The population structure of our people is quite phenomenal in that it resembles the Eiffel Tower. At the base we have an enormous length representing the under-five age group, and then in each ascending age-group we have the structure pulling back at quite a quick recession so that the whole appearance of the Maori population is rather like a truncated triangle with its sides moving less sharply as the age groups drop step by step from much smaller percentage death-rates. Because there is a much smaller proportion of Maoris in the higher age groups where death must inevitably occur, the crude death-rate of the Maori is much the same as the European. In this way, figures tend to conceal the true position. If, however, we compare deaths with specific ages per hundred-thousand, we find a totally different story. We must remember that 50% of Maoris having half or more Maori blood are under the age of fifteen years. This is an incredible proportion and raises all sorts of problems of overcrowding and lack of housing. And if we take this group and compare the death-rate of the pre-school child with that of the European, we find that three times the number of Maori children die in this period, as compared with the European child. In the group five to fourteen years there is a lower death-rate, but again it is four times greater in the Maori as compared with the non-Maori group. In the group fifteen to twenty-five years, the death-rate among men is twice as heavy among Maoris, but four times as heavy among the women of the race, because it is here in this age-group that T.B. takes its heaviest toll of Maori women. In the age group 24–44 years, the Maori death-rate is again three times that of the European. In the 45 plus age group, the disparity in the death rates declines, but it is still higher among Maoris. The reason for the death rate coming closer in proximity to the European in this age-group, is that we feel only the stronger Maori reaches this age group in the first place.

CAUSES (1) Poor housing and overcrowding. These features are ones that must move hand in hand with the large birth-rate of the Maori, which in 1958 was 46.25 per thousand of mean population. When you have such a large proportion of the people still dependent and unable to help in the economy of the race, then I cannot see that one can have anything but sub-standard housing. At the conference held in Auckland last year, it was stated that 50% of Maori housing was sub-standard, perhaps not in actual fact of the type of housing, but in the number of people each house was expected to cater for. In the Statistical Report on the Maori-European Standard of Health, it was suggested that the communal way of life of the Maori might be responsible for the poor standards of health. I thought by this it meant that cross-infection occurred in sleeping in over-crowded houses and in meeting-houses. I feel however, that to say it is the communal life of the Maori is rather inaccurate. There is, after all, a lack of houses for the people and if one house holds fourteen or fifteen people because relatives are staying there with the family unit, it only means that if these relatives were not staying there, they would have to stay in another house. And overall, I think that if we were to spread the Maoris among the houses they have to occupy there would inevitably be overcrowding. I think it would be found that if one crowd of relatives went to stay with another crowd, it would not leave an empty house behind, but rather that their place would simply be filled by a group of relatives from another part of the country. Poor housing and overcrowding account for such infections as rheumatic fever, meningitis, pneumonia and enteritis. Quite a number of diseases from which the Maori suffers and for which there seems no real explanation could well be the aftermath of damage caused in the younger age groups. I feel that when a mother has too much work with too many children there are two reactions she might have. She might get worried about the whole business but this is not the usual Maori mode of behaviour when confronted with trouble; her other method of dealing with the situation would be simply to give up. She would find it too much of an effort to cook proper meals for her children, too much of an effort to clothe her children properly, and too much of an effort to look after her children with the simple methods of hygiene which she knows should be instituted. And so it is that these mothers neglect to blow their childrens' noses which is a simple measure that can avoid much of the ear and chest troubles that we have today. We have been told by the North Island people at the Auckland Conference, that tablets given by doctors have to be controlled from the school. Either the children have to be instructed that they must take their tablets when they get home, or the tablets have to be given from school. This is simply because these women have so many children they are unable to exert themselves to look after them. I think that if we want to attain the standards that are available to Europeans today, whether the mother is European or Maori, families should be limited to only four children. I find that very capable women can manage six children, but only a few can manage more. The rate of T.B. and rheumatic fever among the Maori is ten times the rate of the European. These two diseases however, are thought to increase where there is over-crowding and poor housing. All over the world—in Japan, and among the American negroes—the level of these diseases tends to decrease where there is an improvement in the level of sanitation and standards of living conditions.