Māori cancer patients tend to be younger, poorer, less likely to have material resources, more likely to be looking after family members, and more likely to have comorbidity than non-Māori patients. In other words, Māori cancer patients are different in many important respects to non-Māori patients – and thus it is not surprising that a health system designed primarily to serve the latter will result in unequal outcomes for the former.
In 2018, Dr Jason Gurney (Ngāpuhi) was awarded a Health Research Council of New Zealand (HRC) Māori Emerging Leader Fellowship to further investigate cancer survival and palliative care disparities between Māori and non-Māori New Zealanders. Though a comprehensive body of investigative work – combined with key professional development objectives – this Fellowship aimed to confront the issue of cancer survival, quality of life and palliative care for Māori cancer patients, and to influence change.
The four research objectives of his Fellowship were:
- To identify and prioritise cancers for which the most urgent attention is needed to improve survival outcomes for Māori;
- To describe the most important quality of life and palliative care priorities for terminally-ill Māori patients suffering from these priority cancers;
- To determine the extent to which survival, quality of life and palliative care factors are modifiable, and at what level, for each priority cancer;
- To propose the key social and health service investments required to improve these outcomes for Māori as quickly as possible.
This Fellowship provided the opportunity for both PI Gurney and the Cancer and Chronic Conditions (C3) Research Group to complete a substantial body of research in the context of Māori cancer survival equity. As a direct result of this work, PI Gurney and members of the C3 team have formed a close working relationship with policy makers in government, including a foundational relationship with Te Aho o Te Kahu – Cancer Control Agency.
The work completed during the Fellowship identified some crucial pathways across the cancer spectrum where services can work better for Māori, with a view to improving cancer survival outcomes and reducing survival disparities. PI Gurney and the C3 team are ensuring the continuity of this work through our current HRC project in the context of lung cancer (21/941, ‘Equity by 2030: Achieving equity in lung cancer survival for Māori’), as well as our HRC Programme grant (23-447, ‘Whakatōmuri, whakamua: Walking backwards into the future of Māori cancer care’), which both build directly on the research foundations set by this Fellowship.
Key publications
Virginia Signal, Rhiannon Jones, Cheryl Davies, Jeannine Stairmand, Moira Smith, Jonathan Adler, Jason Gurney (2023). It’s more than just physical: Experiences of pain and pain management among Māori with cancer and their whānau. International Journal of Indigenous Health, 18(1), p1-21.
Jones, R., Signal, V., Smith, M., Stairmand, J., Davies, C., Gurney, J. (2023). Palliative care and quality of life needs and outcomes for Māori with cancer: what do we know? AlterNative, 19 (2), p219-228.
Gurney, J.K. (2022). The long road to good care. New Zealand Medical Journal, 135 (1565), p9-11.
Clough, S., Cleverley, T., Kerrison, C., Harwood, M., Koea, J., Gurney, J. (2022). The past, present and future of liver cancer control for Māori. New Zealand Medical Journal, 135 (1567), p91-104.
Gurney, J.K., Whitehead, J., Kerrison, C., Stanley, J., Sarfati, D., Koea, J. (2022). Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand. PLOS One, 17(8): e0269593.
Gurney, J.K., Stanley, J., Koea, J., Robson, B., Adler, J., Atkinson, J., Jackson, C., McLeod, H., Sarfati, D. (2022). Where are we dying? Ethnic differences in place of death among New Zealanders dying of cancer. JCO Global Oncology, 8: e2200024.
Gurney, J., Sarfati, D., Stanley, J., Kerrison, C., Koea, J. (2022). Equity of timely access to surgery for liver and stomach cancer among Indigenous and non-Indigenous patients in New Zealand. BMJ Open, 12:e058749.
Gurney, J., Stanley, J, Adler, J., McLeod, H., Atkinson, J., Sarfati, D. (2021). National study of pain medicine access among Māori and non-Māori lung cancer patients in New Zealand. JCO Global Oncology, 7, p1276-1285.
Davies, A., Diaz, A., Garvey, G., Gurney, J., Segelov, E. (2021). Cancer care disparities among Australian and New Zealand First Nations Peoples. Current Opinion in Supportive and Palliative Care, 15(3), p162-168.
Gurney, J., Robson, B., Scott, N., Fraser, L., Ikihele, A., Manderson, J. (2021). Telehealth as a tool for equity: pros, cons and recommendations. New Zealand Medical Journal, 134(1530).
Gurney, J., Robson, B., Koea, J., Scott, N., Stanley, J., Sarfati, D. (2020). The most commonly-diagnosed and most common causes of cancer death for Māori New Zealanders. New Zealand Medical Journal, 133, p77-96.
Gurney, J., Stanley, J., McLeod, M., Koea, J., Jackson, C., Sarfati, D. (2020). Disparities in cancer-specific survival between Māori and non-Māori New Zealanders, 2007-2016. JCO Global Oncology, 6, p 6:766-774.
Gurney, J., Stanley, J., Jackson, C., Sarfati, D. (2020). Stage at diagnosis for Māori cancer patients: disparities, similarities and data limitations. New Zealand Medical Journal, 133(1508), p43-64.
Gurney, J., Campbell, S., Turner, S., Scott, N. (2020). Addressing cancer inequities for indigenous populations: the New Zealand story. Journal of Cancer Policy, 23 (100204), p1-6.
Jason K. Gurney, Diana Sarfati, Ben Lawrence, Chris Jackson, Michael Findlay, Kathryn McPherson (2020). Cancer research in the New Zealand context: challenges and advantages. Journal of Cancer Policy, 23 (100209), p1-5.
Gurney, J., Campbell, S., Jackson, C., Sarfati, D. (2019). Equity by 2030: Achieving equity in survival for Māori cancer patients. New Zealand Medical Journal, 132(1505), p66-76.