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Sites of institutional racism in public health policy making in New Zealand

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  • Came, Heather

Abstract

Although New Zealanders have historically prided ourselves on being a country where everyone has a ‘fair go’, the systemic and longstanding existence of health inequities between Māori and non-Māori suggests something isn't working. This paper informed by critical race theory, asks the reader to consider the counter narrative viewpoints of Māori health leaders; that suggest institutional racism has permeated public health policy making in New Zealand and is a contributor to health inequities alongside colonisation and uneven access to the determinants of health. Using a mixed methods approach and critical anti-racism scholarship this paper identifies five specific sites of institutional racism. These sites are: majoritarian decision making, the misuse of evidence, deficiencies in both cultural competencies and consultation processes and the impact of Crown filters. These findings suggest the failure of quality assurance systems, existing anti-racism initiatives and health sector leadership to detect and eliminate racism. The author calls for institutional racism to be urgently addressed within New Zealand and this paper serves as a reminder to policy makers operating within other colonial contexts to be vigilant for such racism.

Suggested Citation

  • Came, Heather, 2014. "Sites of institutional racism in public health policy making in New Zealand," Social Science & Medicine, Elsevier, vol. 106(C), pages 214-220.
    • Handle: RePEc:eee:socmed:v:106:y:2014:i:c:p:214-220
    DOI: 10.1016/j.socscimed.2014.01.055
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    References listed on IDEAS

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    1. Ford, C.L. & Airhihenbuwa, C.O., 2010. "Critical race theory, race equity, and public health: Toward antiracism praxis," American Journal of Public Health, American Public Health Association, vol. 100(S1), pages 30-35.
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    1. Prussing, Erica & Newbury, Elizabeth, 2016. "Neoliberalism and indigenous knowledge: Māori health research and the cultural politics of New Zealand's “National Science Challenges”," Social Science & Medicine, Elsevier, vol. 150(C), pages 57-66.
    2. Salway, Sarah & Mir, Ghazala & Turner, Daniel & Ellison, George T.H. & Carter, Lynne & Gerrish, Kate, 2016. "Obstacles to “race equality” in the English National Health Service: Insights from the healthcare commissioning arena," Social Science & Medicine, Elsevier, vol. 152(C), pages 102-110.
    3. Lee, Sandy & Collins, Francis L. & Simon-Kumar, Rachel, 2021. "Blurred in translation: The influence of subjectivities and positionalities on the translation of health equity and inclusion policy initiatives in Aotearoa New Zealand," Social Science & Medicine, Elsevier, vol. 288(C).
    4. Came, H. & Doole, C. & McKenna, B. & McCreanor, T., 2018. "Institutional racism in public health contracting: Findings of a nationwide survey from New Zealand," Social Science & Medicine, Elsevier, vol. 199(C), pages 132-139.
    5. Anna Matheson, 2020. "Health Inequality as a Large-Scale Outcome of Complex Social Systems: Lessons for Action on the Sustainable Development Goals," IJERPH, MDPI, vol. 17(8), pages 1-11, April.
    6. Chin, Marshall H. & King, Paula T. & Jones, Rhys G. & Jones, Bryn & Ameratunga, Shanthi N. & Muramatsu, Naoko & Derrett, Sarah, 2018. "Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States," Health Policy, Elsevier, vol. 122(8), pages 837-853.
    7. Came, Heather & Griffith, Derek, 2018. "Tackling racism as a “wicked” public health problem: Enabling allies in anti-racism praxis," Social Science & Medicine, Elsevier, vol. 199(C), pages 181-188.
    8. Danielle Emma Johnson & Karen Fisher & Meg Parsons, 2022. "Diversifying Indigenous Vulnerability and Adaptation: An Intersectional Reading of Māori Women’s Experiences of Health, Wellbeing, and Climate Change," Sustainability, MDPI, vol. 14(9), pages 1-40, May.
    9. Kuili Zhang & Bing Ran, 2022. "Active Health Governance—A Conceptual Framework Based on a Narrative Literature Review," IJERPH, MDPI, vol. 19(4), pages 1-14, February.
    10. Nellums, Laura B. & Powis, Jaynaide & Jones, Lucy & Miller, Anna & Rustage, Kieran & Russell, Neal & Friedland, Jon S. & Hargreaves, Sally, 2021. "“It's a life you're playing with”: A qualitative study on experiences of NHS maternity services among undocumented migrant women in England," Social Science & Medicine, Elsevier, vol. 270(C).
    11. Cécile Rousseau & Youssef Oulhote & Mónica Ruiz-Casares & Janet Cleveland & Christina Greenaway, 2017. "Encouraging understanding or increasing prejudices: A cross-sectional survey of institutional influence on health personnel attitudes about refugee claimants' access to health care," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-14, February.

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