New Zealand prisons are increasingly being recognised as a powerful determinant of health and wellbeing — particularly for Māori — and the age at first imprisonment is a major predictor of adverse health outcomes.
Two recently completed studies by the University of Otago (Wellington) also show the government may be breaching the rights of imprisoned and recently released Māori.
Lead author and public health researcher Associate Prof Paula King said one study found primary healthcare services were not meeting the high health needs of Māori just released from prison; and the second study found Māori were undercounted by 6% in prisons, which had a major impact on resource allocation and policy decisions.
Assoc Prof King said it was a particular problem for Māori, because they were imprisoned on a mass scale due to “racialised inequities in the criminal legal system”.
She said the researchers analysed the health service contacts of nearly 7400 Māori who were released from prisons in a 12-month period, from June 2021.
It found community re-entry from prison presented multiple challenges in accessing healthcare.
Only 76% were enrolled with a primary health organisation, compared with 95% of the total New Zealand population, meaning 24% did not have access to subsidised primary care.
She believed this was likely due to Ministry of Health and Te Whatu Ora Health New Zealand rules that excluded those in prison or on remand from being enrolled with a primary health organisation.
The study found Māori recently released from prison were able to access primary care services despite financial barriers, but there was still evidence primary care services were not meeting their high health needs.
Meanwhile, the second study found a 6% undercount of the Māori prison population.
She said it was calculated by comparing Department of Corrections and Stats NZ data with Census data, which showed 405 fewer than what was publicly reported by the government.
Assoc Prof King said it was important the numbers accurately reflected reality because the government needed to understand how its criminal legal system was performing in relation to Māori health, and the elimination of inequities.
“Both of these studies reflect a breach of the government’s Te Tiriti obligations to monitor and evaluate impacts of government actions and inactions for Māori.”
She said the studies were a “critical intervention point”, which could disrupt cycles of intergenerational harms and support restoration of health and wellbeing for Māori.
“We know our research will provide the most comprehensive knowledge to date about community re-entry for Māori in an area where there is a need for available and effective solutions.
“We want the solution generated to contribute to restoration of wellbeing for Māori and also for indigenous peoples globally.”