A New Zealand government health committee has just released a report which establishes a clear link between the growing levels of poverty and ill-health. 'With few exceptions, the financially worst-off experience the highest rates of illness and premature death,' it concluded.
The National Health Committee is a permanent body established to advise the Minister of Health. The report, entitled The Social, Cultural and Economic Determinants of Health in New Zealand, arose from a recent decision to examine matters of public health. It was written by an eight-member advisory group chaired by Auckland University professor of community health, Robert Beaglehole.
The report demonstrates that New Zealand's national health statistics are rapidly worsening. It points out that, compared with other developed countries, there are particularly high rates of preventable health problems such as cardiovascular disease, respiratory disease, breast and bowel cancer, motor vehicle injuries and suicide.
Infant mortality rates have worsened relative to other OECD countries. In 1960, New Zealand's rate was sixth out of 21 organisation countries, but by 1995 it was 15th.
Significantly, the relatively poor health of the Maori people is identified as 'mostly due to poorer socio-economic circumstances' rather than cultural and ethnic factors, as is often claimed. Pacific Islanders, who make up a large percentage of the workforce in low-paid, temporary and menial jobs, have the highest rates of meningococcal disease, rheumatic fever, rheumatic heart disease and obesity, with an increasing rate of sudden infant death syndrome, low immunisation rates and high rates of diabetes, tuberculosis and liver cancer.
Bill English, the Minister of Health in the National-NZ First coalition government, immediately dismissed the report, saying that it produced 'no new solutions', and failed to demonstrate a 'high degree of awareness of what the Government is doing'.
In fact, the document is an indictment of the entire economic and political program imposed by the present and previous governments -- including Labour during the period 1984-90. Social inequality is now at its most extreme levels since the 1930's. The report singles out income as the most significant determinant of health and warns that the health crisis will worsen due to the country's widening social and economic chasm.
The findings of this committee are consistent with similar reports undertaken by health professionals in recent years -- all of which show declining standards of health among working people.
A 1997 investigation carried out with the co-operation of local schools by paediatricians at Porirua's Kenepuru Hospital pointed to significant increases in the diseases of poverty among young people. These included glue-ear, asthma, skin sores as well as alarming levels of iron deficiency leading to brain damage. It emphasised the impact of disease and ill-health on the learning and educational opportunities of working class youth.
The deterioration of the health of ordinary people has been exacerbated by the 'reforms' of the public health system itself -- begun by the Labour government during the mid-1980's -- and its transformation into a two-tier system. The government's share of total health spending declined throughout the early 1990's, while private health insurance and the private health sector catering to the middle class expanded rapidly.
Cuts to the public health system have deepened under the current government. A program of hospital closures, hitting provincial areas in particular, has been carried through, often against mass popular opposition. The number of public hospital beds has declined, while waiting lists for surgery have increased.
Capped funding for hospitals has forced the rationing of health services through the prioritising of certain services and categories of patient. In one recent case, a heart patient died while on the waiting list for surgery.
Conditions in the public health system are set to worsen as the government slashes spending in response to the fall in the New Zealand dollar and the country's deteriorating economic position. On the same day the health committee's report was released, an emergency cabinet meeting received reports from the heads of the Reserve Bank and Treasury on the impact of the Asian crisis and decided to slash a further $300 million from government expenditure.
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[3 July 1998]