Dr Corina Grey has been the Director of Public Health since May this year. In this kōrero with Dale, she talks about her commitment to addressing the wider causes of health inequalities and why health policy should be driven by evidence and data.

 

Corina, I always start with references to our old people. Out of respect to them, might you be kind enough to mention your villages and your people?

I was born and raised in a place called Alafua, which is in Apia. It’s also where my mum, Toreka (nee Filiki), grew up. My dad, Vance Grey, is Pālagi. His family moved from Australia to New Zealand before he was born.

When I was born, the only grandparent I had who was still alive was my maternal grandmother, whose name was Sina. When we moved away from Sāmoa, she stayed, so we only saw her when she came to visit us in New Zealand. But she had a huge influence on me. As a Pacific person, it’s your ancestors that shape who you are, and your life.

How many in your family, Corina?

There are five siblings. Two older sisters, Sunite and Sina, an older brother Sa’aga, and a younger sister, Diedre.

So your dad’s an Aussie guy. Did he meet your mum in Sāmoa or did they meet here?

He was working for the Sāmoan government, teaching accounting at night school in Sāmoa. My mum was studying accounting, and they fell in love, and that’s how I came to be born in Sāmoa. And then, because my brother had needs that weren’t able to be met in Sāmoa, we moved to New Zealand.

What happened to your bro, Corina?

He had a completely normal birth, but then, around the age of nine months, he had an adverse reaction to a medical procedure. He was really unwell, had seizures, and must have suffered some kind of stroke because for the rest of his life he was paralysed on one side of his body and had chronic epilepsy.

Despite the harm from the medical procedure, I’m completely on board with medical science and the benefits for so many people. As a doctor, I encourage people to take full advantage of the benefits modern medicine offers.

So, you moved to Auckland. Don’t tell me it was Māngere?

It was Glen Innes!

Which schools did you go to?

I went to GI primary for a couple of years, and then to Kohimarama primary school when I was in standard 1.

It was a bit of a culture shock. This is in the 1980s, and they didn’t see many non-Pākehā children at that school, and I don’t think they could get their heads around a child who had a brown mum and a white dad. My parents were always like: “Just work hard, put your head down, do your schoolwork.” So that’s what I did.

Did you make some friends there, even so?

I did, actually. It was really the few brown kids that were there that I was closest to. They came from GI, too.

Yeah, it’s just over the hill, isn’t it? And now all the people from that side are going to GI because that’s where the Pak’n’Save is.

Exactly, but GI is becoming very gentrified, I’ve noticed.

Some people say that children from mixed relationships get the best of both worlds. Others say you get shortchanged on both sides. How does it sit with you to have parents from different ethnicities?

It wasn’t that common back when I was growing up, but it’s so awesome to see how diverse our young people are now. According to the census, more than half of Pacific children under the age of 15 identify with more than one ethnicity. So we’re becoming increasingly diverse.

You know, it’s funny when people say: “Oh, you’re half this and you’re half that.” No. I’m not half, I’m both, and you do get the best of both worlds. Growing up, you don’t go: “Oh, this is my Sāmoan side, and this is my European side.” It’s very much that this is my family’s culture, and this is what we do.

Apparently, half the Tongan marriages in New Zealand are to Māori, so it’s an ongoing thing. Yet for a long time, we differentiated ourselves, saying: “Oh, those are the PIs and we’re the Māori.” But hopefully it’s changing now, accepting that we are all Pasifika peoples.

I have a good friend who constantly reminds me that the relationship between Māori and Pacific peoples is ancient and predates Te Tiriti o Waitangi. We’ve got a very ancient relationship as tangata o le Moana, but, obviously, we pay deference to tangata whenua as the Indigenous peoples of Aotearoa.

And we’re really grateful, for instance, that the advancements in Māori health have helped Pacific peoples. Really grateful to Māori for always bringing Pacific along with them.

You went off to varsity, and it can be a daunting place for Māori and Pasifika at times. I wonder how you felt on the first day?

