What supports are needed by New Zealand primary care to improve equity and quality?

While some primary care practices have found ways to deliver quality care more equitably to their Maori and Pacific patients, others have struggled to get started or be successful. Quality Symposium attendees shared their views on barriers and success factors, both within the practice and beyond. When practices have collaborated and used their own ethnic-specific data in quality improvement techniques, they have improved Maori and Pacific health and equity. Attendees asked for greater practical support and guidance from the profession and sector. They report a funding gap for services needed by their patients to enable primary care to deliver equitable services for Maori and Pacific people.

Health and equity impacts of climate change in Aotearoa-New Zealand, and health gains from climate action.

Human-caused climate change poses an increasingly serious and urgent threat to health and health equity. Under all the climate projections reported in the recent Intergovernmental Panel on Climate Change assessment, New Zealand will experience direct impacts, biologically mediated impacts, and socially mediated impacts on health. These will disproportionately affect populations that already experience disadvantage and poorer health. Without rapid global action to reduce greenhouse gas emissions (particularly from fossil fuels), the world will breach its carbon budget and may experience high levels of warming (land temperatures on average 4-7 degrees Celsius higher by 2100). This level of climate change would threaten the habitability of some parts of the world because of extreme weather, limits on working outdoors, and severely reduced food production. However, well-planned action to reduce greenhouse gas emissions could bring about substantial benefits to health, and help New Zealand tackle its costly burden of health inequity and chronic disease.

Climate change and the right to health for Maori in Aotearoa/New Zealand.

Climate change is widely regarded as one of the most serious global health threats of the 21st century. Its impacts will be disproportionately borne by the most disadvantaged populations, including indigenous peoples. For Maori in Aotearoa/New Zealand, as with other indigenous peoples worldwide, colonization has led to dispossession of land, destabilization of cultural foundations, and social, economic, and political marginalization. Climate change threatens to exacerbate these processes, adding future insult to historical and contemporary injury. Yet the challenges posed by climate change are accompanied by considerable opportunities to advance indigenous rights and reduce health disparities. In this paper, we examine issues related to climate change and Maori health using a right to health analytical framework, which identifies obligations for the New Zealand government.

Why New Zealand must rapidly halve its greenhouse gas emissions.

New Zealand must commit to substantial decreases in its greenhouse gas emissions, to avoid the worst impacts of climate change on human health, both here and internationally. We have the fourth highest per capita greenhouse gas emissions in the developed world. Based on the need to limit warming to 2 degrees C by 2100, our cumulative emissions, and our capability to mitigate, New Zealand should at least halve its greenhouse gas emissions by 2020 (i.e. a target of at least 40% less than 1990 levels). This target has a strong scientific basis, and if anything may be too lenient; reducing the risk of catastrophic climate change may require deeper cuts. Short-term economic costs of mitigation have been widely overstated in public debate. They must also be balanced by the far greater costs caused by inertia and the substantial health and social benefits that can be achieved by a low emissions society. Large emissions reductions are achievable if we mobilise New Zealand society and let technology follow the signal of a responsible target.