As part of our drive to keep our comment section the best in New Zealand we showcase each week an example of a top-notch comment that adds value to The BFD.
Today’s comment was written by Rebecca. Thank you Rebecca for taking the time to craft such an interesting comment.
There are some conditions with ethnic predominance. For example, melanoma strikes down lighter-skin people far more than darker-skinned people. The solution in New Zealand is to exclude melanoma from the stats claiming Maori disadvantage. Suddenly the “averaging” habit isn’t followed, I wonder why.
Looking at cancer: where screening is available, that is because epidemiologists believe that it is worth society’s and the individual’s effort to detect cancer early to improve life and longevity. Those who participate in screening can expect to see this benefit; those who decline, miss out.
If a particular group declines more than others and therefore does not see the benefit, does that make the health system racist?
It could be an issue of access, meaning some groups are unable to participate as easily as others. That could be true for some rural poor populations. I’d expect to see some proof of that and I’d expect to see funding directed at that rural region, not to new tiers of Maori elites in Wellington.
Secondly, some lifestyle behaviors like smoking and obesity are strongly connected to cancer incidence and outcomes. As an example, gynae cancers that used to be seen predominantly in elderly women 20 years ago, now are seen in young women who almost invariably are obese. Is there an ethnic connection to obesity?
Similarly, the US CDC says smokers are 20%-40% more likely to get Type II diabetes, even greater if you’re obese, and anecdotally more likely in some ethnic groups anyway. Is there an ethnic connection to smoking?
This matters because if the issue is that Maori smoke more than other ethnicities, the current proposition condenses to “Because too many Maori smoke and get sick and die younger, we need a separate Maori healthcare system.”
If it is established that Maori have more risk of diabetes than Polynesians, certainly I’d expect to see funding for diabetes prevention and management focused on Maori. But where’s the evidence, correcting for obesity and smoking? Unless there’s a demonstrable ethnic contribution, you’d expect to see funding directed at fitness and smoking cessation campaigns, not ethnicity- unless only Maori are fat smokers?
On and on it goes. My concern is that numbers are habitually smudged. For example, when calculating COVID percentages they use ethnic “prioritization” meaning if you list Maori as one of your ethnicities, you’re counted as Maori. This tends to boost Maori incidence since it includes wealthy urbanites who might have a Maori ancestor but are more genetically and behaviorally connected to other ethnicities. However, when it comes time to count vaccination- now they use “major” ethnicity so the above Maoris are now counted as other ethnicities and Maori vaccination now is depressed compared to incidence.
They also calculate per capita vaccination rates while it’s still reserved for specific groups whose ethnic proportions may not match the whole population. If close to 100% of these groups are required to be vaccinated by now according to the PM, suggesting that any ethnicity is under-represented compared to the whole population is an anti-science contrivance. And then the habit of excluding Melanoma and other hugely important but inconvenient diseases, means we really need to see the raw data for ourselves. This is of course the scientific method; it’s supposed to be reproducible, so you really ought to make your supporting data available.
Please share this BFD article so others can discover The BFD.