Manifestations of institutional racism and privilege in public health policy making & funding practices in Aotearoa
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Inequitable health outcomes have plagued the New Zealand health system since the establishment of the Department of Health in 1900. Considerable energy has been invested in describing and quantifying these inequities over decades – we are now painfully clear that Māori have higher rates of a range of diseases and have lower life expectancy than non-Maori. Explanations of these inequities have included a) the failure of Māori, b) the failure of individual health professionals and c) generic claims of the failure of the health system to be responsive to Māori. This presentation based on my activist scholarship orientated doctoral research attempts to add detail to the claims the health system is failing Māori. Specifically it will outline my research findings which exposed how Crown agencies consistently produce mono-cultural health policy and then systemically privilege generic health providers in their administration of public health funding. This study was guided by a research whānau and utilised a mixed methods approach including collaborative story-telling with Māori leaders, a survey of public health providers and both an historical and funding analysis. The exposure of institutional racism within this research echoes the findings of Puao te ata tu and other landmark reports from the 1980s… and therefore raises questions of how we can achieve sustainable change within the administration of the public sector.