By the close of the 19th century, there was a strong possibility that the Maori race might not survive, and the government was advised by a Dr Featherston: 'Our plain duty is to smooth down their dying pillow. Then history will have nothing to reproach us with' (Newman, 1881). Muskets, infectious diseases, alcohol and starvation contributed to the reduction of the population from an estimated 200 OOO (pre-European contact) to 42 OOO (1906 census). Dr Featherston's prediction may well have come true, had it not been for the energies and adaptability of a relatively small group of youthful Maori leaders who launched a revival movement that in 50 years turned the 'dying race' into a highly virile one. Today the Maori population is in excess of 390000, and makes up 12 per cent of the total population. It is youthful, over 65 per cent being under the age of 25 (non-Maori 40 per cent), but only 3.9 per cent over age 60 (non-Maori 14.9 per cent). Maori fertility is at a higher level (2.6) than that of non-Maori (1.9), and Maori babies make up over 13 per cent of all births.
Despite these trends, there remains considerable concern about the state of Maori health, and data are rapidly accumulating to indicate highly significant mortality and morbidity differences. A Medical Research Council publication (Pomare, 1980) highlighted many of these anomalies, and drew attention to the relevance of lifestyle in the aetiology of a wide variety of contemporary health problems. Maori women appear particularly disadvantaged, with a rate of lung cancer three times higher than the non-Maori rate, ten times greater for cancer of the cervix, four times higher for coronary artery disease, and three times higher for diabetes. Maori children are eight times more likely to develop rheumatic fever, eight times more likely to die from accidents, and nine times more likely to suffer from ear infection and deafness. Maori deaths from asthma, obesity, cancer (except bowel), renal disease and diabetes are all well in excess of the non-Maori population. Mental hospital admission rates are three times as high for Maori patients in the 20-34 year age group, and the prevalence of broad mental health problems is indicated in other statistics. Offending by Maori juveniles is six times greater than for non-Maori, 60 per cent of all prisoners are Maori, and the 'street kid' phenomenon is a predominantly Maori development. In those urban New Zealand neighbourhoods which have special health needs ('pockets of misery') (Reinken et al., 1985), there are disproportionate numbers of Maori people, and in a recent survey of Maori women (Murchie, 1984) symptoms of poor mental health were the most frequently cited health problems. In 1983, 33 per cent of children aged 5-12 admitted to health camps were Maori, and the reasons for admission were largely attributed to mental health problems (Hancock, 1984).