The role of communication in addressing Māori health disparities: An appeal for voice
The Māori Affairs Select Committee on Māori health inequalities point to the entrenched disparities in health outcomes for Māori compared to Pākehā, highlighting the importance of examining and understanding the sources of these inequalities.
The sources of inequalities in outcomes in health and wellbeing is also the subject of the hearings of the Waitangi Tribunal, drawing on presentations that point to systemic structural racism that impact the experiences of Māori in the health system.
These inequalities in experiences of and with health and care are communicative, tied to the nature of interactions in health settings and in the various ways in which racism shapes these interactions.
In our research with the culture-centred approach to health and communication, we attend to the question of voice in the realm of unequal health outcomes. We suggest that the erasure of Māori voices in health interactions and in how the health system is constructed is integral to the perpetuation of inequalities.
Our approach therefore invites voices of those at the margins of society, voices that have been historically erased, as anchors for addressing the entrenched health inequalities.
We are honoured to be hosting Tāme Iti of Ngāi Tūhoe as our next activist-in-residence, and we will work with him in understanding this question of voice. His intervention from the Māori proverb “kanohi ki te kanohi” [dealing with it face-to-face] is a powerful solution to the marginalisation of Māori in health systems. Making the spaces for Māori voices to be heard in health systems and in spaces where knowledge is produced is a critical starting point for addressing inequalities in health and wellbeing outcomes.
When such voices from the margins of New Zealand society speak, they are meant to disrupt the unequal structures. The very act of speaking is meant to disrupt because it is only through disruption of powerful structures that erase voice can opportunities for solving inequalities be created.
Because for those in entrenched positions of power, voice is threatening, an invitation to voice is a direct challenge to the organising categories of power.
That within Universities and within mainstream structures of society a certain cross-section feels threatened with the voice of Tāme Iti speaking is a reflection of the communicative inequalities that constitute colonial structures. Under the guise of civility and appropriate conduct, voices that challenge the status quo and its inherently racist logics are strategically and systematically silenced. So for many of the free speech advocates within colonial structures, the right of an indigenous voice to speak can be sacrificed under the pretext of appropriate speech.
It is however in this very space of voice that interventions need to be made if inequalities in outcomes of health and wellbeing are to be addressed.
Professor Mohan Dutta
Director of Centre for Culture-Centred Approach to Research and Evaluation (CARE)
Dean’s Chair of Communication, School of Communication, Journalism and Marketing
Dr Steve Elers
School of Communication, Journalism and Marketing