Health (Article 12) Cancer prevention, screening and treatment 6. Wāhine Māori face inequitable rates of cancer. Outcomes from breast cancer are significantly worse for Wāhine Māori.6 Wāhine Māori are more likely to be diagnosed with advanced breast cancer, are less likely to be diagnosed through screening, and are less likely to receive timely and optimal cancer treatment.7 Wāhine Māori are also more than twice as likely as non-Māori women to be diagnosed with cervical cancer, and 2.5 times more likely to die from the disease.8 Wāhine Māori also have higher rates of lung cancer and mortality - four times that of non-Māori women.9 7. Pacific women are also over-represented in breast cancer, cervical cancer and lung cancer mortality rates.10 Recommendations: (a) Provide information on steps being taken to achieve equity for wāhine Māori in cancer prevention, screening and treatment. (b) Provide information on steps being taken to achieve equity for Pacific women in cancer prevention, screening and treatment. Access to mental health services 8. 6 7 8 9 10 11 12 13 The He Ara Oranga government inquiry into mental health and addiction highlighted the inaccessibility of mental health services, characterised by long delays, overworked staff, inadequate environments, a lack of clear information, and gatekeeping rules that served as barriers.11 The report found that people with severe mental health or addiction challenges had higher rates of many health conditions and shorter life expectancy, and the risk was greater for women and Māori.12 A recent report outlined the high unmet need for perinatal mental health support, including broader support for whānau.13 Breast Cancer Foundation “30,000 voices: Informing a better future for breast cancer in New Zealand” (4 February 2022) http://www.breastcancerfoundation.org.nz/downloads/assets/d23e/Breast%20Cancer%20Foundation%20National%20R egister%20Report%202022%20FINAL.pdf. See also Charis Brown et al, “Characteristics of and differences between Pasifika women and New Zealand European women diagnosed with breast cancer in New Zealand” (2017) 130(1467) New Zealand Medical Journal 50, where Wāhine Māori were 33% more likely to die of breast cancer within 10 years than women of European ancestry, and more likely to have higher-risk HER2+ breast cancer. Sandar Tinn et al, “Ethnic disparities in breast cancer survival in New Zealand: which factors contribute?” (2018) 58 BMC Cancer 1, at 2. Despite a national screening programme, Māori women are a third less likely to attend cervical cancer screening and more than twice as likely to be diagnosed with, and die from, cervical cancer than their peers of European ancestry. See The Lancet Oncology “Cervical cancer screening and New Zealand's uncomfortable truths” (1 May 2021) 22(5) The Lancet Oncology 571. Ministry of Health “Cancer” (2 August 2018) https://www.health.govt.nz/our-work/populations/maori-health/tataukahukura-maori-health-statistics/nga-mana-hauora-tutohu-health-status-indicators/cancer. Georgina S. McPherson et al, “Overcoming Barriers to Cervical Screening Among Pacific Women: A Narrative Review” (2019) 3(1) Health Equity 22; Radio New Zealand “Breast cancer outcomes worse for Māori, Pacific women, new study finds” (4 February 2022) https://www.rnz.co.nz/news/national/460861/breast-cancer-outcomes-worse-for-maori-pacificwomen-new-study-finds. See also Brown et al, “Characteristics of and differences” above n 6. Mental Health and Wellbeing Commission “Te Huringa: Change and Transformation: Mental Health Service and Addiction Service Monitoring Report 2022” (2022) https://www.mhwc.govt.nz/assets/Te-Huringa/FINAL-MHWC-Te-HuringaService-Monitoring-Report.pdf at 2.10.1. It also found mental health responses were inconsistent with Te Ao Māori and other world views, including Pacific world views. Government Inquiry into Mental Health and Addiction “He Ara Oranga” (November 2018) https://mentalhealth.inquiry.govt.nz/assets/Summary-reports/He-Ara-Oranga.pdf at 75. The report found that perinatal distress is widespread, complex and linked to systemic inequities and that making sure parents and whānau (family) have access to support is the best way to protect perinatal mental health and contribute directly to wider whānau wellbeing. See The Helen Clark Foundation | Āhurutia Te Rito “It takes a village” (22 April 2022) https://helenclark.foundation/publications-and-media/ahurutia-te-rito-it-takes-a-village/. 4