Indigenous inequalities in cancer: what role for health care?

Sarah Hill, Diana Sarfati, Bridget Robson, Tony Blakely

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction
Poorer cancer survival in Indigenous populations contributes to health inequalities in both New Zealand and Australia.

Methods
We reviewed recent evidence of cancer treatment and outcomes among Māori and non-Māori New Zealanders and examined the range of factors that may contribute to poorer survival in Māori.

Results
There is clear evidence that Māori have poorer cancer survival compared with other ethnic groups, particularly European New Zealanders. Two recent studies show that Māori patients receive poorer quality treatment for cancers of the lung and colon, even after adjusting for patient factors. These findings suggest the need to consider how the health-care system as a whole may disadvantage Indigenous patients.

Discussion
We present a framework for considering how inequalities may arise in the delivery of cancer care, taking account of the health system as a whole – including the structure and organization of cancer services – as well as treatment processes and patient factors. A key feature of this framework is that it directs attention towards system-level factors affecting cancer care, including the location, resourcing and cultural focus of services. Our analysis suggests a need to look beyond individual patient factors in order to improve the quality and equity of cancer services and to optimize cancer survival in Indigenous populations.
Original languageEnglish
Pages (from-to)36-41
Number of pages6
JournalANZ Journal of Surgery
Volume83
Issue number1-2
DOIs
Publication statusPublished - Jan 2013

Keywords

  • cancer survival
  • cancer treatment
  • ethnic inequality
  • Indigenous
  • Māori

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