The Multidimensional Impacts of Inequities for Tāngata Whaikaha Māori (Indigenous Māori with Lived Experience of Disability) in Aotearoa, New Zealand

Abstract

People with lived experience of disability have poorer health and socioeconomic outcomes than people without it. However, within this population, certain social groups are more likely to experience poorer outcomes due to the impacts of multiple intersecting forms of oppression including colonisation, coloniality and racism. This paper describes the multidimensional impacts of inequities for Indigenous tāngata whaikaha Māori (Māori with lived experience of disability). Semi-structured in-depth interviews were conducted with 28 tāngata whaikaha Māori and their whānau (extended family) using a kaupapa Māori Research methodology. An equity framework was used to analyse the data. The results describe: (1) inequitable access to the determinants of health and well-being; (2) inequitable access to and through health and disability care; (3) differential quality of health and disability care received; and (4) Indigenous Māori-driven solutions. These data confirm that tāngata whaikaha Māori in the nation-state known as New Zealand experience racism, ableism and disablism, compounded by the intersection between these types of discrimination. Recommendations from the data support the inclusion of tāngata whaikaha Māori in decision-making structures, including all policies and practices, along with equal partnership rights when it comes to designing health and disability systems and services.

Measuring Māori Health, Wellbeing, and Disability in Aotearoa Using a Web-Based Survey Methodology

“…This is the first large-scale, independent, representative survey of Māori, designed specifically to understand the prevalence and impact of disability in NZ; an area that is widely recognised as underprioritized [ 5 ]. We have presented the methodology and design of a survey that resulted in over 7200 participants of Māori descent.…”

“…Further details on the data gathering and analysis can be found in the previously published papers referenced below. In summary, these results emphasise how Western-centric constructs of ‘disability’ fail to align with te ao Māori perspectives of disability, resulting in multidimensional impacts for tāngata whaikaha Māori [ 5 ]. The interpretations were inclusive of the notion of “karanga rua, karanga maha” (two identities, or multiple identities) as a potential framework to understand how tāngata whaikaha Māori conceptualise and express a plurality of identities within Māori collectives [ 18 ].…”

“…Māori, as the Indigenous people of Aotearoa New Zealand (NZ), claim a unique partnership relationship legislated under Te Tiriti o Waitangi (the Māori version of the Treaty of Waitangi) as tāngata whenua (people of the land)—see Appendix A ( Table A1 ). Māori continue to suffer inequitable health outcomes due to colonial Western models of government, and there is growing evidence towards an association between disability, multidimensional poverty, and inequities [ 5 ].…”

“…There is a need to better understand the performance and sociocultural contextualisation of the disability items in the current census to more accurately inform future national data collection methods. Our broader research project aimed to extend an understanding of Māori cultural perspectives of disability identity by ensuring that national survey questions accurately quantify the prevalence of disability among Māori and to use these prevalence estimates to quantify the impacts of disability [ 5 ].…”

Working Together to Support Self-Determination for Tāngata Kāpō (Blind and Low Vision) Māori: An Exemplar

“…Sadly, the rights of kāpō (blind, deafblind, low vision, vision impaired) to self-determination, partnership, and full participation are not always upheld within vision-related research. For example, researchers working with datasets that include Māori patients have not consistently connected their work with Māori knowledge or perspectives [ 3 , 4 ]. Within a disability context, Māori identities are poorly understood [ 5 ], and biomedical deficit-oriented models dominate research approaches [ 6 ].…”