Yeah, it was daunting, but I was incredibly lucky to be part of MAPAS, the Māori and Pacific Admission Scheme, at medical school. We were lucky to have people like professors Colin Mantell, David Tipene-Leach, Sir Collin Tukuitonga, and Sue Crengle as our mentors.

There’s some resentment, though, from people who say that Māori and Pasifika students get a smoother run into med school. What would you say to those who hold that view?

When I went to university, way back when it was still the era of bursary, I think the cut-off mark for anyone to get into med school was 386 out of 500 — and I got 441, so it wasn’t like we got worse marks. MAPAS is about supporting Māori and Pacific students through what can be a daunting experience. Being able to see these amazing Māori and Pacific doctors and professors — the people I mentioned before, but also doctors like Debbie Ryan, Api Talemaitoga, Teuila Percival, Faumuina Fa’afetai Sopoaga — was inspiring and really helped us through med school.

How important is this culturally focused pastoral care to help the students get across the line?

Varsity can be a tough time, and you spend a long time in medical school. It’s really important to have that support.

And in my own work, I always try and think about how I can support more junior staff, because of all the opportunities that were given to me by so many different people throughout my life. I always think about how I can help the younger generation coming through.

You mentioned some wonderful names there, Corina. And I know that this idea of paying it forward is something that helps to guide you.

Did you have to do any horrid jobs to get yourself through varsity, or did you rack up a huge student debt and pay it off when you got working?

I was pretty lucky. My dad worked at the Auckland Council, and sometimes when the receptionist was away, I got to fill in for her. But mostly it was my parents who supported me. I lived with my parents in Tāmaki Makaurau throughout varsity, so I’m incredibly grateful to them for supporting me through university and beyond.

Did you go to church? Can you sing?

I had to go to church, but I am absolutely tone deaf. My mum’s a beautiful singer. My daughter’s a beautiful singer. But that skill completely skipped a generation.

Did your dad get used to Sāmoan kai? And was that a feature in your reality?

Oh yeah, my dad loved Sāmoan culture. Unfortunately, he got dementia and passed away last year.

Oh, we know so many people who are getting mate wareware. It’s a challenging journey for whānau, and it’s something to be very mindful of as we live longer lives. How did that challenge sit with you, and what tools might it have provided for you to awhi others going forward?

It’s a growing issue, and one of my good friends, Etuini Ma’u, is a psychogeriatrician who’s done a lot of research on dementia. He says that one of the biggest risk factors for dementia is hearing loss. So if people do lose their hearing, it’s really important that they’re able to access hearing aids, because there’s something about the hearing loss that leads to dementia.

I would describe it as death by a thousand cuts — you’re slowly losing the person that you know and love. But my mum was incredible. She looked after my dad for so long. He went into care in the last few years of his life, but she was always at the dementia care unit, and a lot of the staff there were Tongan, Sāmoan, Niuean. I’m just so grateful to them for all the love that they gave my dad. It was just like another family that we had towards the end of his life.

I see you’re interested in psychiatry. How valuable is that in the role that you’re undertaking now?

Firstly, hats off to everybody who works in mental health in Aotearoa. It’s an incredibly challenging and complex space, and they do a fantastic job.

When I was doing psychiatry, I would see people experiencing mental distress, and it would be obvious that there were things that exacerbated this distress, such as poverty and trauma. And I felt powerless, not being able to fix those underlying issues. What drew me into public health was the ability to address the wider determinants that contribute to mental distress and physical unwellness.

What would you say about the need to factor in these determinants — housing, employment, access to healthcare, income, and other trauma — in the work that you’re doing now? It’s a groundbreaking opportunity for you, isn’t it?

You can’t separate the conditions in which people live from their health. They’re completely interwoven, and I absolutely feel a deep sense of responsibility and commitment to addressing those wider determinants. What we know about health inequalities is that they’re not inevitable. It’s something that we can address.

I’ll give you some examples.

We know that Pacific and Māori people have much lower rates of home ownership than other ethnic groups, and there are lots of different reasons behind that. But if you don’t own your own home, the evidence is that your tenancy is more precarious. You could be asked to leave at any time.

