Research funded by the Waikato/Bay of Plenty Cancer Society will identify the drivers behind health inequities for Māori with multiple myeloma, a type of blood cancer affecting up to 2,500 New Zealanders.
The research will be carried out by Dr Myra Ruka (Raukawa, Ngāpuhi), who has just completed her advanced training in haematology at Waikato Hospital. Dr Ruka says the 12-month research project is an ideal opportunity to look into something she’s passionate about and will contribute to her doctorate degree.
“There’s a body of research looking at drivers of inequity for Māori patients with solid tumours, but no research yet for cancers in the blood or lymphatic system. It is critical that we describe the cancer care pathway for Māori patients in our region and identify the pressure points along that pathway where inequity arises.”
Statistics show the incidence of multiple myeloma in Māori is twice that of non-Māori, and survival outcomes are also worse.
“The only national data that has been published on multiple myeloma is derived from the New Zealand Cancer Registry and mortality data, which is informative, but is limited as it does not provide clinical information to assess why these inequities persist.”
Dr Ruka will compare clinical data on Māori and non-Māori patients with myeloma in the Midlands region from the last 13 years. Specifically, the research will look at patient characteristics at diagnosis, disease characteristics, the type of treatments used and response to treatment. Social and demographic data and patient access and interactions with the health system will round out the data.
“Drivers of inequity for Māori with cancer in Aotearoa, New Zealand are multifactorial and include patient factors, environmental factors and health system factors.”
Identifying these factors is the first step to developing improved cancer services that deliver equitable outcomes.
“Research in this area is something I’m passionate about for lots of reasons. I grew up in Waikato. My marae is based in Putaruru. My grandparents lived on the marae and I spent a lot of time there.
“Growing up in rural Waikato, I saw the impact of social deprivation on health and wellbeing.”
More recently while attending clinics across the Midland region, Dr Ruka observed concerning trends when it comes to accessing primary and tertiary care services, severity of disease at presentation and access to supportive care services throughout the cancer journey.
“Access has a lot of prongs. There are financial barriers; barriers due to location; a deficit in culturally safe clinical environment that they can present to. There’s lots of really good work happening currently, but there is room for improvement.”
Dr Ruka aims to develop the research further for her PhD through the University of Auckland and she’s hopeful it will have practical applications, such as helping to inform the redesign of the cancer care model in Midlands and national standards of service provision for multiple myeloma patients.
“For me there’s no point in doing research if the findings aren’t going to help affect positive change. Seeing meaningful change makes it easier to work hard and get the mahi done.”