Personal care treatments

Māori and Pasifika Miss Heart Treatments Due to Inadequate Diagnoses

In the past, medical best practice encouraged doctors to divide the various measurements of a person by their body surface area.

“When you’re going to have an ultrasound of your heart, the stenographer doing it will take a lot of measurements and of course if someone’s 5 feet tall their heart will be smaller than someone who’s 6 feet tall because that your heart is obviously proportional to the rest of your body and how much blood it needs,” Whalley said.

Professor Whalley said taking measurements using current diagnostics assumes the person’s underlying body composition is fat rather than muscle.

However, plenty of evidence has shown that Maori tend to have greater muscle mass than non-Maori.

“A lot of evidence, over 20 years of evidence has shown us that if you take two people of the same height and weight, one who is Maori and one who is not Maori, the Maori patient will have much more muscle mass in his body than the No. – Maori patient,” she said.

The correlation between muscle mass and heart size suggested Maori possessed larger hearts than non-Maori, but the medical profession had not factored this into their calculations, Whalley said.

It was unclear whether this meant that Maori and Pasifika patients diagnosed using this formula had been given under-prescribed drugs to help with their condition, but it was possible, she said.

“A lot of times people talk about Maori patients and Pacific patients showing up late for surgery and other treatment and I think that’s an example of the health system failing to meet their needs. “

Maori women were most affected by the implicit bias of existing heart size calculations, mainly due to body composition.

Whalley said that’s not surprising because much medical research has focused on white American men, a demographic that was a wealthy target audience for medical companies.

Professor Whalley said the ineffective cardiac treatment diagnoses were another reminder that the health system was stacking the odds in its favor against Maori and Pasifika.

“It’s my profession so I was as bad as anyone for many years before I started thinking about it, about 15-20 years ago I followed international guidelines. It seemed like the best practice.

“And individually, none of us are racist…we all care about our patients…but systemically it’s racist. Once you understand that and once you see it, there’s no no going back if it makes sense, you can’t ignore more once you realize this really is blatant systemic racism.”

A stronger approach was needed to recognize the higher risks and biases in cardiology practices, she said.

She urged the Cardiac Society of Australia and New Zealand to come together to develop a set of guidelines to recognize a higher risk of heart disease in certain demographic groups and do all they can to mitigate any inequities.

Whalley said it’s likely there are other medical practices that discriminate against minority populations that have yet to be discovered.