Burkhardt Natalie, Gomez Fernandez Claudia, Dunn Donna
Family and Community Medicine, Oceania University of Medicine, Whangarei, NZL.
Family Medicine, Devonport Naval Base, Auckland, NZL.
Cureus. 2024 Jul 1;16(7):e63571. doi: 10.7759/cureus.63571. eCollection 2024 Jul.
Māori, the indigenous population of New Zealand, represent 17.1% of the country's population (Statistics New Zealand 2021) and are over-represented in all negative indices. In particular, Māori are underprivileged in terms of socioeconomics and health due to the residual effects of colonization. The global COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has been one of the most significant public health crises in modern history. Vulnerable populations, such as the elderly and those with underlying health conditions, were and remain at higher risk of severe outcomes. In the New Zealand context and given the health statistics, Māori were identified as a group that was at high risk from COVID-19. Using a mixed method approach, we attempt to identify the reasons why a cohort of New Zealand Māori with type II diabetes mellitus (DM II) and a history of regular attendance failed their Diabetes Annual Review (DAR) post-COVID-19. Twelve Māori participants were recruited (> 18 years) from a Māori Diabetes database of an urban General Practitioners (GP) Clinic in Northland. A 9-point questionnaire and an unstructured telephone conversation utilizing a Kaupapa Māori (Māori philosophy) approach were utilized, and data were collated. Findings suggest the New Zealand government's COVID-19 vaccine mandates served to exacerbate Māori distrust of health professionals. Trust is the foundation of every successful relationship whether it be business, professional, health, or personal. Health delivery and uptake are based on this foundation. Whatever the reason for the loss of trust in the medical profession, historical colonial trauma, swayed by conspiracy theory, or otherwise, considering this factor should influence the structure and approach of public health initiatives directed toward Indigenous people internationally.
毛利人是新西兰的原住民，占该国人口的17.1%（新西兰统计局，2021年），且在所有负面指标中占比过高。特别是，由于殖民统治的残余影响，毛利人在社会经济和健康方面处于弱势地位。由新型冠状病毒SARS-CoV-2引发的全球新冠肺炎疫情，是现代历史上最重大的公共卫生危机之一。弱势群体，如老年人和有基础健康状况的人，过去是、现在仍然是出现严重后果的风险较高的人群。在新西兰的背景下，鉴于健康统计数据，毛利人被确定为感染新冠肺炎风险较高的群体。我们采用混合方法，试图找出一群患有II型糖尿病（DM II）且有定期就诊史的新西兰毛利人在新冠肺炎疫情后糖尿病年度复查（DAR）未通过的原因。从北地一家城市全科医生（GP）诊所的毛利糖尿病数据库中招募了12名毛利参与者（年龄>18岁）。使用了一份9分问卷，并采用毛利哲学（Kaupapa Māori）方法进行了一次非结构化电话交谈，然后对数据进行了整理。研究结果表明，新西兰政府的新冠肺炎疫苗强制令加剧了毛利人对卫生专业人员的不信任。信任是每一段成功关系的基础，无论是商业、专业、健康还是个人关系。医疗服务的提供和接受都是基于这个基础。无论对医疗行业失去信任的原因是什么，是历史殖民创伤、受阴谋论影响，还是其他原因，考虑到这一因素都应该影响针对国际原住民的公共卫生举措的结构和方法。
