Oranga Kaumatua: perceptions of health in older Maori people.

This paper explores some of the opportunities for Maori health uncovered by recent developments in the measurement and analysis of health-related behaviours. Presented is a case study, the findings of a survey incorporating Short Form 36 (SF36) of more than 400 older Maori, many considered kaumatua'. The case study is a window through which we may observe and understand health-related behaviour, the notion of cultural norms and social values, and how health states may be interpreted. Oranga Kaumatua, finding health for "older Maori", is as much about what may be considered everyday (maori) as about what is unusual. The underlying difference or diversity in society may tell us what will most useful to measure. The findings identify important cross-links between health and other factors contributing to health, indicating that higher standards of health are strongly associated with active marae" participation, and cultural affiliation, home ownership, and higher incomes. Low income appears to be generally associated with poorer health, and it seems that older Maori may have less opportunity to supplement their income compared with other New Zealanders in the same age groups. In this paper, the risks and protective behaviour of the participants covered the breadth of the social policy sector, and underline the need for long-term policy planning. Provision for Maori retirement is a matter that iwi"', hapu" and the State should consider. Older Maori will continue to rely heavily on State provision. High home ownership is less likely among the next generation of older Maori, and many will have known long periods of unemployment. Long hours of voluntary work (on marae or among whanau") are not atypical, and there may be a case for recognising those efforts through a revised system of marae management. As dependency ratios change with a larger proportion of older people, policies should also be revised to assure that potential at both ends of the life cycle is fulfilled.