Abstract
Background: Māori kaumātua (elders) face stark health and social inequities compared to non-Māori New Zealanders. The tuakana-teina (older sibling-younger sibling) peer education programme is a strengths-based approach to enhance well-being and social connectedness. The purpose of this study is to present the baseline data from this programme and identify correlates of well-being outcomes.Method: Participants included 128 kaumātua who completed a self-report survey about health-related quality of life, spirituality, social connection and loneliness, life satisfaction, cultural identity and connection, elder abuse, health service utilisation and demographics.Findings: Multiple regression models illustrated the following correlates of outcomes: (a) self-rated health: needing more help with daily tasks (β = −0.36) and housing problems (β = –0.17); (b) health-related quality of life: needing more help with daily tasks (β = –0.31), housing problems (β = –0.21), and perceived autonomy (β = 0.19); (c) spiritual well-being: understanding of tikanga (cultural protocols) (β = 0.32) and perceived autonomy (β = 0.23); (d) life satisfaction: social support (β = 0.23), sense of purpose (β = 0.23), cultural identity (β = 0.24), trouble paying bills (β = –0.16), and housing problems (β = –0.16); (e) loneliness: elder abuse (β = 0.27), social support (β = –0.21), and missing pleasure of being with whānau (extended family) (β = 0.19).Conclusions: Key correlates for outcomes centred on social support, housing problems, cultural connection and perceived autonomy. These correlates are largely addressed through the programme where tuakana/peer educators provide support and links to social and health services to teina/peer recipients in need. This study illustrates needs and challenges for kaumātua, whilst the larger programme represents a strengths-based and culturally-centred approach to address health issues related to ageing in an Indigenous population.
Highlights
The Aotearoa (New Zealand) population is ageing and there are a number of health and social challenges that can result including loneliness and social isolation, chronic conditions and end-of-life issues [1]
Russell and colleagues [6] highlighted that “Maori experience systematic disparities in health outcomes, determinants of health, health system responsiveness, and representation in the health sector workforce” (p. 10). These inequities are due to unequal distribution of social determinants, lack of access to social and/or health services and structural discrimination resulting from the effects of colonisation [3, 7, 8]
Loneliness Support Elder Cultural Sense of Health Housing Historical Understanding Missing Needing Needing Perceived Trouble rated wellbeing satisfaction abuse identity purpose service Problems trauma of tikanga pleasure more more autonomy Paying health with Help emotional
Summary
The Aotearoa (New Zealand) population is ageing and there are a number of health and social challenges that can result including loneliness and social isolation, chronic conditions and end-of-life issues [1]. The stark health and social inequities between Maori (Indigenous people of Aotearoa) kaumatua (elders) and non-Maori elders [3,4,5] are of key importance for this study. The research, recognises that kaumatua may have vastly different experiences of tikanga Maori and te reo Maori, with many having varying degrees of cultural dissonance and feelings of separation and even fear of interaction with their own Indigenous culture. Such cultural dissonance has led to a number of health and social inequities and poor health outcomes [13,14,15]. The purpose of this study is to present the baseline data from this programme and identify correlates of well-being outcomes
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