And we know that rental accommodation tends to be of lower quality than homes that are owned. So when you look at the census data around damp and mould, that tends to be much higher in rental accommodation, and therefore, Māori and Pacific people are more likely to be exposed to housing conditions that can cause ill health. We know that if you live in a damp, mouldy house, you’re more likely to experience respiratory and infectious illnesses.

So if we, as a society, can address home ownership and housing conditions, then we can go a long way towards improving people’s health outcomes. I know there’s lots of work going on with iwi around papakāinga and other housing initiatives. You wouldn’t say they’re health providers, but actually, they are, because they’re addressing housing conditions.

We had Te Aka Whai Ora (the Māori Health Authority) as a vehicle to try and do something about our Māori health ourselves, but that was cut off at the knees, as you’re well aware, and I just wonder whether this current one-size-fits-all model is the right way to go.

What I would say is that in anything that we do in health, we’re guided by evidence and we’re guided by data. I think there is evidence that targeted approaches can and do work, so it’s really important that across the system, we get the data first, locate the issues and where the need is the greatest, and then decide what programmes and what services can best address those needs.

The data suggests a gross inequity in health outcomes and life expectancy. I’m sensing that you know the data is there to support targeted interventions, but the willingness, politically, perhaps is not.

Another thing I wanted to touch on is immunisation. How might we overcome some of the distrust of the system that our people, Māori and Pasifika, have? They’ve looked at the colonial process, they’ve looked at the political imbalance, and all the social determinants we’ve touched on, and then somebody says, “Oh, listen, put this into yourself or into your pēpi.” There is a pocket of people who distrust these things. How might we overcome that distrust?

Immunisation is so important, and right now, we’re experiencing an increase in measles cases across the country. Around the world, there’s been a drop in immunisation rates, which is really heartbreaking, because we know the measles vaccine in New Zealand — the MMR vaccine for measles, mumps, and rubella — is incredibly effective in preventing measles. If you get two doses of your MMR vaccine, it’s 99 percent effective.

Measles is incredibly infectious. One person with measles can infect up to 18 other people who aren’t immune to measles. So vaccination is our best strategy to prevent illness. And people can get really sick from measles. In the 2019 outbreak that New Zealand experienced, one in three people who got measles, many of whom were young babies, were hospitalised. It’s a thing that’s really close to my heart, because during that 2019 measles outbreak, New Zealand inadvertently exported measles to Sāmoa, and 83 people died.

How do we address vaccination uptake? I think we address it by approaching everything with empathy. People are at different stages of their lives, and a lot of the time, it’s just about needing to have a few conversations to be comfortable and to be ready to be immunised.

Some people will be immunised straight away, and that’s fantastic. But some people do require trusting relationships and more discussions, and I know there’s a lot of work being done to make sure that people have access to those conversations. I would encourage everyone to consider getting immunised. We know that vaccination is safe and effective in preventing illness and protecting our loved ones, our communities, and particularly our pepe.

What are you most proud of in your life?

That’s an easy question for me. I’m most proud of my three kids — Sina (16), Lucius (15), and Ryker (13). I think they’re the most incredible, funny, smart people I know. But I’m also incredibly proud of all the people I work with.

What else do you do outside of work? I’m thinking of you sitting in an office considering heavyweight kaupapa. I’m pleased that you mentioned that your kids are delightful and funny and talented. What do you do to keep yourself on a level keel so you can go out and work well?

I love spending time with my husband, Chris, my kids, my mum, my sister, my friends. I also run, but very, very slowly. People probably think I’m walking when I’m running. And I love watching documentaries on Netflix.

I can recommend Kaikohe Demolition. It was made in 2004, and it’s about the demolition derby in Kaikohe. I watched it last night with my sweetheart. You’ll love it, Corina. It’s a hoot.

Oh, okay! I’m putting it on my list right now.

(This interview has been edited for length and clarity.)

E-Tangata, 2025