平等问题的必要条件。
