SMA is a genetic, neuromuscular disease caused by progressive degeneration of nerve cells in the spinal cord that
leads to muscular weakness and atrophy and increased risk for
early death due to respiratory failure.
``... these cuts will disenfranchise a segment of the population and
lead to increased non-compliance with their doctor's requests for pathology testing
due to the requirement of a co-payment... including: delaying the effective
early diagnosis of cancer
leading to premature
deaths; compromising the effective treatment of diabetes and chronic diseases; and threatening the services of rural pathology» (Dr Michael Harrison RCPA).
In New Zealand, recent strengthening of the Māori health workforce has
led to a number of successes: interventions
led by, focused on, and targeted
to Māori; consistent investment in Māori health over a prolonged period; and an emphasis on the development of dual cultural and clinical competencies.14 In the United States, successful Native American health service development in the
early 1990s appears
to have been shaped by federal government administration, the separation of the Indian Health Service from other Native American affairs, and provision of an integrated health service.15 In both countries, recent reductions in overall
death rates for indigenous people have been noted; in the US this relates
to injury prevention, whereas in NZ it relates
to fewer
deaths due to circulatory conditions.16 Although it is not known whether improved health services for indigenous peoples in the US and NZ have a causal relationship with decreased mortality, the two appear
to «travel together» well.