International diabetes research criticised

PALMERSTON NORTH: New Zealand health professionals have criticised new research on disparities in health outcomes for patients with type 2 diabetes.

The Global Burden of Disease Study found Maori had the highest mortality rates compared with people of European heritage.

Lead researcher David Simmons said the issues facing Maori were exacerbated by inequities in access to modern medications.

However, public health scientist Geoff Kira, of Massey University, said the value of this research was diminished given the plethora of work available highlighting those disparities over time.

He believed more work needed to be done on how to address those disparities, Dr Kira said.

‘‘What we really need to do is to be able to translate all this data that we have saying that there are problems into something actionable at the national and regional levels.

‘‘We keep talking about disparities but what are we actually doing about it?’’

He wanted more focus on the unconscious bias at the healthcare level, which Maori witnessed on a daily basis, he said. He wanted Maori to have better access to healthcare services, and for there to be further research on the social determinants of health.

‘‘Social determinants such as employment, income and education need to be addressed. We’re talking about health in all policies.’’

Dr Kira said people knew the disparities existed, but what was missing was using that data to come up with government policy that would create change.

Rhys Jones, of the University of Auckland, said he was also concerned by the research, and pointed to the inconsistency in the language used to identify patients. He found it difficult to interpret the findings given the authors used different concepts regarding ancestry and ethnicity to define the groups that were studied, Dr Jones said.

He would have preferred to see a clear articulation of what the issues were that were being investigated.

‘‘If the study was about looking at genetic differences, then it would be appropriate to use ancestry, to look at patients according to whether they have Maori or Pacific or European ancestry, or some combination.

‘‘But if it’s looking at social, structural and economic and other factors, then we really need to focus on looking at those groups by ethnicity.’’

He also wanted to see a study that specifically looked at factors that might be driving inequities.

‘‘For example, looking at healthcare and whether Maori in that group tended to receive poorerquality care, or [were] less likely to be prescribed the appropriate medication. Those sorts of things would give us some insights into what the actual mechanisms are and that would allow us to define what the problems are and then identify solutions to address them.’’ — RNZ