Foundations of Hauora and Relational Learning

How does Te Whare Tapa Wha frame health?

Collective, relational, and interconnected

What is Taha Wairua?

Spiritual Health- an experience beyond the mind and body- felt rather than spoken about

What is Taha Tinana?

Physical Health- Body that is fit for purpose- doesn’t mean being a ‘super athlete’ it depends on who it is and to have a body capable of doing what you want it to do

What is Taha Hinengaro?

Mental and emotional health- about having a clear mind that can think and respond in an appropriate way- clarity of thought

What is Taha Whanau?

Social health- being able to establish relationships with other people that are helpful and permanent- and doesn’t have to be blood related

What is Taha Whenua?

A Connection to the land- if the land isn’t right it affects whanau and hinengaro

How does Te Whare Tapa Wha view a biomedical problem? (e.g. fatigue and low iron)

It adds the holistic view to the context of someone’s health, it gives the deeper picture. Giving a broader understanding of what impacts health

What is Te Wheke?

It is a Maori health model which depicts an octopus in which the eyes are Wairoa (total well-being) and each tentacle is a dimension of health which works interdependently.

What is emphasised in the Te Wheke health model?

It centres ancestral connection and collective identity and sees wellbeing as a dynamic, living system.

Why did Maori health models emerge?

They emerged because colonisation disrupted Maori systems of knowledge, wellbeing, and social connection. Western biomedical frameworks didn’t meet Maori needs as they focused on symptoms not the whole context of peoples lives

Are Maori models of health optional in Aotearoa?

NO, they are a treaty obligation that supports equitable health practice and population wellbeing

What articles of Te Tiriti o Waitangi support Maori health models?

Articles 2 and 3

How does article 2 of the treaty relate to Maori health models?

Article 2 is Tino rangatira tanga which protects taonga, including Maori knowledge and hauora frameworks

How does article 3 of the treaty support Maori health models?

Article 3 is Equity which requires active protection of Maori wellbeing

Do we define privilege as structural or personal?

Structural

Can privilege and hardship co-exist?

yes

What does the life expectancy gap between Maori and non-Maori show?

The gap in available health services and systems in place

What does deprivation data show us?

That we purposely create areas of affluence and deprivation

How does privilege shape health outcomes?

Access to services, quality of care, exposure to determinants of health

How does privilege shape health outcomes in terms of Maori?

Even when Maori practices are put in place, they still hit the same systemic barriers because the system was not built for Maori

What is the main cause of health privilege and inequity in Aotearoa

It is tied to colonisation. Consequences of health outcomes have to do with colonisation

What are the four levels of privilege?

Societal, institutionalised, interpersonal, and internalised

What is societal privilege?

Living in well resourced areas where the health system works as intended

What is institutionalised privilege?

Policies, systems, processes embedded in advantage e.g.) court outcomes, financial systems, school achievement patterns

What is interpersonal privilege?

Assumptions of whose behaviour is “right”

What is Internalised privilege?

A sense of belonging, ease, or assumption that one’s culture is the default

What is Positionality?

Your social location

What is important about recognising your own positionality?

That our perspectives lie in our positionally and that our story shapes how we interpret other’s

Why does positionality matter in health?

It is central to understanding cultural safety, equity, and honouring Te Tiriti

What is intersectionality?

It helps us understand how systems of oppression overlap

What is the purpose of WAI2575?

To show that Maori health inequities don’t come from individuals, they come from systems

What does WAI2575 investigate?

Wether the crown has met its Te Trite obligations and has two main parts: Stage 1) PHOs and Stage 2) Broader health system impacts

What has WAI2575 found?

There are Te Tiriti breaches in regards to the crown failing to uphold Tino Rangatiratanga- absolute sovereignty

How does the Crown fail to uphold Tino Ranatiratanga in regards to Maori Health?

The underfunding and marginalisation of Maori health providers, maintaining structures which disadvantage Maori, and inadequate responses to decades of evidence

How is the system not built for Maori?

The system funds models which do not benefit Maori and have policies written for Maori but not by Maori. This is mainly because of lack of Maori governance. We use systems imbedded with racist ideology

How has colonisation impacted Maori health inequities?

With the land loss and disruption of iwi/hapu, there wan an economic marginalisation and western health systems were imposed- this systemic marginalisation is still seen today

What does the Whitehead and Dahlgren Model help us see?

Layers around individuals and what we can change

How does the Whitehead and Dahlgren Model help us realise why we need Maori health models?

Because it doesn’t include things like discrimination and colonisation as these things add what shapes health inequities in New Zealand

What does the Indigenous Model: Curtis et al (2023) offer?

An indigenous framework which makes power visible

What does the Indigenous Model: Curtis et al (2023) include?

Whakapapa, Cultural Identity, and collective wellbeing

What is Whakapapa, Cultural Identity, and collective wellbeing?

protective factors

What does the indigenous model show?

How racism and colonisation shape health and wellbeing

What does the indigenous model make visible?

How health inequities aren’t individual but structural

What are the 3 levels of Racism?

Institutional, Interpersonal, and Internalised

Institutional Racism

Differential access to the goods, services, and opportunities of society by ethnicity

Personally Mediated/ Interpersonal Racism

prejudice and discrimination, where prejudice means differential assumptions about the abilities, motives, and intentions of others according to their ethnicity, and discrimination means differential action toward others according to their ethnicity

Internalised Racism

Acceptance my members of the stigmatised ethnic group of negative messages about their own abilities and intrinsic work

Structural Racism Explained

The structural barriers that are really hidden, but become overt when you’re accessing services